--- title: "How to Choose a Dental Bookkeeper: 12 Questions" description: 12 questions to ask before you hire a dental bookkeeper, what good answers sound like, and the red flags that mean keep looking. image: https://reciprocityaccounting.com/hubfs/blog-images/post_208.png --- [Skip to content](https://reciprocityaccounting.com/blog/how-to-choose-dental-bookkeeper#main-content) [![](https://reciprocityaccounting.com/hs-fs/hubfs/logo-horizontal-transparent.png?width=1298&height=290&name=logo-horizontal-transparent.png)Homepage](https://reciprocityaccounting.com) - [Services](https://reciprocityaccounting.com/services) - [Pricing](https://reciprocityaccounting.com/pricing) - [FAQ](https://reciprocityaccounting.com/faq) - [Blog](https://reciprocityaccounting.com/blog) - [About](https://reciprocityaccounting.com/about) [Book a Discovery Call](https://reciprocityaccounting.com/contact) - [Services](https://reciprocityaccounting.com/services) - [Pricing](https://reciprocityaccounting.com/pricing) - [FAQ](https://reciprocityaccounting.com/faq) - [Blog](https://reciprocityaccounting.com/blog) - [About](https://reciprocityaccounting.com/about) [Book a Discovery Call](https://reciprocityaccounting.com/contact) ![Reciprocity Accounting card: How to Choose a Dental Bookkeeper, a How To post.](https://reciprocityaccounting.com/hs-fs/hubfs/blog-images/post_208.png?width=1200&height=630&name=post_208.png) How To # How to Choose a Dental Bookkeeper: 12 Questions to Ask Before You Hire ![Greg Hudnall](https://app.hubspot.com/settings/avatar/49dbd5c12b604f92786349ba17b92e2c) Greg Hudnall October 20, 2026 How To  ·  6 min read The fastest way to choose a dental bookkeeper is to ask twelve specific questions and listen for specific answers. Vague answers to specific questions are the whole test. Most practice owners hire a bookkeeper the way they would hire a plumber: someone they know uses them, the price sounds fair, they seem competent. That works until the first month you need the books to answer a question and they cannot. The better approach is an interview with a short list of questions that a dental-specific bookkeeper answers easily and a general bookkeeper usually has to think about. Here are the twelve, what a good answer sounds like, and the answers that should end the conversation. ## 12 Questions to Ask ### 1. What date are my books closed every month, and is that in writing? A good answer is a date. "By the 10th of the following month" is a date. "Usually within a few weeks" is not. Ask whether the date is in the engagement letter and what happens when they miss it. A close date nobody wrote down is a hope. Here is [why the 10th matters](https://reciprocityaccounting.com/blog/dental-books-monthly-close-deadline). ### 2. Do you tie my practice management system to the books every month? Your practice management system knows what you produced, what you adjusted, and what you collected. Your books know what hit the bank. A dental bookkeeper reconciles the two every month and can explain the difference. Listen for the words production, collections and deposits. If the answer is about bank reconciliation alone, that is a general answer. ### 3. How do you record insurance write-offs and adjustments? This is the question that separates the two kinds of bookkeeper fastest. Open Dental's manual [defines net production](https://www.opendental.com/manual/productionincome.html) as "gross production, plus adjustments, minus insurance write-offs," and notes that "adjustments themselves only affect production amounts, not income." A good answer explains where contractual write-offs live in your books, how they differ from patient bad debt, and how they show up in your reporting. If you hear "we just record what gets deposited," the write-offs are invisible. Our post on [insurance write-offs in your books](https://reciprocityaccounting.com/blog/dental-insurance-write-offs-bookkeeping) covers what the answer should include. ### 4. Which practice management systems have you worked in? You want names: Open Dental, Dentrix, Eaglesoft, or whatever you run. Then ask which reports they pull from it each month. Someone who has done this before can name the reports without looking them up. ### 5. How do you code lab fees versus clinical supplies? Lab and clinical supplies each run 5% to 7% of net production in a healthy practice, and the two say different things about your practice. A bookkeeper who puts both in one "supplies" line has made both numbers useless. A good answer keeps them separate and can tell you where clear aligners go. ### 6. Will you show me my numbers against dental benchmarks, and against what base? The right base is net production. A good answer names it without being asked and knows that some numbers, like rent and marketing, do not have a credible benchmark at all. A bookkeeper who quotes a benchmark for everything is guessing on some of them. ### 7. Cash or accrual, and why? There is no single right answer, but there should be a reason tied to your practice. A bookkeeper who has never thought about it will default to whatever the software was set up with. A good answer tells you what each basis hides in a dental practice. Here is [the difference](https://reciprocityaccounting.com/blog/cash-vs-accrual-dental-practice) if you want the background before you ask. ### 8. What exactly will I receive each month? Ask for a sample package. At a minimum: a profit and loss statement, a balance sheet, reconciliations you can see rather than hear about, and a short set of practice metrics. If the honest answer is "a P&L when you ask for one," you are buying data entry. ### 9. Who does the work, and who do I call? Ask who actually touches your books, where they are, and who answers when you have a question. None of those answers is wrong in itself. What you are listening for is whether they are clear. ### 10. Will you sign a business associate agreement? If your bookkeeper will see patient information, this one is not optional. HHS lists [accounting among the services](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/business-associates/index.html) a business associate provides when the work involves protected health information, and dentists are [covered entities](https://www.hhs.gov/hipaa/for-professionals/covered-entities/index.html) when they transmit health information electronically in a standard transaction, such as an electronic claim. Under [45 CFR 164.502(e)](https://www.law.cornell.edu/cfr/text/45/164.502), the assurances a practice needs from a business associate "must be documented through a written contract or other written agreement or arrangement." A bookkeeper who works in your practice management system will see patient information. A good answer is yes, with the agreement ready to sign. A blank look is the answer too. ### 11. How do you price, and what is outside the price? Flat monthly fees are the norm. In Ignition's [2025 pricing benchmark](https://www.ignitionapp.com/us/2025-accounting-tax-pricing-benchmark), a survey of 219 US firms using its software, the most common monthly fee for bookkeeping and accounting was $250 to $499, reported by 29% of firms. Dental-specific work sits above that band on purpose, and our breakdown of [what dental bookkeeping costs](https://reciprocityaccounting.com/blog/how-much-does-dental-bookkeeping-cost) shows why. Whatever the number, ask what triggers an extra charge: catch-up work, a second location, payroll, year-end, tax. Surprises live in the scope, not the headline price. ### 12. What happens if I leave? The answer you want: the accounting file is in your name, you keep full access, and they hand over everything at the end. If the books live in their subscription and leaving means starting over, you have hired a landlord. ## What the Answers Should Sound Like Good answers have three things in common. They are specific: a date, a report name, an account. They are tied to dentistry: production, write-offs, providers, the practice management system. And they arrive without hesitation, because someone who does this every month has answered these questions many times before. You do not need to judge the technical content of every answer. You need to notice whether the person across the table is describing a process they run or describing what they would figure out if you hired them. ## Red Flags in the Answers - **"Whenever the bank statements are ready."** That means no close date, which means your numbers arrive when they arrive. - **"We record what's deposited."** That means write-offs, adjustments and production never reach your books. - **"We can learn your software."** Fine for a new hire, not for the person you are paying to already know it. - **"We don't really need a BAA."** If they will see patient data, they do. - **"Our reports are standard."** Standard reports were not built to answer a dentist's questions. - **"The file stays with us."** Your books should never be hostage to the relationship. One red flag is a conversation. Two is a decision. ## Dental-Specific vs General: How to Tell The questions above do most of the work. Questions 2, 3 and 6 are the ones a general bookkeeper usually struggles with, because they require knowing how a dental practice earns money: a fee set by a contract, adjusted by an insurer, collected weeks later, partly from a patient. A general bookkeeper usually sees deposits. A dental bookkeeper sees the whole path from the chair to the bank, and can show you where money fell off along the way. That does not mean a general bookkeeper is wrong for every practice. If all you want is a clean file for your tax preparer, plenty of general firms do that well. Just know that it is what you are buying. Our comparison of a [dental bookkeeper and a dental CPA](https://reciprocityaccounting.com/blog/dental-bookkeeper-vs-dental-cpa) covers who does what once you have both. *P.S.* [*Reciprocity Accounting*](https://reciprocityaccounting.com) *closes your books by the 10th and ties your practice management system to your books every month, so these twelve questions already have answers.* [*See how we can help your practice.*](https://reciprocityaccounting.com/contact) ## Frequently Asked Questions ### What should I ask a dental bookkeeper before hiring? Ask when the books are closed each month, whether they tie your practice management system to the books, how they record insurance write-offs, which dental software they know, whether they will sign a business associate agreement, what is outside their price, and what happens to your file if you leave. ### Does my dental bookkeeper need to sign a BAA? If the bookkeeper's work involves access to protected health information, yes. HHS lists accounting among business associate services when the work involves PHI, and the rule requires the practice's assurances from a business associate to be documented in a written agreement. ### How do I know if a bookkeeper is really dental-specific? Ask how they record insurance write-offs and whether they reconcile production and collections to deposits each month. A dental bookkeeper answers both immediately and in dental terms. A general bookkeeper usually talks about bank reconciliation instead. ### Should the accounting file be in my name or the bookkeeper's? Yours. You should own the file and keep full access so that changing bookkeepers never means rebuilding your books. ### How much should I expect to pay for a dental bookkeeper? Dental-specific bookkeeping usually runs $700 to $3,500 a month, depending on practice size and scope. The most common monthly bookkeeping fee across accounting firms is lower, so ask what the difference covers before you compare quotes. **Related reading:** - [What Dental Practice Owners Should Know About Outsourcing Their Bookkeeping](https://reciprocityaccounting.com/blog/outsourced-dental-bookkeeping) - [What Does a Dental Bookkeeper Actually Do?](https://reciprocityaccounting.com/blog/bookkeeping-for-dentists) - [What Financial Reports Should Your Dental Practice Review Every Month?](https://reciprocityaccounting.com/blog/dental-practice-monthly-financial-reports) ## Share this post [mailto:https%3A%2F%2Freciprocityaccounting.com%2Fblog%2Fhow-to-choose-dental-bookkeeper](mailto:https%3A%2F%2Freciprocityaccounting.com%2Fblog%2Fhow-to-choose-dental-bookkeeper) ## Keep reading ### [![Reciprocity Accounting card: Ohio City Tax Withholding, a How To post.](https://reciprocityaccounting.com/hs-fs/hubfs/blog-images/post_44.png?width=1200&height=630&name=post_44.png) How To Ohio Municipal Withholding for Dental Payroll](https://reciprocityaccounting.com/blog/ohio-dental-practice-payroll-withholding) ### [![Reciprocity Accounting card: Ohio City Income Tax, Explained, a How To post.](https://reciprocityaccounting.com/hs-fs/hubfs/blog-images/post_65.png?width=1200&height=630&name=post_65.png) How To Ohio Municipal Income Tax for Dental Practices](https://reciprocityaccounting.com/blog/ohio-municipal-income-tax-dental-guide) | ![Reciprocity Accounting](https://reciprocityaccounting.com/hubfs/logo_horizontal_dark_transparent.png) Accounting built for dental practices. 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