Bookkeeping for Audiologists and Hearing Care Practices
Bookkeeping led by Andrew Pizzello, CPA, for solo and group AuD practices. Hearing aid retail and trial periods, manufacturer rebate accruals, insurance reconciliation, S-Corp planning, and HIPAA-aware workflows. From $199/mo.
Audiology Practices Hide Real Inventory and Real Refund Exposure
Audiology is a clinical practice grafted to a hearing aid retail business. A typical patient walks out with a $4,000 device pair under a 30 to 60 day trial period during which their payment is fully refundable. Until the trial closes, you may still owe that money back. Most generic bookkeepers book it as income on day one and never track which trials are still open, which mishandles refunds and hides what you could owe back.
Layer in hearing aid inventory by manufacturer, volume rebates and co-op marketing dollars from Phonak, Oticon, Widex, Signia and Starkey, and the cash-pay versus insurance versus Medicare Advantage benefit-program mix, and the books most audiology practices inherit from a generalist bookkeeper miss almost everything that matters.
We built our workflow around how AuD practices actually operate. Every client gets inventory-aware bookkeeping, a running schedule of open hearing aid trials, manufacturer rebate accruals, and HIPAA-aware financial workflows, in an engagement led by Andrew Pizzello, CPA.
Audiologists We Serve
Single-AuD practices dispensing hearing aids, with or without insurance contracts.
Multi-AuD shops with associate clinicians, manufacturer relationships, and partner draws.
Tinnitus, vestibular, hyperacusis, and out-of-network specialty practices.
Multi-payer EOB reconciliation, Medicare benefit tracking, and contractual write-off discipline.
School and early-intervention contracts alongside private-pay assessment work.
Remote-fitting, teleaudiology, and hybrid in-clinic plus tele models, with revenue tracked by patient state.
What We Handle That Generic Bookkeepers Miss
Hearing Aid Trial Periods, Tracked Until They Close
A hearing aid sold under a 30 to 60 day trial can still come back. Your monthly reports stay on the cash basis, and we keep a running schedule of open trials, so you always know what you could owe back, and a return comes off the schedule cleanly.
Hearing Aid Inventory and Manufacturer Rebates
A serious audiology practice carries real inventory and earns volume-based rebates and co-op marketing dollars from manufacturers. We track inventory by serial number where it matters, surface margin per manufacturer, and book rebates correctly so they hit your P&L when earned, not when received.
Insurance and Cash-Pay Mix Tracking
Hearing aid coverage varies wildly by payer. We separate insurance, cash-pay, third-party benefit programs, and Medicare Advantage cash-aid programs in your chart of accounts so you can see which referral sources actually drive margin.
EOB Reconciliation and Contractual Adjustments
For practices on insurance, EOBs need real reconciliation, not summary booking. We separate gross billed, contractual write-offs, and net collected by payer so you know what each contract is actually costing.
Equipment Depreciation
Audiometric booths, REM systems, OAE/ABR equipment, and impression supplies are real capital. We track depreciation properly and run the Section 179 vs straight-line vs bonus depreciation analysis annually.
HIPAA-Aware Workflows, BAA Available
We never need PHI to do bookkeeping. Financial data is separated from clinical by design, and we sign Business Associate Agreements on request.
S-Corp Election and Reasonable Comp
Audiology services are SSTB so QBI phases out fast. The S-Corp self-employment tax savings still pencil out once profit clears overhead. We benchmark reasonable comp against BLS audiologist wage data with adjustments for retail-heavy practices.
Your Practice Software, Connected
Sycle, Blueprint OMS, CounselEAR, TIMS. We pull billing data from your practice software into QuickBooks Online cleanly so your clinical system stays the system of record for patient care, and QBO is the system of record for finance.
Packages Starting at $199/mo
Every package includes a dedicated bookkeeper, monthly reports, and tax-ready books. Surge adds a licensed CPA's review of every deliverable (PizzelloCPA, PLLC).
Solo AuD, clean books, monthly recon
Hearing aid inventory, open-trial tracking, rebate accruals
Group practices, manufacturer programs, live dashboard
Common Questions
How do you handle hearing aid trial periods?
We keep a running schedule of every open trial (typically 30 to 60 days), and your monthly reports stay on the cash basis, so you always know what you could owe back. If a patient returns the aids, the refund comes off the schedule. On the cash method, a trial payment is income in the year you receive it (IRS Publication 538), and a refund paid after year end reduces income in the year you pay it.
Do you track hearing aid inventory?
Yes. For practices with serious volume we track by manufacturer and model, surface margin per line, and book manufacturer rebates and co-op marketing dollars as earned. Smaller practices that order per-patient still get clean COGS reporting without the overhead of full inventory tracking.
How do manufacturer rebates and co-op marketing dollars get treated?
As accrued income recognized when earned, not when checks arrive. For practices doing serious volume with one or two manufacturers, the accrual approach gives a much cleaner monthly P&L than dropping six months of rebates into one quarter.
Do you offer a Business Associate Agreement?
Yes. Audiology clients can request a BAA during onboarding. We never need PHI to do bookkeeping. Financial data is segregated from clinical records by design.
Should my audiology practice elect S-Corp status?
Often, once profit clears about $80,000 for a solo. Audiology is SSTB so QBI phases out quickly, but self-employment tax savings on owner draws still make sense. We run the analysis during onboarding and account for any retail-heavy mix.
I do teleaudiology in multiple states. Is that a tax problem?
It can be. Whether serving patients in another state creates an income tax or sales tax filing obligation depends on the states involved and is a question for your tax preparer; for our clients that is PizzelloCPA, PLLC under a separate engagement. Our part is making sure revenue can be reported by client state when it is asked for.
Do you integrate with Sycle, Blueprint OMS, or CounselEAR?
Yes. We pull billing data from your practice software into QuickBooks Online so your clinical system stays the system of record for patient care, and QBO is the system of record for finance.
What does pricing look like for a solo AuD?
Most solo practices start at our $199/mo Starter tier. Practices with significant inventory or multi-clinician group practices usually land in Grow ($349/mo) or Surge (custom). Every engagement is led by Andrew Pizzello, CPA, and Surge adds a licensed CPA's review of every deliverable.
Cited authorities and resources
We benchmark our work against primary sources, not opinion. Some of the references we coordinate with for audiologists engagements:
- • BLS Occupational Employment & Wage Statistics for reasonable-compensation benchmarks.
- • IRS Form 2553 for S-Corp election timing and eligibility.
- • IRS Section 199A (QBI) guidance for the SSTB phaseout that applies to most private practices.
- • IRS Publication 946 for depreciation, Section 179, and bonus depreciation choices on practice equipment.
- • HHS HIPAA for Professionals for the workflow expectations on practices that touch PHI.
S-Corp planning, reasonable-comp analysis, and tax strategy are performed by our affiliated CPA firm, PizzelloCPA, PLLC, under a separate engagement (see PizzelloCPA’s tax services for audiologists). For legal questions, we coordinate with your attorney.
Guides from our blog for audiologists
Year-end bookkeeping for private practices · Hearing aid trials and deferred revenue
Not an audiologist?
We serve the full private practice ecosystem. Therapists & Counselors, Veterinarians, Optometrists & Ophthalmologists, Nurse Practitioners, Physical Therapists, Psychologists & Psychiatrists, Nutritionists & Dietitians, Acupuncturists, Speech-Language Pathologists, Dentists, Behavior Analysts (BCBAs), and more.
Books built for hearing care practices
Book a free 30-minute consult. Bring a recent month's hearing aid sales and any return data you have. We'll show you what open-trial tracking would look like on your numbers and whether we are the right fit.
Book Your Free ConsultOr call us: 855.297.BOOK (2665)