Frequently asked questions
Straight answers about bookkeeping for private practices.
Cost, fit, S-Corps, HIPAA, and what happens after the quick call — in plain language.
Cost & fit
What we charge, who we work with, and how to tell if we're the wrong call.
What does a bookkeeper cost for a private practice?
Ongoing bookkeeping and advisory at Line & Ledger starts at $1,500/mo for Core, $2,750/mo for Clear, and $5,500/mo for Compass fractional CFO support. Every practice begins with Connect onboarding, which is scoped and quoted before you start based on how far behind the books are.
What size practice do you work with?
We are generally the right fit for practices around $500K+ in annual revenue with at least one to two employees. Below that, the membership is usually more support than the practice needs.
What's the difference between a bookkeeper and a fractional CFO?
A bookkeeper records and reconciles what already happened; a fractional CFO helps you decide what happens next. Our Core and Clear levels cover the bookkeeping and reporting rhythm, while Compass adds forecasting, scenario modeling, and decision support for hiring, expansion, and equipment.
Who is Line & Ledger not a fit for?
There are a few. We'd rather be upfront than waste your time — we've written out 7 signs it might not be our season yet.
Do you work with practices outside Alaska?
Yes — we serve private practices nationwide, remotely. Line & Ledger is based in Alaska and works with owners across the United States.
How we work
The rhythm of a month with us, from onboarding through ongoing check-ins.
How often will we actually talk?
Core includes quarterly check-ins with email support in between, Clear includes a monthly meeting, and Compass includes a monthly strategy session plus on-call access for big decisions.
Can I change membership levels?
Yes. The levels exist to match seasons, not to lock you in — move up when a big decision is coming, move down when things are steady. Zero pressure to stay put.
What is the Connect onboarding and how long does it take?
Connect is Step One for every member: books cleaned up, chart of accounts rebuilt for your practice type, systems aligned, and workflows documented. Length depends on how far behind things are — typically a defined multi-month period scoped and quoted before you begin.
My books are a mess. Is that a problem?
No, and it is more common than you think. Clean-up lives inside Connect, which is exactly where messy, behind, or inherited books get brought current before we start a monthly rhythm.
Services & compliance
What we handle, what we hand off, and how we treat your information.
Do you do taxes?
No, we do not prepare or file tax returns. We coordinate with your tax preparer and hand them clean, closed books plus a year-end package, which usually makes their work faster and cheaper.
Do you run payroll?
Core includes payroll support. Payroll processing is included in the Clear and Compass memberships. What we don't do is payroll as a standalone service. It works best as part of the whole picture, where we can see how it lines up with your cash flow and the rest of your numbers.
When should my practice convert to an S-Corp?
Usually when your profit is consistently high enough that the payroll tax savings outweigh the added payroll and filing costs. We offer an S-Corp analysis for $650 that answers this with your actual numbers, and implementation for $3,850 if it makes sense.
Are you HIPAA-familiar?
Yes. We are HIPAA-familiar, cyber-secure, and background-checked. We work with financial data rather than clinical records, and we handle practice information accordingly.
What software do you use?
We work in QuickBooks Online, supported by secure document sharing and reporting tools. If you are on something else, we will tell you honestly during the quick call whether a move makes sense.
Getting started
What the first step looks like.
How do we get started?
Book a 15-minute quick call. We will talk about your practice, where the books stand, and which level fits — or whether it is not our season yet.
Still have a question? Ask us directly or see the membership levels.
Next step
Not sure where you land?
A 15-minute quick call is the fastest way to find out whether we're the right fit.
Book a quick call15 minutes. No prep needed. No pressure.