Books, payroll, and reporting for dental practices, built around collection ratios, hygiene department margin, and the real cost of running each operatory.
Dental economics do not look like general medical economics. You carry a large fixed investment in chairs, imaging, and build-out. A meaningful slice of your revenue is elective and cash-pay. Your hygiene department can be a profit center or a break-even babysitter depending on scheduling. And production written on the schedule is a long way from money in the account.
We build the reporting that separates those things. Production, adjustments, and collections tracked as three distinct numbers. Hygiene tracked as its own department with its own revenue and its own cost. Supplies and lab measured as a percentage of production so a creeping vendor increase gets caught. We work with practices in Lexington, out through Georgetown, Nicholasville, and Versailles, on site or remote, and keeps the monthly close on a schedule you can count on.
Three numbers, and most practices only watch one. Production is what you scheduled and performed at full fee. Adjustments are what insurance contracts, courtesy discounts, and write-offs take back. Collections are what actually arrived. The collection ratio between production and deposits is the single fastest read on whether your front desk and your insurance follow-up are working. We track all three monthly, split collections between insurance and patient responsibility, and age the patient balances so a growing pile of small unpaid amounts gets addressed while it is still collectible. Cash-pay and membership plan revenue stay separate, because the economics are different.
Hygiene is where a lot of practices lose money without knowing it. Assign the hygienist's wages, the assistant time, the supplies, and a fair share of the operatory cost against hygiene production and you get a real answer about whether that department pays for itself. Some do very well. Some run at a loss and survive only because they feed restorative cases to the doctor, which is a legitimate reason but should be a decision, not an accident. We set up departmental reporting so hygiene, restorative, and any specialty work each carry their own revenue and cost, and you can see which chair hours are worth the most.
Dental payroll has its own shape. Hygienists often paid hourly with production bonuses. Assistants and front office hourly. An associate on a percentage of production or collections, which needs to be calculated from numbers everyone agrees on. Sometimes a doctor-owner taking a salary plus distributions. We run payroll through ADP, Paychex, Paycor, Gusto, RUN Powered by ADP, or QuickBooks Payroll, keep the payroll tax filings current, and calculate associate compensation off the same production and collection data the reporting uses, so nobody is arguing about the basis at the end of the month.
A scanner, a mill, a cone beam, a full operatory build-out. These are six-figure decisions made a few times a decade, often on a financing pitch rather than on your own numbers. We model the payment against the incremental production the equipment realistically supports, factor in the collection lag, and show what it does to monthly cash. Same approach applies to adding an operatory or bringing on an associate. Budget versus actual runs every month so the assumptions get checked against reality, and a rolling forecast keeps the debt service visible next to payroll and lab.
The accounting lives in QuickBooks Online, QuickBooks Desktop, Xero, Sage, or NetSuite. Practice management systems produce production and collection reports that we reconcile against actual deposits. That reconciliation is where discrepancies show up, and it is worth doing monthly rather than hoping the two systems agree.
We report on them so you can act. Adjustments get tracked by payer, so you can see what each plan really pays against your fee schedule and how that has moved. Deciding whether to stay in a network is a business decision, and this is the data behind it. We do not advise on billing codes or clinical matters.
No on both. Baum's Accounting Services is not a CPA firm and does not prepare income tax returns. The work is bookkeeping, payroll and payroll tax filings, sales tax compliance, monthly reporting, and fractional controller or CFO advisory. Income tax filing goes to an outside CPA, and we hand them books that are already clean.
Other work in this area that tends to come up in the same conversation.
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Read moreBook a consultation. You will leave the call knowing what shape your numbers are in.
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