Practice accounting that reconciles collections against what you billed

Can you show revenue and cost per provider?

Yes. Rationale Services reports revenue, direct cost and contribution per provider where your practice management system carries the detail. Each provider's collections are set against their compensation and the direct cost of supporting them, so you can see what each one contributes rather than only the practice total.

This is the number behind most partnership and compensation conversations, and it is usually argued without evidence. Once it is reported consistently, those discussions start from a shared figure. It also shows where capacity is going unused, which is often more valuable than the comparison between providers. Allocating shared cost needs a basis you agree with us, applied the same way every period.

Why is there such a long gap between treating a patient and being paid?

Rationale Services reports the lag explicitly: what has been billed and not yet collected, how long each balance has been outstanding, and how that is trending. The practice's cash position is reported alongside it, so you can see the working capital the gap is consuming.

The gap itself is a feature of how practices get paid, but its size is not fixed. Aged balances grouped by payer and by age show where the delay is concentrated and whether it is getting worse. That turns a general sense that collections are slow into a specific list. We keep the monthly reporting steady so improvements, or a new problem with one payer, show up as a change in the numbers.

Can you handle several locations or more than one entity?

Yes. Rationale Services reports each location or entity on its own and then consolidated, on identical definitions. Where a management entity sits above the practices, transactions between them are recorded consistently so the consolidated picture holds together and each entity's own figures remain usable.

Practices grow by adding sites and entities faster than their bookkeeping is redesigned, and the result is records that answer neither question well. We set up the structure once: a clean chart of accounts repeated across entities, shared costs allocated on an agreed basis, and intercompany entries handled the same way every period.

Can you run payroll across clinical and administrative staff?

Yes. Rationale Services runs payroll for practices with mixed staff: salaried providers, hourly clinical staff, administrators, part-time cover and bonus or production-based pay. We process the run and post the cost so provider compensation and support staff cost can be reported separately.

Practice payroll is complicated less by volume than by variety. Production-based compensation, several locations, staff who cover more than one role and benefit arrangements all have to be handled consistently and documented. We build the calculation around your actual arrangements, write it down, and keep it unchanged, so each run can be checked against the one before it. Payroll covers the run itself.

What do you need from our practice management system?

Rationale Services works from the reports your system already produces: charge and payment detail, remittance summaries, aged balances and payroll hours. We also need your bank feeds and your current books. We do not need access to clinical records, and we do not ask for them.

We only want the financial data, at the level of detail needed to reconcile and report. If your system can export charges, adjustments and payments by provider and by payer, that is enough to build everything described on this page. Where it cannot, we will tell you what the reporting will and will not be able to show before you commit to anything.

What does accounting for a practice cost?

It depends on the number of providers and locations, whether payroll is in scope, how much reconciliation your current records need, and how detailed you want provider-level reporting to be. Rationale Services scopes that in conversation rather than from a list. See how we work.