Problems
How To
What Your Dental Bookkeeper Should Deliver Every Month, and by When
Greg Hudnall
How To · 5 min read
Your bookkeeper should hand you the same monthly package by the 10th of the following month, including reconciliations you can see and a tie-out of your practice software to the bank.
Most owners know roughly what they pay their bookkeeper. Far fewer could list what they get for it each month, or say what date it arrives. A dental bookkeeper should deliver eight things every month: a profit and loss statement, a balance sheet, the account reconciliations, a production and collections tie-out, an accounts receivable summary, a page of dental ratios, a list of open items, and a short note on what changed. All of it should arrive by the 10th of the following month. Put each one, and its date, in the engagement letter.
The Deliverables List
| Deliverable | What it is | What it tells you |
|---|---|---|
| Profit and loss statement | Production, collections and expenses for the month, with dental categories | Where the money went |
| Balance sheet | What the practice owns and owes at month-end | Cash, debt, and what is really free to distribute |
| Bank and card reconciliations | Each account matched to its statement | That the other reports can be trusted |
| Production, collections and deposits tie-out | Your practice software matched to the bank | That what you collected reached the bank |
| Accounts receivable summary | What patients and insurers still owe, by age | Whether collections are slipping |
| Dental ratios | Collection rate and key costs as a % of net production, plus trends | Which costs are out of range |
| Open items list | Uncoded transactions and questions for you | What still needs a decision |
| A short written note | Two or three sentences on what changed | What to look at first |
Many bookkeepers stop at the first two. The tie-out, the receivables summary and the ratios are what make it dental bookkeeping. Our post on the reports to review every month goes deeper on reading each one.
The Date: Why the 10th
The package should arrive by the 10th of the following month. That is early enough to act on last month while claims are recent and patients still remember the visit, and late enough for statements and processor deposits to have posted. We explain why the books should close by the 10th in a separate post.
Get the date in the engagement letter, and ask what happens when it is missed. Also ask what happens when the 10th falls on a weekend, which it does four times in 2027.
A close by the 10th also depends on your office. Your bookkeeper needs the month-end production and collections reports from your practice software in the first few days of the month, whether they run them through their own login or your office sends them. If your bookkeeper is regularly waiting on you, agree on a standing list of what comes from your side and when.
Reconciliations You Should Receive
Ask for the reconciliations themselves, or a one-page summary, for every account, every month. That means every bank account, every credit card, and any loan or line of credit, each showing the statement balance, the book balance and any reconciling items. IRS Publication 583 tells businesses to "check your account for errors by reconciling it." For a practice, the reconciliation is also where duplicate charges, missing deposits and unauthorized payments get caught.
The most important reconciliation in a dental practice ties production and collections in your practice software to deposits in the bank. Your system records what you produced, what you wrote off, and what you collected. The bank records what arrived. The tie-out shows where the two agree and lists the items that explain where they do not, such as a deposit still in transit at month-end or an insurance payment posted to the wrong month. The numbers will rarely match to the penny. What you want is a list of the differences and the reason for each. Our post on production versus collections explains what the gap tells you.
Payroll belongs in the reconciliations too. It is often the largest expense in the practice, so the package should show that payroll in the books matches what your payroll provider reported and what left the bank. A mismatch there throws off every staffing ratio built on top of it.
Reports That Change Decisions
The ratios page should show your collection rate and your key costs as a percentage of net production, next to the ranges a healthy practice runs in: collections at 98% to 100% of net production, clinical supplies and lab at 5% to 7% each, staff payroll at 25% to 30%, and total overhead at 55% to 65%. If you want to check last month's numbers yourself, our free Dental Practice Benchmark Scorecard compares them with those ranges in about two minutes.
Some lines should have no range at all. Rent, marketing, owner pay and associate cost are driven by your building, your market, your entity and your contracts, not by the dentistry, so no national benchmark applies. They should appear as amounts and as a % of net production, read against your own history. If your package shows a target range for any of them, ask where it came from.
The accounts receivable summary should show total receivables, the share that is over 90 days old, and whether that share is rising. A climbing over-90 share is one of the clearest early warnings that claims are not being worked. Our post on the 90-day problem covers what to do about it.
Last, the written note: what moved, why, and what to look at. For example, "Lab rose to 8% because two large cases landed in one month; expect it to settle." A note like that turns a stack of reports into a five-minute read, and it shows someone read your numbers before sending them.
Checking What You Get Now
Hold last month's package up against the table above. Anything missing, or anything you had to ask for, is the conversation to have with your bookkeeper, and the same list makes a good scope to hand anyone you are thinking of hiring.
P.S. Reciprocity Accounting sends the same monthly package on a fixed date, with the books closed by the 10th. See how we can help your practice.
Frequently Asked Questions
What should a dental bookkeeper deliver every month?
A profit and loss statement, a balance sheet, account reconciliations, a production and collections tie-out, an accounts receivable summary, dental ratios against net production, a list of open items, and a short note on what changed.
When should I receive my monthly financial package?
By the 10th of the following month, with the date in your engagement letter. Ask what happens when the 10th falls on a weekend.
Should my bookkeeper send me the bank reconciliations?
Yes, or a one-page summary for each account.
What is a production and collections tie-out?
A monthly match between what your practice software says you collected and what reached your bank, with each difference explained.
Should every number in my monthly package have a benchmark?
No. Collections, supplies, lab, staff payroll and total overhead have credible ranges against net production. Rent, marketing, owner pay and associate cost do not. Track those against your own history.
