Precision Accounting & Consulting is based in Melville, New York and works with clients nationwide.
Medical practice accounting is not regular accounting. Your revenue doesn’t arrive as one number — it starts as charges in a billing system, gets carved down by contractual adjustments, splits into insurance and patient responsibility, and lands in the bank weeks later as batched deposits that look nothing like what you billed. A generalist bookkeeper records the deposits and calls it done. We reconcile the whole chain — billing system to A/R reports to collections to bank to QuickBooks — so your financials tell you what the practice actually earned, by provider, by location, and by service line.
What we do: full-service accounting, bookkeeping, and tax built specifically for medical practices — medical A/R and billing-system reconciliation, provider and location profitability, payroll and staffing analysis, KPI reporting, cash-flow visibility, and proactive tax planning for physicians and physician groups across New York.
Our medical practice division didn’t start as a marketing page. It grew out of our work with dental practices, where we learned the mechanics that define healthcare accounting: production versus collections, insurance write-offs that quietly reshape revenue, and the gap between what a practice-management system says you earned and what the bank says you deposited. Those same mechanics run every physician practice — the systems and payer rules just get more complicated. Today we apply that discipline across primary care, surgical and specialty medicine, therapy practices, and multi-location physician groups.
Here’s the test we start with. Take a month: charges posted in your billing system, minus contractual adjustments and write-offs, should explain your net revenue. Payments posted — insurance and patient — should tie to your bank deposits. The change in your A/R aging should equal billings minus collections and adjustments. In most practices we review, those numbers don’t tie, and nobody can say why: payments posted to the wrong period, adjustments dumped in bulk, patient refunds and merchant fees netted invisibly against deposits, or an EHR conversion that orphaned half the aging. Until the chain reconciles, your P&L is an estimate. Making it reconcile — and keeping it that way every month — is the core of what we do.
Practices run on their EHR, practice-management, and billing platforms — athenahealth, eClinicalWorks, Epic, NextGen, AdvancedMD, Tebra, DrChrono, ModMed, and CareCloud among them; WebPT, Prompt, Raintree, and Clinicient on the therapy side; Dentrix, Eaglesoft, and Open Dental in dentistry; clearinghouses like Waystar and Availity in between. We don’t replace those systems, and we don’t need to be certified in them — we work from the reports they produce: charges, payments, adjustments, ERAs, and A/R aging. Whatever combination you run, our job is the same: reconcile what those systems report back to the bank and to your accounting records, and turn the result into financials you can run the practice on.
A medical practice can be profitable on paper and broke in the bank — or the reverse — because the books are built on deposits instead of reconciled revenue. Recording deposits as revenue hides denials, underpayments, and posting errors inside a number that looks fine. Blending providers and locations into one P&L hides a losing office behind a winning one. Treating adjustments as invisible makes your worst payer contract look identical to your best. These aren’t bookkeeping quirks; they decide what you take home, what you can pay a new associate, and what your practice is worth when you eventually sell. We build the reporting that keeps those answers visible all year — not just at tax time.
Based in Melville on Long Island, Precision Accounting & Consulting works with medical, dental, and therapy practices across Long Island, the five boroughs, and New York State — on-site where it makes sense and remotely everywhere else.
A medical practice accountant reconciles the revenue cycle — charges, contractual adjustments, insurance and patient collections, and bank deposits — back to the accounting records, and reports profitability by provider, location, and service line. A generalist bookkeeper typically records deposits as revenue, which hides denials, write-offs, and posting errors.
Yes. That reconciliation is the core of our medical practice work: we tie your billing system’s charges, adjustments, and payment postings to bank deposits and to QuickBooks each month, and we flag the gaps — unposted payments, netted refunds and fees, and adjustments that were never reviewed.
Almost certainly. We work from the standard reports produced by systems like athenahealth, eClinicalWorks, Epic, NextGen, AdvancedMD, Tebra, DrChrono, ModMed, WebPT, Prompt, Raintree, Dentrix, Eaglesoft, and Open Dental, among others — charges, payments, adjustments, and A/R aging — and reconcile them to your books.
Family medicine and primary care, surgical practices, orthopedics, cardiology, neurology and neurosurgery, gastroenterology, dermatology, pain management, physical therapy and rehab, dental practices, and multi-location physician groups, along with other specialty and private practices.
Yes. We build location-level P&Ls, allocate shared costs sensibly, keep intercompany activity clean, and roll everything into consolidated reporting your partners and lenders can rely on.
Yes. We regularly take on cleanup and catch-up engagements — rebuilding the chart of accounts, reconciling historical billing-system activity to the bank, and getting the practice back to an accurate, timely monthly close.
If you want financials that tell you the truth about what your practice earns — by provider, by location, and by service line — and that actually reconcile to your billing system and your bank, Precision Accounting & Consulting can help. Contact us to talk with a medical practice accounting specialist about your practice.
Disclaimer: General information only, not accounting, tax, or legal advice. Consult a qualified professional about your practice’s specifics.