Multi-practitioner clinics run on Jane. Their books run on QuickBooks or Xero. The gap between the two is where deposits stop matching, practitioner pay gets fuzzy, and year-end becomes a mess. Closing that gap is the only thing this practice does.
These are the five things clinic owners tell us they've given up trying to fix. They're all fixable.
Jane Payments batches split across days, fees come out in lumps, and the bank never ties to the Sales Report on the first try.
Percentage-of-collected splits, cross-period payments, and a Compensation Report that puts collections in odd periods. Paying a practitioner wrong is the error that hurts most.
Jane counts a 10-pack as revenue the day it sells. Your accountant (and the tax office) see a liability until the visits happen. Most clinic books never record it.
Billed and collected are different numbers on different days, insurer remittances land in lumps, and write-offs hide in the gap.
Some services are exempt, others taxable, and retail is taxable again. Multi-discipline clinics carry mixed supplies, and most books treat everything the same.
Twelve months of CSVs handed to an accountant in March is not a close. A monthly rhythm with numbers you trust is.
We pull your Jane reports and your ledger, reconcile one recent month, and hand you a written findings memo: what's tying, what isn't, what it's costing you, and exactly what to fix. Useful on its own even if we never speak again.
We build your clinic's close system: chart of accounts by discipline and location, Jane Payments clearing workflow, practitioner comp process, package and gift card liability schedules, insurance A/R policy, and tax mapping. Documented, so it survives staff turnover.
We run the rhythm: a ten-minute export ritual on your side, a closed set of books and a one-page owner summary on ours. Deposits tie. Comp is right. No March surprise. Already have a bookkeeper you like? We work under them, not around them — many clinics come to us through their bookkeeping firm.
Kevin Cosgrove is a fractional CFO who has spent his career fixing the hookup between operating systems and accounting systems — the unglamorous plumbing between the software that runs a business and the ledger that reports it. The Clinic Ledger is his clinic-focused practice, built specifically around Jane's reports, dates, and quirks. Also the founder of Steel City CFO, where he does the same work for contractors and multi-location businesses.
Plain-language reads for clinic owners and their bookkeepers. No gate, no sales sequence.
Answer a few questions and get an estimate of what your manual Jane close costs, plus a plain-language list of where your books are exposed. Two minutes, nothing saved.
Why Jane doesn't sync, how to import your sales properly, the Jane Payments trap, and the four other places clinic books go wrong.
The CSV import that actually works, tracking by practitioner and location, and the Jane Payments trap in Xero.
Why Jane can't show it, and how to structure your books to get a real per-practitioner margin each month.
Why prepaid money is a liability until it's used, the journal entries, and how to track it without the busywork.
Sales tax on retail, 1099 vs W-2 practitioners, HSA/FSA and superbills, and the Jane Payments trap, for US clinics.
The order of operations to close a Jane clinic's books cleanly every month, from reports to owner summary.
The lean set of accounts a clinic actually needs, and why to track practitioners with classes, not accounts.
What that difference actually means for your books, and why a sync still isn't a month-end close.
We run the Jane close white-label under your brand. You keep the client, the pricing, and the relationship.
Why the bank deposit never matches a day's sales, and the clearing-account method that fixes the double-count.
Why billed isn't collected, recording insurer receivables on accrual, keeping an A/R aging, and writing off denials and short-pays to the allowed amount.
Who charges the patient, who charges whom, registration thresholds, and mixed exempt services under one roof.
The whole playbook: which reports to export, the Payments reconciliation, deferred revenue, and mixed sales tax. Download the PDF.
The same close, wherever your clinic runs. Honest, platform-specific guides to getting your numbers into QuickBooks or Xero — and why a sync or an export still isn't a month-end close.
Cliniko syncs to Xero but not QuickBooks — and the sync breaks on credit notes and stops short of the close.
No auto-sync, just a CSV export. The payment-fee trap and the package deferred-revenue entry most books miss.
Noterro's export button is the best in the category — and still invoice-level, not a close.
Bookkeeping for a therapy practice: exempt sessions, card payouts, and associate splits.
One month reconciled, findings in writing, $500 flat. If your books are already clean, we'll tell you that too — that's a good outcome.
Book a Diagnostic AuditTell us a bit about your clinic and what's not tying out. One human reply from Kevin, usually within a day.