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Industries · medical & dental practices

Practice bookkeeping that lives in the gap between billed and collected.

Insurance AR aged, contractual adjustments booked honestly, collections reconciled against production, and your practice-management software tied to the bank. Bookkeeping built for the way a medical or dental practice actually earns — and waits to collect.

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Production vs collection · insurance & patient AR · PMS reconciled. Fixed-fee, CPA-ready. We're not a CPA firm.

Collections vs production PMS reconciled to bank 40 years on the books
PRODUCTION → COLLECTION Billed production − adjustment − still in AR Collected Insurance ARaged, reconciled to PMS Patient ARseparate, tracked, chased

In brief

Medical & dental bookkeeping, in plain terms.

What's different about it?

Billed production isn't revenue. The books have to live in the gap between what you produce, what you adjust away for insurers, and what you actually collect — or income looks inflated and the real collection rate hides.

What about the PMS?

Your practice-management software records production and collection, but it isn't your books. We reconcile it to the bank so deposits, merchant fees, and patient financing all tie out.

Who's it for?

Dental, medical, and specialty practices across Texas — solo or multi-provider — that need their books to reflect real collections, not a full fee schedule.

What does it cost?

A fixed monthly fee, set in writing after a free review — never hourly. See the pricing page for published ranges.

The reality of practice books

Why a profitable-looking practice can still be starved for cash.

A practice can have a strong production month and a weak bank balance, because production and cash are two different things separated by insurers, adjustments, and time. The whole job of practice bookkeeping is to make that separation visible: what you produced, what you agreed to write off, what's still sitting in receivables, and what actually arrived.

Get it wrong and the damage is quiet. Contractual adjustments booked as revenue inflate income; insurance AR that nobody ages hides a collection problem until it's a crisis; a practice-management system that's never reconciled to the bank lets fees and financing payouts drift. We keep each of these straight so the practice's real financial health is readable.

Reconciled monthly, closed on a fixed date, and reported in plain terms — with payroll for associates and staff kept reconciled too via our payroll support.

Production vs collection

Collections reconciled against production so you can see whether a soft month was less work or just slower payers.

Adjustments booked honestly

Contractual write-downs recorded as adjustments, not buried — so revenue reflects what you'll actually keep.

PMS reconciled to the bank

Deposits, merchant fees, and patient-financing payouts tied out, so the software and the books finally agree.

What practices come to us for

The work behind clean practice books.

Monthly bookkeeping

Production, collections, AR, and PMS reconciliation kept current every month.

Monthly bookkeeping

Payroll support

Associates, hygienists, and staff payroll run and reconciled to the books.

Payroll support

Books behind?

Months of unreconciled deposits and untracked AR — caught up to a clean baseline.

Bookkeeping cleanup

Based in Conroe, serving practices across the Houston metro and Texas. We keep the books; coding, billing, and tax stay with your team and CPA.

Practice bookkeeping FAQ · Updated July 2026

Direct answers for medical & dental practices.

The gap between what you bill and what you keep. A practice produces a dollar of treatment, bills insurance, writes off a contractual adjustment it agreed to, waits weeks to collect, chases a patient balance, and maybe never sees part of it. Books that treat billed production as revenue overstate income wildly. Practice bookkeeping has to live in the difference between production, collection, and adjustment — which is invisible to generic bookkeeping that just records the deposits.
By tracking the whole arc, not just the cash that lands. Production is the work performed; collection is what actually comes in from insurers and patients; the gap is contractual adjustments, write-offs, and aging receivables. We keep the books so collection is reconciled against production and the receivable is visible and aged — insurance AR separate from patient AR — so you can see whether a slow month was less work or just slower payers. That distinction drives real decisions and it's the first thing generic books blur.
A contractual adjustment is the difference between your standard fee and the lower rate you agreed to accept from an insurer. It isn't bad debt and it isn't a loss you chose — it's a write-down you signed up for, and it has to be recorded as an adjustment so your revenue reflects what you'll actually collect, not your full fee schedule. Booked wrong (or not at all), a practice's income looks inflated and its real collection rate stays hidden. We record adjustments cleanly so the numbers mean what they say.
Yes — the practice-management system (Dentrix, Eaglesoft, Open Dental, athenahealth, and the like) is where production and collection are recorded, but it isn't your accounting system, and the two have to agree. We reconcile what the PMS reports against what actually hit the bank, so deposits, merchant fees, and patient-financing payouts (CareCredit and similar) all tie out. The PMS tells you about the practice; the books have to tie it to reality, and we keep them reconciled to each other.
Yes. Once there's more than one provider — associates, hygienists on production, a partner — the books need to support seeing the practice as a whole and the contribution of each provider, which matters for compensation and for knowing what's actually driving the practice. We structure the books so per-provider production and the overall picture both hold, rather than collapsing into one blurred number.

See your real collection rate

Get practice books that show what you actually keep.

A senior operator reviews how your practice's books are kept and scopes a fixed monthly fee to run them right — collections reconciled to production, AR aged, PMS tied to the bank. No pressure, no obligation.

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Collections reconciled to production PMS tied to the bank Fixed fee, in writing
832-702-3325 Free books review