Clear payer mix. Clean provider pay. A P&L that matches how care actually runs. QuickBooks, QuickBooks, fixed fee. Free assessment.
Austin scales faster than its back office — revenue arrives before the systems do, and the books are usually the last thing to catch up. For private practices and clinics across Travis County — from downtown and South Congress to the Domain and East Austin — that shows up as era deposits, patient co-pays, and refunds mix together, so collections never match production and one deposit covers dozens of claims across payers — untangling it by hand never happens
Steven Palmieri works remotely with Austin owners in a market defined by a technology-and-startup boom layered over hospitality and creative small business. We split payer vs. patient revenue, reconcile clearinghouse deposits, and clean owner comp so your CPA can actually plan. You get a documented before/after trail your CPA can verify — no offshore rush job, no judgment about how far behind the books have slipped.
You're not bad at business. The books just stopped telling the truth about your practice.
Insurance, patient pay, and write-offs blur — so you never know what a day of practice really earned.
Splits, guarantees, and bonuses live in spreadsheets while the books stay wrong.
Messy books don’t just waste time — they make audits, partners, and lenders harder than they should be.
Two minutes. No document dump. Just the truth about how behind it feels.
We map deposits, adjustments, and provider economics to a chart that fits a practice — not a retail shop.
Backlog cleared. Accounts reconciled. A before/after report you — and your CPA — can act on.
Practice cleanup that makes revenue, payers, and provider pay legible.
Every account reconciled and every anomaly documented before we change a thing.
The backlog cleared with healthcare business-correct categories — not a generic chart of accounts.
A before/after summary and a simple monthly rhythm so it stays clean after we leave.
If our assessment can’t show you exactly what’s wrong and what it costs to fix, the assessment costs you nothing — no obligation either way.
“Finally handed my CPA a clean QuickBooks file instead of a shoebox.”
“Collections finally reconcile to my PM system.”
“Clean books made the practice loan renewal painless.”
Illustrative examples of typical client situations — not statements from specific named clients.
Tell us a little about the business — we reply within one business day.
Yes — we serve Austin and the wider Travis County area entirely remotely, working from your QuickBooks exports and bank feeds. No office visit required.
Most cleanups finish in 2–4 weeks depending on backlog size and account volume.
Fixed fee, quoted after the free assessment — based on months behind, accounts, and transaction volume. No hourly surprises.
Yes — we work from financial exports only (no PHI needed) under a confidentiality agreement.
Never. Messy books are a symptom of a busy business. Fixing them is literally what we do all day.