Monthly Accounting & Bookkeeping
Reconciliations, closes and clean records maintained every month, not at year-end.
Healthcare Practice Accounting
Financial Management, Payroll and Tax Support for Independent Healthcare Practices
One accounting team for your practice, payroll, financial reporting, business taxes and owner tax planning.
Monthly Accounting • Payroll • Location Reporting • Quarterly Projections • Owner Tax Planning
Designed for Independent and Growing Practices
Engagements are scoped to the practice's size, locations and reporting needs.
- Approximately $500,000–$5 million in annual revenue
- One to five locations
- Owner-operated or partner-owned practices
- Approximately 3–50 employees
- Established practices that have outgrown basic bookkeeping
- Practices seeking one firm for accounting, payroll and tax coordination
- New York and New Jersey practices, including NYC, Long Island, the Hudson Valley and northern New Jersey
Practice types we support
Accounting requirements differ meaningfully between these practice types — payroll structure, equipment, collections and entity setup are rarely the same twice.
Dental and orthodontic practices
Physical and occupational therapy practices
Independent physician practices
Primary-care practices
Mental and behavioral-health practices
Optometry practices
Chiropractic practices
Veterinary practices
Med spas and aesthetic practices
See the Financial Performance Behind the Patient Care
Our work is financial, not clinical. We help practice owners understand:
Profitability by location
Payroll as a percentage of collections
Provider and staffing costs
Practice overhead
Cash available for owner distributions
Estimated quarterly taxes
Equipment and lease costs
Whether another provider or location is financially sustainable
ESBS does not measure clinical performance and does not access patient-level clinical information.
One Financial Team for the Practice and Its Owners
Payroll Administration
Provider and staff payroll, payroll tax filings and year-end reporting.
Payroll Conversion & Setup
Moving from an existing provider without losing history or missing filings.
Financial Statements
Practice-level statements prepared on a consistent, comparable basis.
Location-Level Reporting
Revenue, payroll and overhead separated by site where the data supports it.
Accounts Payable Support
Vendor, supply and lab payables organized and tracked against cash.
Deposit & Collection Reconciliation
Bank deposits reconciled to the collections reported by the practice's systems.
Cash-Flow Forecasting
Visibility into upcoming payroll, tax, debt and equipment obligations.
Equipment & Fixed Assets
Chairs, imaging, therapy and clinical equipment tracked with depreciation schedules.
Owner & Partner Compensation
Owner draws, salaries and partner compensation accounted for consistently.
Business Tax Preparation
Practice returns prepared from the same records maintained during the year.
Owner Return Coordination
Individual returns coordinated with the practice's results and distributions.
S-Corporation & Entity Planning
Entity structure, reasonable compensation and distribution planning.
Quarterly Tax Projections
Estimated payments calculated from actual results rather than last year's return.
Retirement-Plan Coordination
Contribution planning coordinated with payroll and the plan's advisors.
Acquisition & Expansion Analysis
Financial analysis behind adding a provider, a location or acquiring a practice.
Practices comparing payroll providers can review our payroll services, and owner-operated practices often start with small business accounting.
Financial Access Handled with Appropriate Controls
Practice financial data moves through secure document exchange rather than email attachments, and system access is granted by role — each team member receives only the access their part of the engagement requires.
We also apply data minimization: we request the financial information needed for accounting, payroll and tax work, and no more.
Access levels and any additional agreements are evaluated based on the specific systems and information involved in the engagement.
What we typically need
- Bank and merchant statements
- Payroll registers and employee census
- Collections and deposit summaries from billing systems
- Vendor invoices and equipment or lease agreements
- Entity, ownership and prior tax filings
Financial Reporting That Supports Better Practice Decisions
Revenue and collections trends
Payroll and benefits
Provider and staffing costs
Occupancy and location expenses
Equipment expenses
Operating overhead
Cash flow
Owner compensation
Tax reserves
Location-level profitability
Provider-level or location-level reporting depends on the quality and structure of the practice's source data. Where attribution is incomplete, we identify what needs to change before that reporting can be relied on.
How Engagements Begin
Practice assessment
Review the entities, locations, payroll, accounting records, reporting needs and existing systems.
Cleanup or conversion
Reconcile the books, organize the chart of accounts and establish consistent payroll and reporting workflows.
Ongoing financial management
Maintain the accounting, payroll, financial statements and cash-flow visibility throughout the year.
Tax coordination
Coordinate practice tax returns, owner returns, quarterly projections and tax-planning opportunities.
Healthcare Practice Accounting Questions
What size healthcare practice does ESBS serve?
The service is built for independent practices with roughly $500,000 to $5 million in annual revenue, one to five locations and about 3 to 50 employees. These are practices that have outgrown basic bookkeeping and want accounting, payroll and tax handled by one firm.
Do you provide accounting for dental practices?
Yes. Dental and orthodontic practices are among the practice types we support, including lab and supply cost tracking, associate and hygienist payroll, equipment financing and owner compensation planning. Requirements differ by practice type, so the chart of accounts and reporting are set up for how your practice actually operates.
Can you support a multi-location medical or therapy practice?
Yes. Where the source data supports it, we report revenue, payroll, occupancy and overhead by location so owners can compare sites and see which locations carry the practice's profitability.
Can ESBS manage our payroll?
Yes. We administer provider and staff payroll, handle payroll tax filings and year-end forms, and manage conversions from an existing payroll provider. Details are on our payroll services page.
Do you provide medical billing?
No. ESBS does not provide medical coding, insurance-claim submission, denial management or patient-collection services. We reconcile the deposits, collections and financial activity reported by your billing systems.
Can you report profitability by location?
In most cases, yes. Location-level and provider-level reporting depends on how cleanly revenue, payroll and expenses can be attributed in the practice's source systems. Where that attribution is incomplete, we identify what would need to change before the reporting is reliable.
Do you prepare both the practice and owner tax returns?
Yes. Preparing the practice return and the owners' individual returns from one set of records keeps compensation, distributions and estimated payments consistent, and makes planning during the year possible rather than retrospective.
How does ESBS handle sensitive information?
We use secure document exchange, role-based access to systems and data-minimization practices — meaning we request only the financial information required for the engagement. Access levels and any additional agreements are evaluated based on the specific systems and information involved.
Do you work with practices in NYC and New Jersey?
Yes. Evening Star has served clients since 1985 and works with practices across New York and New Jersey, including New York City, Long Island, the Hudson Valley, the Capital Region and northern New Jersey, with remote service where appropriate.
Related Services
The capability pages behind this work.
This page describes the industry. The pages below explain how the underlying accounting, payroll and tax work is performed.
Payroll Services
Provider and staff payroll, payroll tax filings and conversions from an existing provider.
Explore PayrollSmall Business Accounting
Monthly bookkeeping, reconciliations and financial statements for owner-operated practices.
Explore AccountingS Corporation Tax
Entity structure, reasonable compensation and distribution planning for practice owners.
Explore S CorporationsTax Planning & Advisory
Quarterly projections, retirement contributions and year-end planning for practice owners.
Explore Tax Planning
Your Practice Needs More Than Year-End Tax Preparation
Build a coordinated accounting, payroll and tax system that gives you visibility throughout the year.