Accounting, tax planning, and CFO support for practices
Accounting and tax for medical, dental, and specialty practices.
Ashmore Books works with physician-owned, dentist-owned, and specialty practices: monthly financials delivered on time, tax planning that fits a high-margin practice, guidance on the tax treatment of equipment purchases before you buy, and CFO-level reporting on production, collections, and overhead. Tax returns are prepared by the same Enrolled Agent-led team that keeps the books.
Why practices work with Ashmore
High margins, big equipment decisions, and no time to chase the numbers.
Financials on time, every month
Practice owners are busy seeing patients. Monthly financials arrive by the 20th of the following month when records and responses are received timely, with the Balance Sheet reviewed, not just the P&L.
Tax planning that matches a high-margin business
When margins are strong, planning is where the money is: entity structure, owner compensation, retirement plan design, and timing of income and purchases, decided during the year rather than discovered in April.
Equipment purchases planned before the invoice
Chairs, imaging, CBCT, lasers, sterilization, surgical and diagnostic equipment. We model the tax treatment, financing, and cash effect before the purchase so the decision is made with the full picture.
CFO reporting for the practice
Production versus collections, overhead percentage, payroll as a share of revenue, per-provider profitability, and a cash forecast, reviewed monthly so the practice is managed, not just recorded.
What is included
One team for the books, the planning, and the return.
01
Monthly accounting and close
Bank, credit-card, loan, and merchant reconciliations; payroll reconciled to filings; practice management deposits tied to the bank; reviewed financials delivered monthly.
02
Equipment and capital planning
Before a purchase: Section 179 and depreciation options, lease versus buy, financing and cash impact, and the timing that fits the year. After: fixed assets recorded correctly and depreciation tracked.
03
Tax planning
Quarterly projections, S-Corp reasonable compensation, retirement plan funding (401(k), cash balance, and defined benefit considerations), income timing, and multi-entity coordination where real estate or a management company is involved.
04
Tax preparation
Forms 1120-S, 1065, 1120, and the owners’ 1040s, prepared from reconciled books, with the planning decisions carried into the filed return.
05
CFO services
Management financials with commentary, overhead and per-provider analysis, budget versus actual, 13-week cash forecast, and a monthly review call.
06
Practice acquisition and expansion
Financial due diligence on a practice you are buying, purchase price allocation, financing structure, and the entity setup for a second location.
07
Real estate and management entities
Rent between the practice and an owner-held building entity, management company arrangements, and intercompany balances kept clean and tax-consistent.
08
Cleanup and catch-up
If the practice manager or a prior bookkeeper left the books behind or unreconciled, we rebuild from bank, payroll, loan, and practice management records first.
Equipment and tax
A large purchase is a tax decision as much as a clinical one.
Equipment can often be expensed in the year it is placed in service under Section 179 or bonus depreciation rules, or depreciated over time, and the choice affects this year’s tax, next year’s, and the cash needed at closing. Financing terms, whether the practice or an owner entity buys it, and the timing within the year all matter. Practices that ask before buying keep those options open.
- Expense now versus depreciate over time, modeled
- Lease versus purchase comparison
- Financing and cash-flow effect over the loan term
- Which entity should hold the asset
- Timing to fit the tax year and estimated payments
- Fixed asset schedule maintained for the return
Systems we work with
Built around how practices already run.
QuickBooks Online or Xero for the books, with deposits tied to practice management and clearinghouse reports (Dentrix, Eaglesoft, Open Dental, eClinicalWorks, Athena, and others), payroll from Gusto, ADP, or Paychex, and merchant, financing, and patient-financing statements reconciled monthly.
- QuickBooks Online
- Xero
- Dentrix, Eaglesoft, Open Dental
- eClinicalWorks, Athena
- Gusto, ADP, Paychex
- CareCredit and patient financing
Pricing
Fixed monthly fee, scoped to the practice.
Practice engagements are priced as a fixed monthly fee based on the number of entities and locations, providers, transaction and payroll volume, and the level of CFO support. Tax planning is a fixed-fee engagement, tax preparation is quoted upfront by entity, and any cleanup is quoted as a fixed project after a free Books X-Ray. You approve the scope and pricing before work begins. See how pricing works and CFO Services.
FAQ
Common questions
General information for practice owners, not tax advice for your situation.
Can I deduct dental or medical equipment in the year I buy it?
Often yes. Qualifying equipment placed in service during the year can frequently be expensed under Section 179 or bonus depreciation rules rather than depreciated over several years, subject to limits and your practice’s taxable income. The right choice depends on this year’s and next year’s picture, which is why we model it before the purchase.
When will I get my monthly financials?
Our target is the 20th of the following month, provided bank access, statements, payroll reports, and answers to open questions are received timely.
Should my practice be an S-Corporation?
Many practices benefit from S-Corp treatment because of the split between reasonable salary and distributions, but the answer depends on profit level, state rules, retirement plan goals, and how the practice and any building entity are structured. We review it as part of tax planning.
What does CFO support look like for a practice?
Monthly management financials with commentary, overhead percentage, collections versus production, payroll as a share of revenue, per-provider profitability, a cash forecast, and a monthly review call focused on decisions such as hiring an associate, adding a location, or buying equipment.
Do you handle the building entity and rent between my entities?
Yes. Rent between the practice and an owner-held real estate entity, management company fees, and intercompany balances are recorded and reconciled so both entities and both returns stay consistent.
My practice manager has been doing the books. Can you take over mid-year?
Yes. We review the current file through a free Books X-Ray, quote any cleanup as a fixed project, and then move to the monthly rhythm without disrupting the practice.
Tell us about the practice and what is coming up.
Share the entity type, number of providers and locations, your practice management and payroll systems, and any equipment purchase or expansion on the horizon. You will hear back within one business day.