How we think about medical and dental clinics
A clinic usually runs two kinds of economics under one roof. There's the practice itself, which holds the lease, the staff and the equipment. Then there are the professionals who see patients there, often through corporations of their own, and who are paid a share of what they bill or collect.
Coquitlam's clinics tend to cluster where people already go: around Coquitlam Centre and the City Centre towers, along Austin Avenue in Austin Heights, and in the newer buildings near Burquitlam station. Family practices, dental offices, physiotherapy and allied health often share a building, sometimes a front desk.
The money arrives from several directions at once: the provincial plan, private insurers, federal programs and patients at the counter. Our job is to make each stream add up on its own, then show the owner what the clinic actually earned.
What makes the books different
- Each payer has its own reconciliation. MSP pays physicians twice a month, with remittance details available through Teleplan (gov.bc.ca payment schedule). Dental offices that see Canadian Dental Care Plan patients bill Sun Life directly (canada.ca CDCP provider information). We match every deposit to its remittance or explanation of benefits, and keep a running list of refused or adjusted claims so nothing is written off by accident.
- Associate pay is checked against production. Associates are typically paid a percentage of what they produce or collect, less whatever their agreement deducts. We tie each payment to the practice-management report and the agreement terms, so a mis-keyed percentage is caught in the month it happens.
- Most patient revenue is GST-exempt, and that cuts both ways. CRA lists most health, medical and dental services provided by licensed physicians or dentists for medical reasons as exempt, and GST paid on costs for exempt supplies generally can't be recovered (CRA, type of supply). Procedures done for cosmetic rather than medical or reconstructive purposes fall outside the exemption (CRA P-256). Revenue is coded by type so your CPA can confirm which is which.
- Professional corporations get their own books. Physicians and dentists in BC can practise through a health profession corporation that holds a permit from their college (CPSBC). Fees between that corporation and the clinic company are recorded on both sides and reconciled every month.
What a monthly close looks like for you
- MSP remittances, insurer deposits and card batches are matched to the day-end and remittance reports from your practice-management or EMR system.
- Refused and adjusted claims are listed with their explanatory codes for the front desk to follow up.
- Associate payments are recalculated from the production or collections report and compared with what was paid.
- Payroll for hygienists, assistants, MOAs and reception runs through our payroll management service, with source deductions remitted on time.
- By the 10th you receive the clinic's statements, results by provider, and a separate set for each professional corporation we look after.
For more detail, read our notes on bookkeeping for Tri-Cities dental and medical clinics. The routine itself sits within monthly bookkeeping.
Tools we commonly use for clinic clients
- QuickBooks Online or Xero, with a class or tracking category for each provider, and a separate file for each corporation.
- Reports from your practice-management or EMR system: day sheets, production by provider, and accounts receivable by payer. We reconcile to them rather than re-entering patient-level detail, and we never need clinical records.
- Dext for supplier and lab invoices, and Plooto for approving and paying them.
- Wagepoint for payroll, including vacation pay and statutory holiday pay.
Partners we work with
We name partners by type only:
- CPA firms that prepare year-end work for health profession corporations and clinic companies
- Practice-management consultants who advise on fee schedules, scheduling and staffing
- Lawyers who draft associate and cost-sharing agreements
- Equipment lenders and leasing companies, when financing statements need reconciling
When a clinic opens a second site or the owner wants budgets and provider-level margins, our fractional controller service takes over the reporting layer.
A good fit if
- You own or manage a medical, dental, physio or allied health clinic in Coquitlam or nearby
- You pay associates from production or collections and want those payments to tie out each month
- You practise through your own professional corporation and want its books kept apart from the clinic's