Telehealth Practice Accounting & Bookkeeping
Fairlight CPA does the bookkeeping, tax, and reporting for telehealth practices — virtual-first groups whose patients, clinicians, and tax obligations sprawl across state lines. We keep multi-state exposure, platform payouts, and per-visit economics under control.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ CPA-led team
The numbers problems telehealth practices actually have
Every state is a tax question
Clinicians and patients across states create payroll registration, nexus, and filing obligations that accumulate silently until they're penalties.
Platform payouts arrive net and opaque
Telehealth platforms and payment processors deposit net of their fees in batches; unit economics require unwinding the batches back to visits.
Parity laws don't mean parity payments
Telehealth reimbursement varies by payer and state despite parity rules; realized rate per virtual visit needs measuring, not assuming.
Subscription and per-visit models mix
Many telehealth groups run memberships alongside insurance visits — two models whose economics must be reported apart.
What Fairlight takes off your plate
The core engagement is the same discipline we run for every client — monthly close by the 15th, payroll, tax, and CFO-level reporting — built around how telehealth practices actually make and spend money.
- Multi-state payroll registration and filings for distributed clinicians
- Platform-payout reconciliation back to visit-level economics
- Subscription revenue recognition alongside per-visit insurance lanes
- Monthly close by the 15th with state-level exposure tracking
- Business and personal tax prep including state income tax coordination
The three numbers we keep in front of you
No fabricated benchmarks — your own numbers, measured the same way every month, so trends are real and decisions have a floor under them.
Realized rate per virtual visit
by payer and state — parity measured, not presumed
Clinician cost per visit
network comp against delivered volume
State exposure map
where revenue, clinicians, and filings actually sit
Revenue cycle & tax notes
Revenue & reconciliation
We reconcile platform batches, processor settlements, and payer remittances to the visit log, so fees, refunds, and chargebacks stop hiding inside net deposits.
Tax & entity
Multi-state is the defining issue: payroll accounts, entity registrations, apportionment, and owner residency all need a coordinated map — building it early is dramatically cheaper than repairing it.
Simple, published pricing
Bookkeeping from $310/mo · All-In-One (books + tax + advisory) from $800/mo. Every fee is quoted and fixed in writing before any work begins.
Telehealth accounting FAQs
We have clinicians in 12 states — how bad is it?
Manageable with a map: payroll registration where clinicians sit, filing where nexus exists, and a calendar that keeps it current. We build and maintain that map as the network grows.
Our platform handles billing — what's left?
The platform bills; your books still must show unit economics, state exposure, and clinician margin. Net deposits alone can't answer any of those.
What does it cost?
Bookkeeping from $310/month; All-In-One (books + tax + advisory) from $800/month. Exact fee fixed in writing after a short call.
Related healthcare specialties
Get the financial side handled
A free 15-minute call — bring your current setup, leave knowing exactly what clean, specialty-aware books look like for telehealth practices.
The content on this page is for informational purposes only and does not constitute professional tax advice. Accounting and tax considerations for healthcare practices depend on individual facts and circumstances and are subject to change. See our full legal disclaimer.