Talk to a CPA today — Free Practice Bookkeeping Review
Outsourced Bookkeeping for Medical & Dental Practices — EOB Reconciled, Per-Provider P&L, HIPAA-Aware
Stop guessing what your insurance collections ratio is. ProAxis is a CPA-led bookkeeping team that reconciles every ERA / EOB to the bank, runs per-provider profitability, manages multi-provider payroll, and keeps your equipment depreciation schedule audit-ready — all in a HIPAA-aware workflow.
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The 6 Bookkeeping Problems Every Tri-State Practice Has
Every practice we onboard arrives with one of these problems. Most arrive with several. Here’s how a CPA-led bookkeeping team fixes them.
Insurance ERAs and EOBs hit the bank in lump sums and your books just show one big deposit. Nobody knows which procedures actually got paid.
How we fix it
We perform insurance ERA / EOB reconciliation — matching each deposit to the underlying claims, write-offs, and patient responsibility — so your collections ratio, write-off %, and per-payer profitability are visible monthly.
You have 3 associate dentists / providers and you can't tell which ones are profitable after their pay, lab fees, and supply consumption.
How we fix it
We track per-provider P&L: production, collections, comp/benefits, lab fees by case, and direct supply allocation. You see who's accretive and who's not.
Your tax preparer keeps asking for a clean fixed-asset schedule and you've got equipment purchases buried in 'Office Supplies'.
How we fix it
We maintain a medical-equipment fixed-asset register with proper Section 179 / bonus depreciation election tracking on chairs, imaging, lasers, and IT — capturing every dollar of accelerated depreciation.
Patient PHI is showing up in QuickBooks memo fields and you're not sure if you're HIPAA-compliant.
How we fix it
We configure HIPAA-aware bookkeeping workflows: no PHI in QBO memos, BAA-covered tooling for any patient-identifiable docs, and clean separation between practice management and accounting systems.
Multi-provider payroll is a nightmare — W-2 hygienists, 1099 associate dentists, productivity bonuses, and CME stipends all mixed together.
How we fix it
We run provider compensation correctly: W-2 vs. 1099 worker classification, productivity bonus accruals, fringe benefit reporting, and proper expense reimbursement under accountable plans.
Lab fees, supplies, and contract labor are eating your margin and nobody can explain why.
How we fix it
We classify variable cost-of-services by procedure category and generate monthly trend reports, flagging supply or lab-fee creep before it eats another quarter.
What’s Included
What's Included in Practice Bookkeeping
Insurance ERA / EOB Reconciliation
Match each insurance deposit to claims, write-offs, and patient responsibility. Monthly collections ratio reporting.
Per-Provider P&L Tracking
Production, collections, lab fees, and direct supply costs allocated per associate or location.
Medical Equipment Depreciation
Sec. 179 + bonus depreciation strategy for chairs, imaging, lasers, sterilization. Year-end planning included.
HIPAA-Aware Workflow Setup
Clean separation between PMS / EHR and accounting. No PHI in QBO. BAA-covered document tooling.
Multi-Provider Payroll
W-2 staff, 1099 associates, productivity bonuses, retirement contributions, fringe benefits.
Practice-Loan Amortization
Practice acquisition loan or equipment financing tracked with proper interest / principal split each month.
401(k) / SEP-IRA Coordination
Employer contribution calculations, year-end true-up, coordination with TPA.
Monthly Financial Package
P&L vs. budget, balance sheet, AR aging by payer, and a 25-minute CPA review call.
Tax-Ready Year-End Close
Books closed, depreciation booked, accruals trued up — ready for the practice's tax return.
Why ProAxis
Why Tri-State Practices Switch to ProAxis
We Speak Practice Management AND Accounting
Most bookkeepers can't reconcile a Dentrix or Open Dental day-sheet to the bank deposit. We can. We've worked with the major PMS/EHR systems — Dentrix, Eaglesoft, Open Dental, athenahealth, AdvancedMD, Kareo — and we know how the production/collections/adjustments flow into accounting.
Tax Strategy Built Into the Books
Equipment depreciation, S-Corp owner reasonable comp, retirement plan contributions, and entity structure decisions are made all year — not in March. We coordinate practice tax planning with bookkeeping monthly, so April is no surprise.
IRS Tax Resolution Specialists On Staff
Practices generate IRS letters — payroll-tax notices, 1099 misclassification challenges, S-Corp reasonable-comp audits. As an Authorized IRS e-File Provider with a full Tax Resolution practice, we handle these directly. No second firm needed.
100% Virtual, HIPAA-Aware
Secure portal for any document containing PHI, BAA in place where needed, encrypted transmission, no patient identifiers in QBO. Built for the way modern practices actually operate.
Practice Bookkeeping — Frequently Asked Questions
Do you reconcile insurance EOBs and ERAs to bank deposits?
Yes. This is one of the highest-value bookkeeping tasks for any insurance-heavy practice. Each insurance deposit (Delta Dental, MetLife, Aetna, Cigna, BCBS, etc.) is matched to the underlying claims, with proper recording of contractual write-offs, patient responsibility, and the actual deposit amount. Without this, your collections ratio is unknown and your AR is unreliable. We deliver monthly reports showing collections by payer, write-off percentages, and AR aging.
Can you separate per-provider profitability for an associate-driven practice?
Yes. We track production, collections, direct lab fees, and a reasonable share of supplies and overhead per provider. The result is a per-associate P&L that lets you see which providers are net profitable after their compensation arrangement. This is critical for compensation negotiations, partnership decisions, and identifying when an associate's economics aren't working.
Are you HIPAA-aware? How do you handle patient information?
We do not put patient identifiers (names, DOB, insurance ID, account numbers) in QuickBooks. Reconciliations reference internal practice-management IDs only. Any document containing PHI moves through a BAA-covered secure portal, never email. We don't replace your HIPAA compliance program, but we don't create new exposure either.
We have W-2 staff and 1099 associate doctors. Can you handle the mixed payroll?
Yes. We coordinate W-2 payroll with your payroll provider (Gusto, ADP, Paychex, Intuit Online Payroll) and process 1099 associate compensation with productivity-based calculations. We also handle fringe benefits, accountable-plan expense reimbursements, and year-end W-2 / 1099 issuance. We work with you upfront on worker classification — IRS Form SS-8 factors and the dental-practice-specific treatment guidance — so 1099 associates don't get reclassified later.
Can you implement Section 179 and bonus depreciation on equipment we bought this year?
Yes. Medical and dental practices are equipment-intensive — chairs, panoramic imaging, intraoral scanners, CBCT, lasers, autoclaves, IT infrastructure. We maintain a fixed-asset register, calculate the Section 179 expense election within annual limits, apply bonus depreciation where applicable, and coordinate with year-end tax planning so you make the buy/lease and timing decisions before December 31, not in March.
What does monthly practice bookkeeping cost?
Pricing depends on practice size, number of providers, transaction volume, payer mix, and whether we're handling payroll. A solo practitioner running ~$1M in collections typically runs $700–$1,200/month. A 3–4 provider practice runs $1,200–$2,500/month. Catch-up bookkeeping is quoted separately. After a free discovery call we provide a fixed monthly fee.
Ready to Know Your Real Collections Ratio?
Free 30-minute review of your practice's books and insurance reconciliation process. We'll tell you exactly what's broken and what fixing it looks like — no obligation.
Serving medical and dental practices across New York, New Jersey & Pennsylvania — 100% virtual.
More ProAxis Resources for Medical & Dental Practices
- Healthcare Industry CPA Hub →
- Physician Tax Planning Deep Dive →
- Curated Resource Hub for Medical & Dental Practices →
- ProAxis Pricing →
- Bookkeeping Cost Calculator → Quick monthly-fee estimate
- Catch-Up Bookkeeping Calculator → One-time project cost if you're months behind