Accurate books, clear multi-location reporting and steady cash flow management for healthcare practices, wellness businesses and medical equipment providers.
Healthcare businesses run on thin timing margins. Payroll and rent are due on schedule, but insurance reimbursements arrive weeks or months after the service is delivered, and some claims come back short or denied. Add multiple locations, equipment inventory and a mix of clinical and administrative staff, and the books get complicated quickly. Wellness businesses such as med spas, physical therapy and chiropractic clinics, and fitness or wellness studios add memberships, prepaid packages and a mix of insurance and self-pay revenue. Owners need to know which locations are profitable, what is still owed, and how much cash they will have next month.
Skyward provides outsourced accounting, bookkeeping and HR for healthcare practices, wellness businesses and durable medical equipment (DME) providers across San Diego County. We keep your books current in QuickBooks Online, reconcile every account monthly, and report by location so you can see performance side by side. We track receivables by payer and age so collections get attention before balances go stale.
We have done this work before. When a three-location healthcare equipment business found its in-house books in disarray at tax time, we cleaned up the records and built a plan that fit the owner's budget. Today that business receives reliable monthly financials. Sensitive documents are exchanged through our secure client portal, Karbon, rather than email.
Services we typically run
What we handle
01
A combined profit and loss hides which locations are carrying the business. We set up location tracking in QuickBooks Online so revenue, payroll and operating costs are assigned where they belong. Each month you see every site side by side and in total.
02
Insurance and payer balances can sit unnoticed until they are too old to collect. We reconcile receivables monthly and deliver aging reports that show what is outstanding, from whom and for how long. That gives your billing staff a clear list to work from.
03
When revenue is earned today but paid weeks later, a profitable month can still leave the bank account short. We forecast cash based on your actual collection patterns and upcoming obligations, so you can plan payroll, purchases and expansion with fewer surprises.
04
Medical equipment businesses carry inventory for sale, rental units and fixed assets, and each is accounted for differently. We help you track inventory and cost of goods sold accurately and record equipment purchases and depreciation consistently, so your margins and balance sheet reflect reality.
05
Healthcare employers manage varied schedules, overtime, licensed and unlicensed roles, and California's detailed wage and hour rules. Our HR team helps you classify roles correctly, keep payroll compliant, and maintain onboarding records, handbooks and policies that fit how your practice actually runs.
Case study · Healthcare equipment business with three locations
After an in-house bookkeeping attempt left major discrepancies at tax time, Skyward cleaned up the records and built a shared plan that delivers reliable monthly financials.
Read the case studyFAQ
Both. We work with healthcare practices and with businesses that sell or rent medical equipment. Equipment providers have added inventory and asset accounting needs, which we handle alongside the core bookkeeping, receivables and reporting work.
Documents and requests are exchanged through Karbon, our secure client portal, rather than through email attachments.
Yes. We use location or class tracking in QuickBooks Online so income and expenses are assigned to the right site. Your monthly package then shows each location's performance alongside the consolidated total.
Yes. Cleanup is often where we start. We reconcile accounts, correct miscategorized transactions and bring the books current, then move into a regular monthly close. One of our healthcare equipment clients came to us after an in-house bookkeeping attempt left major discrepancies at tax time.
No. Skyward does not prepare or file tax returns. We keep accurate, reconciled books all year and coordinate with your CPA or tax preparer, which makes tax season faster and less expensive for you.
Services
Up-to-date, reconciled, tax-ready books every month. We clean up what is there, set up processes and automations, and deliver accurate monthly statements for a fixed fee.
A full accounting department without the overhead: classifications, reconciliations, AP and AR support, month-end close and reporting, delivered by one steady team for a fixed monthly fee.
Annual budgets, rolling forecasts, scenario planning and financial projections for launches and fundraising, built in models your team can understand and use.
Monthly statements, budget versus actual by department, AR and AP aging, weekly cash reporting and KPI dashboards in Power BI, Excel or Google Sheets.
Comprehensive oversight of HR practices, policies and procedures: onboarding, compliant terminations, contractor classification under AB5, payroll support and audit-ready records.
Tell us where your finance and HR operations stand today. We'll map out what fixed-fee support would look like — usually live within about a week.
