Physician Group & MSO Accounting
Fairlight Accounting handles the books, consolidation, and tax for physician groups and MSO structures — multi-entity organizations where management fees, shared services, and provider comp models all have to reconcile across company lines. We keep every entity, and the structure between them, clean.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ cross-border tax team
The numbers problems physician groups and MSOs actually have
Intercompany flows must actually reconcile
Management fees, shared-service charges, and leases between the MSO and practices have to eliminate cleanly in consolidation — and be defensible individually.
Provider comp models multiply
Base-plus-production, pooled models, and shareholder tracks across a group demand collections attribution and transparent calculation every period.
Location P&Ls decide capital allocation
Which office earns and which coasts is unanswerable on consolidated-only books; location-level closes are the management tool.
Diligence readiness is a standing requirement
Groups in acquisition conversations — either side — need monthly books that survive quality-of-earnings scrutiny without a cleanup project.
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 physician groups and MSOs actually make and spend money.
- Multi-entity bookkeeping with intercompany reconciliation and elimination
- Management-fee and shared-service accounting consistent with your agreements
- Provider comp calculation support across models
- Monthly close by the 15th with location- and entity-level P&Ls
- Partnership/corporate returns, K-1s, and owner-level tax coordination
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.
Location contribution
each site's margin after allocated shared services
Intercompany balance status
what's owed across entities — reconciled monthly, not annually
Comp ratio by provider
compensation against attributed collections across the group
Revenue cycle & tax notes
Revenue & reconciliation
Each practice entity's remittances reconcile in their own lane while the MSO's fee revenue reconciles against them — the whole structure ties, monthly, or we find out why.
Tax & entity
Multi-entity structures live and die on consistent execution: fee agreements followed, eliminations documented, K-1s coordinated across owners; we run that discipline as routine.
Simple, published pricing
Bookkeeping from $310/mo · All-In-One (books + tax + advisory) from $1,955/mo. Every fee is quoted and fixed in writing before any work begins.
Groups & MSOs accounting FAQs
Our MSO agreements exist — but do the books follow them?
That's the audit we start with: whether actual money movement matches the agreements. Aligning the two protects both the structure's purpose and everyone's tax position.
Can you handle a group heading toward a sale?
Yes — monthly closes built to quality-of-earnings standards, add-back documentation as it happens, and clean entity separation are exactly what diligence rewards.
What does it cost?
Bookkeeping from $310/month per entity as a starting anchor; multi-entity engagements are quoted in writing after a short call, per our published pricing approach.
Related healthcare specialties
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 physician groups and MSOs.
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.