Ask any bookkeeper how they'd record your membership revenue, when you'll get your numbers each month, and exactly what the fee covers, and ask us the same things.
Do they understand how DPC money works?
A Direct Primary Care practice doesn't look like a typical medical office on paper. There's no insurance billing. Revenue comes in as memberships, often through a membership platform, along with enrollment fees, meds, labs and sometimes employer contracts. A bookkeeper who mostly works with insurance-billing practices or other kinds of businesses may set up your books in a way that hides what you need to see.
Here's what I'd ask.
- How would you record membership revenue so I can see it apart from meds, labs and enrollment fees?
- How do you handle deposits from my membership platform that come in net of fees, refunds and failed payments?
- Would you set up a chart of accounts for DPC, or use a generic one?
- Can you report on members and revenue per member, or only dollars?
- How would you track employer contracts?
Good answers are specific. If you hear "we'll figure it out once we're in there" to most of these, keep looking.
What happens each month, and when?
You want to know what the monthly work includes and when it's finished. Ask them to walk you through a normal month. Do they reconcile every bank and card account to the statement, or only categorize what comes through the bank feed? Those aren't the same, and here's why reconciling matters.
Then ask for a date. When will last month's P&L and Balance Sheet be in your hands? For us, it's by the 15th of each month. A firm answer is a good sign. "When we get to it" isn't.
Also ask what they'll need from you each month and how they'll ask for it. Statements, receipts, answers about odd transactions. You want a clear routine, not a pile of emails at random times.
How is the fee set?
Ask whether it's hourly or a flat monthly fee, and what's included. If it's hourly, ask what a typical month costs and what makes it go up. If it's flat, ask what's outside the fee and what a setup or cleanup would cost on top.
We charge a flat monthly fee and never bill hourly. DPC Bookkeeping starts at $500 a month, Monthly Financial Partner at $1,200 and Fractional CFO at $2,500, each with a one-time setup fee. The details are on our pricing page. Whoever you hire, you should be able to know your cost before the month starts.
Where does their job stop and your CPA's start?
This one trips people up. A bookkeeper keeps the books every month. A CPA prepares and files your taxes and gives tax advice. Some firms do both, and some don't.
Ask directly. Do you prepare tax returns? Do you give tax advice? If not, how do you work with my CPA at year end? We don't do tax preparation, filing or tax advice. We keep the books so your CPA can file from them without cleanup. A bookkeeper who's clear about where their work ends is easier to work with than one who's vague about it.
What happens if you leave?
It's a fair question to ask on the way in. Who owns the books and the software account? If you part ways, will you get full access to everything, including past reports and records? How much notice do they need?
The answer should be that the books are yours. If it's anything else, ask more questions.
And a few smaller ones worth asking. Who will do the work on your file, and who do you contact with a question? How fast do they reply? How long does onboarding take? Ours takes two to three weeks.
This week, write these questions down before your first call with anyone, us included. Take notes on the answers. Then compare. The right fit is the one whose answers are specific, whose timeline is clear, and who explains your own numbers back to you in plain words.
Common questions
Does my bookkeeper need DPC experience?
It helps a lot. Someone who knows how memberships, platform deposits and employer contracts work will set up your books so you can see what's going on without having to teach them first.
Can my CPA do my bookkeeping?
Some CPAs offer it, and some don't. Ask whether it's monthly and reconciled, and when you'll get your numbers each month.
How long does it take to switch to a new bookkeeper?
With us, onboarding takes two to three weeks. Other firms will have their own timeline, so ask before you sign.
Ready to ask us these questions?
We work only with Direct Primary Care and other patient-paid health practices, for a flat monthly fee, with numbers by the 15th. Apply to work with us and bring your questions to the first call.