A fixed monthly fee starting at $250 for a solo cash-pay practice, plus a one-time setup project quoted flat before any monthly work begins. The fee tracks complexity, not revenue: payroll, provider count, how many accounts money moves through, and how far behind the books are. A multi-provider practice with partner reporting starts at $800 a month.
Every level is a fixed monthly fee. I scope the work once, and the bill stays the same every month. No hourly billing, no per-transaction fees. The word that matters in the numbers below is "from": it is where the scope starts, not a quote.
Every level includes monthly P&L, balance sheet, and cash-flow statements. You can see the Group Practice Pack sample to judge what the top of the range actually delivers.
A practice collecting $40,000 a month from one provider through one account costs the same as one collecting $8,000, when the work is the same. Money in is not the driver. Hands, accounts, and formats are:
That is also why I quote after a 30-minute call rather than from a form. Any number given before I have seen your accounts is a guess, and guesses are how bookkeeping relationships start badly.
Every engagement starts with a setup project, quoted flat before work begins. Most practices do not start with clean books: personal and business spending are mixed, a few months are unreconciled, and the chart of accounts was never built for a practice.
Setup fixes that once. The chart is remapped to your practice, opening balances are tied to the bank, prior months are reconciled, and payroll and contractor records are straightened out. After that the monthly fee stays predictable, because the cleanup is behind you rather than spread invisibly through every month.
Hourly bills you for how slow a mess is to untangle, and it makes a better organized practice pay more per month for the same result. Per transaction charges you more in exactly the month you are busiest and most need to understand the numbers. A fixed fee means the number on the invoice does not move when your caseload does.
The trade is scope, not hours: if your practice changes materially - a new provider, payroll, a second location - I re-scope with you before anything new is billed.
Everything above is written down in the engagement letter before you sign it, including what I will refer elsewhere.
For the simplest case, yes: one provider, one main account, no payroll, books roughly current. That is the floor of the Solo Practice level, and it is a real floor rather than a teaser. If your practice is not that case - and most are not - the proposal is higher, and I will show you which parts of your setup move it before you commit to anything.
No. The fee follows scope, not volume. A month with more sessions, more deposits, and more card batches than usual costs the same as a quiet one. If your practice changes materially - you hire, you start payroll, you open a second account - we re-scope first and I confirm the new fee before any of that work is billed.
Because most practices do not start clean, and fixing that properly is a project, not a habit. Setup remaps the chart of accounts to a practice, ties opening balances to the bank, and reconciles prior months once. It is quoted flat before work begins, which keeps the monthly fee predictable afterward instead of hiding catch-up work inside every invoice.
For a while, often yes - and I would rather say that than pretend otherwise. The honest test: if your books take you under two hours a month and you have never had to build a second spreadsheet to check whether your software was right, keep doing it. The signal to hire is usually different from the one people expect: it is not volume, it is the moment you stop trusting a number and cannot say why.
Thirty minutes on your practice, your providers, and what you need from your books. A fixed-fee proposal follows within 48 hours.
Book an intro callOr read how superbill income is recorded and what a monthly close includes.
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