Insurance AR aging, production-vs-collections analysis, provider compensation models, practice management software integration, and the Stark Law-aware structures that protect your practice — delivered by an accounting team that speaks the language of healthcare. For medical practices, dental practices, and specialty providers across the Houston Metroplex.
From solo primary care offices to multi-provider specialty groups and ambulatory surgery centers. Insurance-driven revenue cycles, provider productivity models, multi-payer contract management, and the regulatory awareness that protects practices in an environment where compliance mistakes are expensive.
From solo general practices to multi-doctor specialty groups (ortho, perio, oral surgery, endo, pedo) and DSO-affiliated practices. Different payer mix than medical (more cash, more PPO, less Medicare), but the same fundamental accounting challenges around production vs. collections, provider compensation, and insurance receivables.
Chiropractic, physical therapy, optometry, audiology, behavioral health, veterinary, and other healthcare-adjacent practices. Each has its own payer dynamics, regulatory environment, and operational rhythm — but shares the core challenges of insurance billing, provider productivity, and the gap between what was produced and what was collected.
You're producing more procedures, more visits, more revenue on paper. But your bank account doesn't reflect it. The gap between production and collections is wider than ever, and nobody has explained why.
Claims sitting at 90, 120, 180+ days. Denials nobody appealed. Patient balances that should have been collected six months ago. Your practice management system shows the data but nobody's actually working it.
Production-based, collections-based, salary plus bonus, equal partnership — every healthcare practice eventually has a compensation conversation that needs real data. Without clean reporting per provider, the discussion is opinion against opinion.
Healthcare practice accounting has one foundational concept that separates practices that make money from practices that don't: the gap between production and collections. Production is the dollar value of services performed at full fee schedule. Collections is the actual cash received after insurance write-offs, contractual adjustments, denied claims, and patient bad debt.
Most practice owners focus on production because their practice management system reports it prominently. The dental EOD shows "today's production: $14,500" and the practice owner feels good. But production is theoretical revenue. Collections is real money. The collections percentage — what you actually keep out of what you produce — is the number that determines whether your practice is healthy.
The power of the production-to-collections waterfall is that each step is a different operational lever:
Each of these problems has a different solution. But you can't solve any of them without first being able to see the waterfall — and that's accounting work, not clinical work.
Beyond production and collections, healthcare practices have a stack of operational KPIs that signal whether the business is healthy. These aren't accounting metrics in the strict sense — they're operational metrics that the accounting needs to support and report. Practice owners who track these monthly are dramatically better at running their businesses than ones who don't.
These targets are general guidelines — every specialty has its own benchmarks and every practice has its own circumstances. What matters is having the numbers in front of you every month so you can spot the trend lines before they become problems.
Medical practice accounting is shaped by one operational reality: the revenue cycle. Patient sees provider. Provider documents the visit and codes the encounter. Coder reviews and submits to insurance. Insurance processes, pays a portion, denies a portion, sends an EOB. Patient gets billed for residual. Patient pays or doesn't. The whole cycle takes 30 to 180 days depending on payer mix and operational discipline, and at every step, money can leak.
Specialty practices (cardiology, orthopedics, GI, dermatology, ophthalmology, OB/GYN, urology) and surgery centers have additional accounting complexity around facility fees, ASC ownership distributions, physician compensation tied to ASC ownership, and the more aggressive scrutiny that comes with higher-revenue specialty operations.
If your practice owns an ASC or holds an equity position in one, the accounting needs to handle both your practice's W-2 income from the ASC and your distributions as an owner — properly categorized so your tax CPA can apply the correct treatment.
Dental practice accounting shares the production-vs-collections discipline of medical practices but operates with a different payer mix and a different revenue model. Most dental practices have a much higher percentage of patient out-of-pocket payment (often 30-50% vs. 10-20% in medical) and a much lower Medicare/Medicaid component. PPO insurance plans are the dominant third-party payer, and the negotiated rate vs. full fee schedule discount is the largest single adjustment on the books.
Standard finding when we take over a dental practice: hygiene production looks healthy, but when we allocate hygienist salaries, supplies, and a fair share of overhead, the hygiene department is actually breaking even or losing money. The fix is rarely dramatic — usually a combination of fee schedule updates, hygienist productivity adjustments, and additional services (fluoride, sealants, periodontal therapy) that improve hygiene margin without changing the patient experience. The first step is knowing the number exists.
Healthcare practices operate under two federal laws that most accounting firms have never heard of: Stark Law (the Physician Self-Referral Law, 42 USC §1395nn) and the Anti-Kickback Statute (42 USC §1320a-7b). Together they govern how money can flow between providers, between providers and entities they own, and between healthcare entities that refer patients to each other.
We are not healthcare attorneys. We don't provide legal opinions on Stark or AKS compliance. But we structure financial transactions, provider compensation calculations, and intercompany activity with awareness of how these laws affect what's allowed and how transactions need to be documented.
Healthcare compliance is a legal specialty, and your healthcare attorney is the one making compliance determinations. What we do is structure the accounting to support those determinations — clean financial separation between entities, fair market value documentation in transactions, and the audit-ready records that protect the practice if questions ever come up. If you don't have a healthcare attorney, we can refer you to several we trust in the Houston market.
Healthcare providers outside traditional medical and dental practice still operate under the production-vs-collections dynamic, but with their own variations in payer mix, regulatory environment, and operational rhythm. We work with several allied health categories and adapt the accounting to each one's specifics.
Regardless of the specific specialty, the foundational disciplines of healthcare accounting are the same: production tracked, collections reconciled, insurance AR aged and worked, provider productivity measured, and the operational KPIs reported monthly so the owner-operators can run their practices on data instead of instinct.
30-minute discovery call. Bring us your last three months of production and collections reports from your PM system. We'll walk through your waterfall during the call and tell you where the leakage is.
Book a Discovery Call →Whether you're running a solo dental practice or a multi-location specialty medical group, every Anchor Point healthcare engagement includes the same operational foundation — plus the healthcare-specific deliverables your practice actually needs to manage the business side of medicine.
Monthly waterfall showing the journey from production through write-offs, denials, and bad debt to actual cash collected. The number every practice owner needs.
Every major payer in your mix tracked separately. 0-30, 31-60, 61-90, 91-120, 120+ days. Denial patterns surfaced for billing team action.
Production and collections per provider per period. Compensation calculations matched to your model — production, collections, RVU, or partnership distributions.
Collections rate, AR days, overhead percentage, hygiene production (dental), and the operational metrics that signal whether the practice is healthy.
Per-location and per-provider P&L. Shared overhead allocated rationally. Ancillary service lines tracked as their own profit centers.
Full financial package — P&L, balance sheet, cash flow — by the 15th of the following month, every month, with plain-English commentary.
Provider compensation, intercompany leases, MSO arrangements, and ASC distributions structured and documented with Stark and AKS considerations in mind.
Quarterly or monthly conversations about practice growth, fee schedule analysis, payer contract negotiation, banking strategy, and exit planning.
Most healthcare practice owners reach two specific financial events in their career: financing (acquiring a practice, buying a building, equipment financing, working capital lines) and eventual exit (selling to a partner, selling to a DSO or PE group, or transitioning to retirement). Both events depend on financial records that hold up to outside scrutiny.
Curtis is one of our two principals and came up through corporate banking and lending before joining Anchor Point. He works directly with healthcare practice clients on:
Production is the total dollar value of services performed at full fee schedule. Collections is the actual cash received. The gap between production and collections — driven by insurance write-offs, contractual adjustments, patient bad debt, and timing of insurance payments — is one of the most important metrics in healthcare practice management. Practices that focus only on production miss the fact that collections is what actually pays the bills. We track both monthly and produce the collections percentage (typically 60-85% depending on payer mix) that tells practice owners how efficiently their billing is actually working.
Insurance receivables in healthcare practices are different from typical commercial AR. Claims age in 60-90+ day cycles. Insurance companies pay at contracted rates, not billed rates. Denials and underpayments require appeals. Patient responsibility balances need to be tracked separately. We work with the major practice management systems to reconcile insurance AR monthly, age receivables by payer, identify denial patterns, and produce the AR aging reports that practice administrators need to manage cash flow.
Yes. Practice management systems handle clinical and billing operations while QuickBooks (or another accounting system) handles the financial side. The data flow between them rarely works automatically — most practices end up with two systems that don't reconcile. We work with Dentrix, Open Dental, Eaglesoft, Curve Dental, Athena Health, AdvancedMD, NextGen, eClinicalWorks, and other major PM systems to bridge the data flow correctly so production, collections, and operating expenses all reconcile monthly.
Healthcare provider compensation can be complex — salary, salary plus production bonus, percentage of collections, RVU-based, work-RVU-based, employed vs. owner-partner distributions, and capital account tracking for partnership structures. We handle each model, with monthly compensation calculations, productivity reporting, and the partnership-level tracking that supports clean year-end tax returns and provider compensation reviews.
Yes. While we're not healthcare attorneys, we structure financial transactions and provider compensation calculations with Stark Law and Anti-Kickback Statute considerations in mind. Issues like fair market value documentation for provider compensation, proper handling of physician referral arrangements, MSO/management company fee structures, and lease arrangements between physicians and ancillary entities all have accounting implications that connect to regulatory compliance. We coordinate with your healthcare attorney where appropriate.
Yes. Healthcare practice sales — to DSOs, PE groups, hospital systems, or partner buyouts — typically include intensive financial due diligence (Quality of Earnings analysis) that rebuilds 3-5 years of financials from scratch. Sloppy books cost real money at sale. We work with practice owners 2-5 years out from a planned sale to clean up historical financials, tighten monthly close, and present the numbers in the format buyers expect. The same applies in reverse for practice acquisitions — we assemble the financial package for the bank or SBA lender.
Monthly engagements for healthcare and dental practices at Anchor Point typically range from $3,500 to $9,000 depending on practice size, number of providers, multi-location complexity, and how much CFO-level guidance is involved. Solo practitioners and small dental offices typically land at the lower end. Multi-provider practices, surgery centers, and specialty groups with multiple locations run higher. All engagements are fixed-fee with no hourly billing.
Whether you're running a solo dental practice or a multi-provider medical group, 30 minutes with us will tell you whether your collections rate, AR aging, and provider productivity are where they should be. Bring your PM system reports and we'll walk through them on the call.