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Healthcare · Dental & Vision

Ophthalmology Practice Accounting & Bookkeeping

Fairlight CPA does the bookkeeping, payroll, and tax for ophthalmology practices — surgical specialties whose economics run through cataract volume, premium lens conversions, and buy-and-bill drug programs. We keep the clinic, surgical, and drug lanes each honestly reported.

✓ Books closed by the 15th   ✓ Fixed monthly fees   ✓ CPA-led team

The problems

The numbers problems ophthalmology practices actually have

Buy-and-bill drugs are six-figure float

Anti-VEGF injectables are bought up front and reimbursed later at tight spreads. Inventory, reimbursement matching, and payer-mix drift here can swing real money monthly.

Premium lens upgrades are the margin engine

Refractive and premium IOL upgrades are patient-pay revenue on top of insured surgery — conversion rate and collected upgrades deserve their own reporting.

Surgical, clinic, and optical mix three businesses

OR days, clinic days, and any optical dispensary have different margins and staffing; one blended P&L can't guide where to add capacity.

ASC ownership complicates the picture

Facility-fee interests, distributions, and allocations from an ASC stake need to be kept distinct from professional-fee economics.

What we handle

What Fairlight takes off your plate

The core engagement is the same discipline we run for every client — monthly close by the 15th, payroll, tax, and CFO-level reporting — built around how ophthalmology practices actually make and spend money.

  • Drug inventory and buy-and-bill reconciliation — purchases, doses, and reimbursements matched
  • Premium lens and refractive upgrade revenue tracked with conversion reporting
  • Surgical, clinic, and optical lanes closed monthly by the 15th
  • Payroll for physicians, techs, and optical staff
  • Business and personal tax prep including ASC distribution handling
What we report on

The three numbers we keep in front of you

No fabricated benchmarks — your own numbers, measured the same way every month, so trends are real and decisions have a floor under them.

Drug spread realized

reimbursement against acquisition per dose — the buy-and-bill scoreboard

Premium conversion rate

insured surgeries upgrading to premium lenses, and dollars collected

Revenue per OR day

surgical throughput valued against its block time

How it works in practice

Revenue cycle & tax notes

Revenue & reconciliation

We reconcile professional fees, patient-pay upgrades, and drug reimbursements each in their own lane, with drug claims matched dose-level — underpayment there is too expensive to miss.

Tax & entity

Drug inventory, equipment cycles (lasers, OCT), and ASC K-1s interact into a genuinely complex return; we run it as one coordinated picture with quarterly estimates that keep up.

Pricing

Simple, published pricing

Bookkeeping from $310/mo · All-In-One (books + tax + advisory) from $800/mo. Every fee is quoted and fixed in writing before any work begins.

Common questions

Ophthalmology accounting FAQs

How closely do you track injectable drugs?

Dose-level: purchases in, doses administered, reimbursements matched. The spread is thin enough that payer drift or a missed claim shows up as real money, so it's watched monthly.

We hold an ASC interest — can you handle that?

Yes — distributions and K-1s from the facility side get incorporated into your tax picture while staying separate from practice operations, so each entity's economics stay legible.

What does it cost?

Bookkeeping from $310/month; All-In-One (books + tax + advisory) from $800/month. Exact fee fixed in writing after a short call.

Get the financial side handled

A free 15-minute call — bring your current setup, leave knowing exactly what clean, specialty-aware books look like for ophthalmology practices.

The content on this page is for informational purposes only and does not constitute professional tax advice. Accounting and tax considerations for healthcare practices depend on individual facts and circumstances and are subject to change. See our full legal disclaimer.