Medical & Dental Practices
Bookkeeping, payroll, and tax planning for practice owners. We keep the books clean and help you keep more of what you earn. Backed by a CPA and Enrolled Agent.
The Practice
You spent years learning to treat patients. Nobody trained you on tax planning. That gap costs high-earning practice owners real money every year. Equipment purchases get expensed wrong. Retirement accounts stay under-funded. The personal return gets filed without any strategy behind it. A CPA and Enrolled Agent can help you close that gap.
Medical and dental practices have their own financial rhythm. Insurance payments arrive weeks or months after treatment. Equipment costs run high. You have clinical staff, front-office staff, and sometimes contractors, all with different pay structures. The books need to track it all accurately, and the tax planning needs to work alongside those books to help you keep more of what you earn.
Who This Covers
Who This Covers
Dentists, chiropractors, optometrists, and physical therapists. Solo practitioners and small group practices across New England and nationwide. The practice types where the owner is both the clinician and the business decision-maker.
Why Tax Matters Here
Why Tax Matters Here
Practice owners are often in the highest tax brackets. Equipment purchases, retirement contributions, and entity structure all affect how much of your income you actually keep. Without planning, you pay more than you need to. With the right guidance, you keep more.
What We Handle
We manage the day-to-day bookkeeping that keeps your practice running. That means tracking insurance receivables and patient payments, reconciling accounts, and producing monthly reports that show you where the practice stands. We also run payroll for your clinical and front-office staff, handling the tax deposits and filings so you are not spending your evenings on it. Clean books feed into everything else.
The real value for practice owners comes from the tax planning side. Simona is a CPA and Enrolled Agent, and that depth matters when you are a high earner with equipment purchases, retirement decisions, and entity structure questions. We help you think through Section 179 deductions on equipment, maximize retirement contributions, and understand whether your current entity setup makes sense. Then we prepare your personal tax return, bringing all of it together.
Practice Bookkeeping and Payroll
Practice Bookkeeping and Payroll
Monthly bookkeeping that tracks insurance receivables, patient payments, and operating expenses. Full-service payroll for your team, with tax deposits and quarterly filings handled. A clear monthly picture of revenue, expenses, and cash flow so you know how the practice is actually doing.
Tax Planning and Personal Returns
Tax Planning and Personal Returns
Tax planning for high-income practice owners, covering equipment deductions, retirement strategies, and entity structure guidance. We prepare your personal tax return with the full context of your practice financials. As a CPA and Enrolled Agent, Simona brings real tax depth to the work.
Common Problems
Practice owners often leave money on the table at tax time. A new X-ray machine or dental chair gets purchased, but Section 179 is not elected. The depreciation schedule never gets set up properly. Equipment deductions that could have lowered your tax bill by thousands get missed because nobody was watching for them. This happens when bookkeeping and tax preparation are disconnected.
The bigger problem is the absence of a tax strategy. Many practice owners max out a basic retirement account and assume that is all they can do. They never explore defined benefit plans, SEP IRAs, or cash balance plans that could shelter significantly more income. The entity structure was set up years ago and never revisited. The personal return gets filed by someone who does not understand the practice finances. All of this adds up to a higher tax bill than necessary.
Equipment Deductions Missed
Equipment Deductions Missed
Section 179 allows you to deduct the full cost of qualifying equipment in the year you buy it, rather than depreciating it over time. But you have to elect it, and the books have to support it. Many practice owners miss this entirely and pay more in taxes than they needed to.
Retirement Strategy Gaps
Retirement Strategy Gaps
High earners who fund a 401(k) and stop there are leaving options unexplored. Defined benefit plans, cash balance plans, and other structures let practice owners shelter significantly more income. Without guidance, most never set them up.
What Changes
Tax planning becomes proactive instead of reactive. Equipment purchases are timed and documented to capture Section 179 deductions. Retirement contributions are maximized within the options that make sense for your income level. Entity structure gets reviewed and adjusted when it makes a difference. Your personal return is prepared by someone who understands the full picture of your practice and your personal finances.
On the operations side, your books stay clean all year. You know which insurance payments are outstanding and which ones have been collected. Payroll runs without eating your time. You have a monthly report that shows you what the practice earned and what it cost to run. The financial side of the business stops being something you avoid and becomes something you understand.
A Real Tax Strategy
A Real Tax Strategy
Deductions captured, retirement maximized, and your personal return prepared by a CPA and Enrolled Agent who knows your situation. This is the difference between filing your taxes and actually planning them. For high-earning practice owners, that difference can mean tens of thousands of dollars.
Clean Books and Time Back
Clean Books and Time Back
Bookkeeping and payroll handled by someone who understands practices. Insurance receivables tracked. Monthly reports delivered. You spend your time on patients, not on chasing down numbers or trying to figure out what you owe.
New England's CPA-Led Bookkeeping Partner
The Next Step:
A Quick Conversation
We'll listen, ask a few questions, and show you exactly how we can help.