Primary Care Practice Bookkeeping & Accounting
Fairlight CPA does the bookkeeping, payroll, and tax for primary care and family medicine practices — thin-margin, high-volume businesses where payer mix and staffing ratios decide everything. We keep per-visit economics and payer performance visible every month.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ CPA-led team
The numbers problems primary care practices actually have
Thin margins leave no room for blur
Primary care nets single-digit margins in bad years. A few percent of missed charges or unworked denials is the difference between profit and loss.
Capitation and FFS don't add the same way
Per-member-per-month payments, quality bonuses, and fee-for-service visits are different revenue species. Books that sum them into one line can't guide panel decisions.
Staffing ratios drift upward
Front desk, MAs, and nursing creep faster than visit volume. Support-cost-per-visit is the discipline number most practices never see.
Value-based bonuses arrive late and opaque
Quality and shared-savings payments land quarters later with cryptic reconciliation. They need their own accrual lane, not surprise-income treatment.
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 primary care practices actually make and spend money.
- Payer-mix revenue reporting — FFS, capitation/PMPM, and quality payments tracked separately
- EOB and remittance reconciliation with your billing team
- Monthly close by the 15th with per-visit and per-provider economics
- Payroll for providers and support staff with ratio reporting
- Business and personal tax prep, quarterly estimates, and CFO reporting for panel and hiring decisions
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.
Net revenue per visit
by payer, so contract renewals negotiate from data
Support cost per visit
staff cost against volume — the staffing-creep alarm
Panel revenue per provider
capitation plus FFS per clinician, the growth-planning number
Revenue cycle & tax notes
Revenue & reconciliation
We reconcile ERAs, capitation rosters, and patient payments to the encounter volume monthly, and accrue value-based payments when earned rather than when they surprise the bank account.
Tax & entity
Practice owners juggling W-2 medical directorships alongside practice K-1 income have estimate and retirement-plan interactions worth planning; we handle both sides together.
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.
Primary Care accounting FAQs
We're in a value-based contract — do books change?
Yes: PMPM revenue, attribution counts, and bonus accruals get their own lanes, so you can see whether the contract outperforms straight fee-for-service before renewal.
Can you benchmark our overhead?
We report your support-cost-per-visit and overhead percentage monthly and trend them — your own history is the most honest benchmark, and it responds fast to staffing changes.
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.
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 primary care 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.