Medical Bookkeeping Services for Physician-Owned Practices

Medical practices operate in one of the most financially complex small-business environments.

Physicians and practice managers must balance patient care, staffing, scheduling, insurance reimbursements, payroll, regulatory requirements, equipment costs, vendor relationships, taxes, and long-term growth. At the same time, they need reliable financial information to understand profitability, manage cash flow, evaluate staffing decisions, prepare for taxes, and plan for the future.

When bookkeeping falls behind, or financial responsibilities are divided among disconnected providers, maintaining visibility becomes harder.

Zavvy provides medical bookkeeping services for physician-owned practices, clinics, and multi-provider medical offices nationwide. We help practices maintain accurate financial records, complete monthly reconciliations, produce reliable financial reports, and coordinate bookkeeping information to support payroll and tax responsibilities.

Our full-service approach includes:

• Bookkeeping
• Payroll
• Tax services

Bookkeeping remains the financial foundation. Payroll and tax services build on that foundation, helping medical practices reduce administrative burden, improve financial coordination, and avoid the problems that often arise when several providers manage related responsibilities independently.

What Is Medical Bookkeeping?

Medical bookkeeping is the process of recording, categorizing, reconciling, and organizing a medical practice’s financial activity.

It includes more than entering transactions into accounting software.

Effective medical bookkeeping helps ensure that:

• Bank and credit card activity is reconciled.
• Revenue and expenses are categorized consistently.
• Payroll activity is reflected accurately.
• Loans and liabilities are recorded properly.
• Equipment purchases are documented.
• Tax payments are identified.
• Financial statements are produced on time.
• Practice owners can understand the business’s financial condition.

Medical bookkeeping also creates the financial records used by payroll professionals, tax advisors, lenders, owners, and other business partners.

A medical billing system may show claims, charges, collections, adjustments, and patient balances. A payroll system may show compensation, withholdings, employer taxes, and benefits. Bookkeeping brings the practice’s broader financial activity together into a single accounting record.

This matters because medical billing, payroll processing, bookkeeping, and tax preparation serve different purposes. They should be coordinated, but not confused with one another.

Specialized Bookkeeping

Medical practices are not ordinary retail or professional-service businesses.

Their financial operations may involve:

• Insurance reimbursements
• Patient payments
• Copays and deductibles
• Medicare and Medicaid
• Self-pay services
• Membership or concierge revenue
• Merchant processing
• Financing arrangements
• Provider compensation
• Clinical and administrative payroll
• Employer payroll taxes
• Medical supplies
• Laboratory expenses
• Malpractice insurance
• Electronic health record systems
• Billing company fees
• Medical equipment
• Equipment financing
• Multiple locations or entities

The accounting process must capture these activities consistently enough to produce meaningful financial reports. A general bookkeeper may be able to record transactions, but medical practice bookkeeping requires an understanding of how healthcare operations affect financial records.

For example:

• Charges are not the same as collections.
• Collections are not always the same as bank deposits.
• Payroll withdrawals do not represent the complete payroll expense.
• Equipment loan payments may include principal and interest.
• Provider compensation may differ from standard employee wages.
• Tax payments must be distinguished from operating expenses.
• Medical billing reports may not align directly with accounting revenue.

When these distinctions are not understood, financial reports may appear complete yet present an inaccurate or incomplete picture of the practice.

Who Zavvy Serves

Zavvy works with independently owned medical practices that need dependable financial records and better coordination across bookkeeping, payroll, and tax responsibilities.

These may include:

• Solo physician practices
• Multi-provider medical practices
• Specialty clinics
• Primary care offices
• Family medicine practices
• Internal medicine practices
• Pediatric practices
• Dermatology practices
• Orthopedic practices
• Cardiology practices
• Mental health practices
• Psychiatry practices
• Physical therapy practices
• Chiropractic practices
• Urgent care clinics
• Multi-location medical groups

The service structure should reflect the practice’s actual needs.

A solo physician with one office and a small staff may require straightforward monthly bookkeeping and payroll. A larger organization may need multiple account reconciliations, more complex provider compensation, location-level reporting, payroll administration, tax planning, and support across several business entities.

Zavvy evaluates each practice’s size, structure, financial activity, staffing model, current records, and reporting needs before recommending a service approach.

Medical Office Bookkeeping Services 

Monthly Transaction Categorization

Every financial statement begins with correctly recorded transactions.

Zavvy helps categorize the practice’s financial activity consistently across areas such as:

• Clinical supplies
• Laboratory expenses
• Payroll
• Employer payroll taxes
• Employee benefits
• Provider compensation
• Malpractice insurance
• Rent and occupancy
• Software
• Billing services
• Credentialing
• Marketing
• Continuing education
• Professional services
• Equipment
• Loan payments
• Owner activity

Consistency matters because financial reporting depends on comparable information. When similar expenses are categorized differently from one month to the next, reports become harder to interpret. A practice may believe spending has changed when the underlying difference is only a classification issue.

A well-structured chart of accounts provides sufficient detail to support management decisions without making bookkeeping more complex.

Bank and Credit Card Reconciliation

Reconciliation verifies that the bookkeeping records align with actual account activity.

Zavvy can reconcile:

• Operating accounts
• Payroll accounts
• Savings accounts
• Tax reserve accounts
• Business credit cards
• Loans
• Lines of credit
• Merchant processing accounts
• Other financial accounts

This process helps identify:

• Missing transactions
• Duplicate entries
• Incorrect amounts
• Bank fees
• Unrecorded transfers
• Credit card discrepancies
• Unexplained deposits
• Payroll differences
• Incorrect loan activity

Accounting software can import transactions, but automation does not guarantee accuracy. Reconciliation is the control that confirms whether the records reflect what actually occurred.

Monthly Financial Statements

Zavvy helps produce recurring financial reports that practice owners and managers can use to understand the business.

Common reports include:

• Profit and loss statement
• Balance sheet
• Cash-flow information
• General ledger
• Reconciliation reports
• Comparative monthly reports
• Year-to-date reports

Depending on the practice, reporting may also include:

• Location-level reporting
• Provider-related reporting
• Expense trend analysis
• Payroll cost analysis
• Customized management reports

Producing reports is only part of the process. The reports must also be timely, organized, and understandable.

Financial statements that arrive several months after the activity occurred have limited value to management. Current reporting gives practice leaders a better opportunity to identify changes, ask questions, and respond.

Balance Sheet Maintenance

Many practice owners focus primarily on the profit and loss statement. The balance sheet receives less attention even though it often reveals bookkeeping problems that are not visible elsewhere.

Balance sheet accounts may include:

• Cash
• Credit card balances
• Equipment
• Loans
• Lines of credit
• Payroll liabilities
• Tax liabilities
• Owner contributions
• Owner distributions
• Undeposited funds
• Other assets and obligations

Old, unexplained, or inaccurate balances can distort the practice’s financial condition.

Zavvy helps maintain these accounts so the balance sheet provides a more dependable picture of what the practice owns, owes, and retains.

Loan and Equipment Accounting

Medical practices frequently purchase or finance clinical equipment, office technology, furniture, leasehold improvements, and other significant assets. These transactions may be recorded incorrectly when the entire payment is treated as an ordinary operating expense.

A loan payment may include:

• Principal
• Interest
• Fees

The principal portion generally reduces the liability. Interest may be recorded as an expense. The related equipment may need to appear as an asset.

Zavvy helps maintain bookkeeping records for these purchases and financing arrangements so they can be appropriately reviewed for financial reporting and tax purposes.

Payroll-Related Bookkeeping

Payroll is often one of the largest expenses in a medical practice.

It may include:

• Physician compensation
• Advanced practice provider compensation
• Clinical staff wages
• Administrative salaries
• Hourly pay
• Overtime
• Bonuses
• Incentive compensation
• Employer payroll taxes
• Employee deductions
• Benefits
• Retirement contributions
• Reimbursements
• Payroll liabilities

A common bookkeeping mistake is recording only the net amount withdrawn from the bank. That withdrawal does not necessarily represent the total payroll expense or the liabilities associated with employee withholdings, benefits, and payroll taxes.

Zavvy helps ensure that payroll activity is accurately reflected in the financial records and reconciled with payroll reports and bank activity. When Zavvy also provides payroll services, it can coordinate the flow of information more directly.

Tax-Ready Recordkeeping

Tax preparation becomes more difficult when financial records are incomplete, unreconciled, or inconsistently categorized. Zavvy helps practices maintain records throughout the year so tax preparation does not begin with a large bookkeeping cleanup project.

Tax-ready bookkeeping may include:

• Reconciled financial accounts
• Accurate payroll records
• Documented equipment purchases
• Current loan balances
• Recorded estimated tax payments
• Identified owner transactions
• Organized expense categories
• Resolved bookkeeping questions

Strong bookkeeping does not eliminate the need for tax planning or professional tax preparation. It provides the financial foundation that those services require.

Historical Bookkeeping Cleanup

Some medical practices seek support because their current books are several months or years behind.

Historical problems may include:

• Unreconciled accounts
• Missing transactions
• Duplicate entries
• Incorrect balances
• Misclassified expenses
• Unrecorded loans
• Inaccurate payroll entries
• Personal and business activity mixed
• Uncategorized transactions
• Old suspense accounts

Zavvy can evaluate the condition of the records and define a cleanup project before recurring bookkeeping begins. Historical cleanup is usually separate from monthly bookkeeping because the scope depends on the number of periods involved, the condition of the records, and the availability of supporting information.

Medical Billing Is Not Medical Bookkeeping

Medical billing and bookkeeping are often confused because both involve practice revenue.

Medical billing generally focuses on:

• Patient charges
• Medical coding
• Claims submission
• Insurance reimbursements
• Denials
• Adjustments
• Patient balances
• Accounts receivable
• Collections

Medical bookkeeping focuses on:

• Bank deposits
• Revenue recording
• Expense categorization
• Payroll accounting
• Account reconciliation
• Loans and liabilities
• Financial statements
• Tax-ready records

A billing company may help the practice collect payments, but it does not necessarily maintain the business’s complete financial records.

Likewise, billing reports do not automatically show:

• Practice profitability
• Total payroll expense
• Employer taxes
• Equipment debt
• Operating cash flow
• Tax liabilities
• Owner distributions
• Complete business expenses

The practice may have excellent billing performance, yet disorganized bookkeeping. Zavvy helps connect financial activity from the bank, payroll system, billing information, and other sources into a more complete accounting record.

Full-Service Payroll for Medical Practices

Medical practice payroll can become complex as the organization adds providers, employees, locations, benefits, and compensation arrangements.

Zavvy’s payroll services can help practices manage recurring responsibilities such as:

• Payroll processing
• Direct deposit
• Employee compensation
• Payroll tax payments
• Payroll tax filings
• Payroll reports
• Employee withholdings
• Employer payroll taxes
• Year-end payroll forms
• Payroll changes
• New hires and terminations

The exact scope depends on the practice’s needs. A major advantage of coordinating payroll with bookkeeping is that payroll information does not have to move between unrelated systems and providers without clear ownership.

When the same financial relationship supports both functions, it may become easier to:

• Record payroll accurately
• Reconcile withdrawals
• Review payroll liabilities
• Identify unusual changes
• Understand labor costs
• Prepare financial reports
• Support tax planning

Payroll remains a separate service from bookkeeping, but the two functions should work together.

Tax Services for Medical Practices

Medical practice owners often have interconnected business and personal tax responsibilities.

Tax considerations may involve:

• Business tax returns
• Owner tax returns
• Estimated tax payments
• Payroll taxes
• Equipment purchases
• Provider compensation
• Owner distributions
• Retirement contributions
• Multiple entities
• Practice growth
• Ownership changes

Zavvy provides tax services designed to work with the financial records maintained throughout the year.

Depending on the engagement, tax support may include:

• Business tax preparation
• Individual tax preparation
• Year-round tax planning
• Estimated tax support
• Tax document coordination
• Review of significant business changes
• Planning related to equipment purchases
• Coordination of business and owner tax considerations

Tax planning is generally more effective when it is based on current financial information.

When bookkeeping is months behind, tax professionals have less visibility into current profitability, payroll activity, equipment purchases, owner transactions, and cash requirements.

An integrated relationship helps keep these connected responsibilities aligned.

Why Coordinate Services?

Many medical practices use separate providers for bookkeeping, payroll, and taxes.

That model can work, but it often places the practice manager or physician owner in the role of financial coordinator.

Someone within the practice may need to:

• Send payroll reports to the bookkeeper.
• Answer repeated questions from several providers.
• Explain bookkeeping entries to the tax professional.
• Transfer financial statements.
• Track tax payments.
• Resolve payroll discrepancies.
• Confirm which provider owns each issue.
• Gather the same documents more than once.

When responsibilities are fragmented, questions may be passed from one provider to another. The bookkeeper may say the issue belongs to payroll. The payroll provider may direct the practice to the tax advisor. The tax advisor may explain that the books must be corrected first.

The practice remains responsible for connecting the process. A coordinated full-service relationship can reduce these handoffs.

Potential benefits include:

• More consistent financial records
• Better payroll reconciliation
• Improved tax readiness
• Fewer information transfers
• Clearer responsibility
• Faster issue resolution
• Reduced administrative burden
• Better financial reporting

Not every practice requires all three services. Zavvy can provide the combination that fits the practice’s current needs.

Common Medical Bookkeeping Problems

Medical practices often seek professional support after experiencing one or more recurring problems.

Bookkeeping Is Several Months Behind

Delayed bookkeeping diminishes the value of financial reporting and complicates reconciliation.

The Practice Relies on Bank Balances

Cash balances do not explain profitability, debt, payroll liabilities, tax obligations, or upcoming commitments.

Payroll Is Not Reconciled

Payroll may be processed successfully while still being recorded incorrectly in the accounting system.

Reports Are Produced but Not Trusted

Unexplained balances, inconsistent categories, or old transactions can cause leadership to question the numbers.

Tax Season Requires Major Cleanup

The practice may spend weeks gathering documents and answering questions that could have been addressed during the year.

The Office Manager Is Overloaded

Bookkeeping, payroll coordination, tax requests, and financial documentation may be added to an already extensive operational role.

Multiple Providers Are Not Coordinated

The practice becomes responsible for moving information and resolving disagreements among bookkeeping, payroll, billing, and tax providers.

The Practice Has Outgrown Its Existing Process

Growth can increase transaction volume, payroll complexity, account count, reporting needs, and tax responsibilities. Professional support can help establish a more dependable process before problems become harder to correct.

Benefits of Outsourcing Medical Bookkeeping

More Consistent Financial Records

A recurring bookkeeping process helps ensure accounts are reconciled, questions are resolved, and transactions are categorized consistently.

Timelier Financial Reporting

Current reports let owners and managers review recent activity instead of relying on information from several months earlier.

Reduced Administrative Burden

Practice managers can spend less time gathering statements, categorizing transactions, reconciling accounts, and coordinating providers.

Better Payroll Visibility

Accurate payroll accounting helps leadership understand total labor costs rather than focusing only on net payroll withdrawals.

Improved Tax Readiness

Current records reduce cleanup before tax preparation and support more informed planning throughout the year.

Stronger Financial Decision-Making

Reliable information can support decisions involving:

• Hiring
• Compensation
• Equipment
• Expansion
• Financing
• Owner distributions
• Cost management
• Cash reserves

Better Continuity

A structured external process reduces dependence on a single employee who holds all the financial knowledge.

Medical Practice Financial Reports

Bookkeeping should produce information that helps leadership understand the business. 

Medical practices commonly benefit from reviewing:

Profit and Loss Statement

The profit and loss statement summarizes revenue, expenses, and profitability over a specific period.

It can help leadership identify:

• Revenue changes
• Payroll trends
• Supply-cost increases
• Vendor expenses
• Changes in profitability
• Unusual spending

Balance Sheet

The balance sheet shows assets, liabilities, and equity.

It provides visibility into:

• Cash
• Debt
• Credit cards
• Equipment
• Payroll liabilities
• Tax obligations
• Owner activity

Cash-Flow Information

Cash-flow reporting helps explain how money moves through the practice and whether available cash is sufficient for upcoming obligations.

Payroll Reports

Payroll reports help the practice review compensation, employer taxes, deductions, benefits, and total labor costs.

Revenue and Collection Reports

Billing or practice management reports may help leadership understand charges, reimbursements, collections, adjustments, and accounts receivable.

Review these operational reports alongside the accounting records rather than treating them as substitutes for financial statements.

Medical Bookkeeping for Growing Practices

Bookkeeping needs often change as a medical practice grows. A solo physician may initially manage with a limited number of accounts and simple monthly reporting. Growth may introduce:

• Additional providers
• More employees
• Multiple locations
• New business entities
• More complex payroll
• Provider compensation plans
• Equipment financing
• Larger tax obligations
• Additional reporting requirements
• Greater administrative workload

The financial process should evolve with the organization. A practice preparing to hire another provider, acquire a location, seek financing, or enter an ownership transaction needs records that can withstand greater scrutiny.

Clean books can support:

• Lending applications
• Expansion planning
• Practice valuation
• Ownership discussions
• Due diligence
• Provider compensation decisions
• Location-level analysis

Growth without stronger financial infrastructure often increases uncertainty.

Multi-Provider and Multi-Location Practices

Multi-provider and multi-location organizations may require more than consolidated monthly bookkeeping.

They may need visibility into:

• Location-level revenue
• Location-level expenses
• Provider compensation
• Payroll by location or department
• Shared overhead
• Equipment and debt
• Intercompany transactions
• Cash requirements
• Tax obligations
• Consolidated financial performance

The accounting structure must support the questions leadership needs to answer. Adding more categories does not automatically produce better reporting. The chart of accounts, tracking structure, and monthly process must remain consistent.

Zavvy can help evaluate the practice’s current reporting needs and establish a service approach that supports the organization’s size and complexity.

What to Look for in a Medical Bookkeeping Provider

Medical practices should evaluate more than price.

A bookkeeping provider should be able to explain:

• Which services are included
• How accounts are reconciled
• How payroll information is handled
• How financial reports are produced
• How questions are resolved
• What documentation is required
• Whether cleanup is separate
• How tax information is coordinated
• How pricing changes as the practice grows
• Which responsibilities remain with the practice

Other important considerations include:

• Reliability
• Accuracy
• Responsiveness
• Healthcare familiarity
• Reporting quality
• Technology
• Security
• Service continuity
• Payroll capability
• Tax capability
• Ability to support multiple locations or entities

The lowest-cost provider may suit a simple practice with limited needs. A more complex organization may receive greater value from a provider that can coordinate several financial responsibilities.

Why Medical Practices Choose Zavvy

Zavvy’s approach is designed around the connected financial needs of medical practices.

Bookkeeping as the Foundation

We begin with accurate records, reconciled accounts, consistent categorization, and dependable monthly reporting.

Integrated Payroll Support

Payroll information can be coordinated with the bookkeeping process to ensure wages, employer taxes, benefits, and liabilities are recorded more accurately.

Year-Round Tax Support

Current books create a stronger foundation for tax planning and preparation.

Reduced Provider Fragmentation

Practices can reduce the number of separate handoffs required to coordinate bookkeeping, payroll, and taxes.

Service Based on Practice Needs

The recommended scope reflects the practice’s size, structure, complexity, and current condition.

National Medical Practice Focus

Zavvy serves physician-owned practices and medical offices nationwide. The medical strategy is not limited to Utah.

Our Medical Bookkeeping Process

Although each engagement is customized, the process generally includes several stages.

1. Practice and Financial Review

We begin by learning about the practice, including:

• Number of locations
• Number of providers
• Number of employees
• Current accounting system
• Payroll process
• Tax service needs
• Financial accounts
• Reporting requirements
• Current condition of the books

2. Scope Development

We identify the recurring and one-time services the practice needs.

The scope may include:

• Monthly bookkeeping
• Historical cleanup
• Payroll
• Tax planning
• Tax preparation
• Reporting
• Multi-location support

3. Setup or Cleanup

If the current records require cleanup, we define the work before normal monthly processing begins. If the books are current, Zavvy establishes the recurring workflow and access requirements.

4. Monthly Processing and Reconciliation

Transactions are categorized, accounts are reconciled, and financial questions are resolved.

5. Reporting

Financial reports are prepared according to the agreed schedule and scope.

6. Payroll and Tax Coordination

When payroll and tax services are included, the related information is incorporated into the broader financial process.

Frequently Asked Questions

What is medical bookkeeping?

Medical bookkeeping is the process of recording, categorizing, reconciling, and organizing the financial activity of a medical practice. It supports financial reporting, payroll accounting, tax preparation, lending, and business decision-making.

Is medical bookkeeping different from regular bookkeeping?

The core accounting principles are similar, but medical practices often have specialized revenue, billing systems, provider compensation, payroll structures, equipment costs, payer reimbursements, and reporting needs. A provider familiar with medical-practice operations may be better prepared to understand these relationships.

Is medical billing the same as bookkeeping?

No. Medical billing manages claims, reimbursements, patient balances, and collections. Bookkeeping records the practice’s broader financial activity, including expenses, payroll, loans, taxes, and financial statements.

Do I need bookkeeping if I already use a medical billing company?

Yes. A billing company generally does not maintain the practice’s complete accounting records.

Bookkeeping remains necessary to reconcile bank activity, record expenses, maintain liabilities, account for payroll, and produce financial statements.

What bookkeeping services does Zavvy provide for medical practices?

Services may include transaction categorization, account reconciliation, monthly financial reporting, balance sheet maintenance, payroll-related bookkeeping, tax-ready records, and historical cleanup.

The final scope depends on the practice’s needs.

Does Zavvy provide payroll for medical practices?

Yes. Zavvy provides payroll services that can be coordinated with the bookkeeping process.

The exact scope of services is based on employee count, payroll frequency, compensation structure, and other practice requirements.

Does Zavvy provide tax services for medical practices?

Yes. Zavvy provides tax planning and preparation services that can be coordinated with the practice’s bookkeeping and payroll information.

Can Zavvy handle bookkeeping, payroll, and taxes all at once?

Yes. Zavvy offers a full-service model combining bookkeeping, payroll, and tax services.

Practices can use all three services or select the combination that fits their needs.

How often should medical practice bookkeeping be completed?

Most medical practices should complete bookkeeping and account reconciliation monthly.

More frequent support may be appropriate for larger practices, multi-location organizations, or practices requiring more current cash-flow information.

What financial reports should a medical practice review monthly?

Common reports include:

• Profit and loss statement
• Balance sheet
• Cash-flow information
• Payroll reports
• Revenue and collection reports
• Accounts payable
• Debt and liability information

The appropriate reporting package depends on the practice’s size and complexity.

Can an office manager handle medical bookkeeping?

An office manager may be able to handle bookkeeping, particularly in a small practice.

The practice should consider whether the manager has the training, time, and capacity to perform the work consistently while managing operational responsibilities.

When should a medical practice outsource bookkeeping?

Outsourcing may be appropriate when:

• The books are consistently behind.
• Reports are unreliable or delayed.
• The owner is doing the bookkeeping.
• The office manager is overloaded.
• Payroll is becoming more complex.
• Tax season requires significant cleanup.
• The practice is growing.
• Multiple providers are not coordinated.

Can Zavvy clean up past bookkeeping?

Yes. Zavvy can evaluate incomplete or inaccurate historical records and recommend a cleanup scope before recurring services begin.

How much do medical bookkeeping services cost?

The cost depends on factors such as:

• Transaction volume
• Number of accounts
• Number of locations
• Number of entities
• Reporting requirements
• Payroll complexity
• Tax service needs
• Condition of the existing records
• Historical cleanup requirements

Zavvy provides a customized recommendation after reviewing the practice.

Does Zavvy work with medical practices outside Utah?

Yes. Zavvy offers medical and dental services nationally.

Zavvy’s broader general-market bookkeeping, payroll, and tax strategy remains focused on Utah.

Can Zavvy work with our existing tax professional or payroll provider?

Depending on the engagement, Zavvy may coordinate with existing providers. The practice should define which responsibilities Zavvy will manage and how it will share information.

Does Zavvy serve multi-provider medical practices?

Yes. Zavvy can support solo practices, multi-provider organizations, and multi-location medical offices. The bookkeeping and reporting structure should reflect the practice’s complexity.

What information is needed to get started?

Zavvy generally needs information about:

• Practice structure
• Locations
• Providers and employees
• Financial accounts
• Accounting software
• Payroll system
• Tax needs
• Monthly transaction volume
• Reporting expectations
• Condition of the current books

This information helps define the appropriate scope of service.

Build a Stronger Financial Foundation

Medical practices need more than technically complete records.

They need current, organized, and dependable financial information to support payroll, taxes, reporting, and business decisions.

Zavvy helps physician-owned practices and medical offices maintain that foundation through coordinated bookkeeping, payroll, and tax services.

Whether your practice needs recurring bookkeeping, historical cleanup, payroll support, tax services, or a more comprehensive financial relationship, Zavvy can recommend a service structure tailored to your specific needs.

Schedule a consultation to discuss your medical practice’s bookkeeping, payroll, and tax requirements.