Bookkeeping and Accounting for Optometrists and Ophthalmologists

One-doctor practice running both exam and optical retail under one roof.

Exam-only practices, often subleasing optical to a separate owner.

Several ODs under one practice, with associate pay tied to production or collections and owner partner draws.

Vision therapy, low vision, dry eye, and contact lens specialty practices.

Out-of-network practices on subscription or membership pricing.

Two or more locations with shared overhead and consolidated reporting needs.

MD-led medical and surgical eye care, comprehensive and subspecialty alike.

Ophthalmologists holding an ownership interest in an ambulatory surgery center.

Integrated practices employing both optometrists and ophthalmologists under one entity.

Exam vs Optical P&L Separation

We split your chart of accounts so the exam practice and the optical shop have their own revenue and direct costs. You finally see which side of the practice carries the margin and where overhead is being absorbed.

Real Inventory and COGS Tracking

Frames, contact lenses, and accessories are real inventory. Lens lab fees are a major COGS line. We track all of it cleanly and reconcile against your practice management system so what you bought, what you sold, and what is on the wall all match.

Vision Insurance Reconciliation

VSP, EyeMed, Davis, Spectera, and the rest pay differently for exam services versus materials. Each has its own contractual adjustments. We reconcile EOBs cleanly so your real revenue (net of write-offs) is visible by payer.

Frame and Lens Vendor Reconciliation

Lab partners and frame vendors send statements that need to match your purchase records. We reconcile vendor statements monthly so disputes get caught before year end and credits do not get lost.

Optometry Groups and Multiple Offices

Once a practice has several doctors or several offices, one P&L stops answering the questions owners ask. We set up location tracking for each office and class tracking for each doctor in QuickBooks Online so each office has its own P&L and the group has a consolidated one, report production and collections by doctor for associate pay, keep each partner's capital account and draws separate, and record frames and lenses moved between offices as transfers rather than sales. Shared costs, like a central billing team or a management company fee, are allocated on one basis you choose and applied the same way every month.

Surgical, ASC, and Facility-Fee Income

Ophthalmology practices carry income an OD practice never sees: global surgical periods that straddle a month end, facility fees, co-management splits with referring ODs, and K-1 income from an ASC ownership interest. Each is taxed differently from professional fee income, and each needs its own line rather than being swept into one revenue account.

Drug and Injectable Inventory

Intravitreal injections and other buy-and-bill drugs are high-cost inventory with their own reimbursement mechanics. We track acquisition cost against reimbursement by drug, so you can see which are margin-positive and which are being administered at a loss.

Equipment Depreciation

Edgers, autorefractors, OCTs, fundus cameras, and slit lamps are real capital investments. We track depreciation properly, and PizzelloCPA, PLLC, our affiliated CPA firm, handles the Section 179 versus bonus depreciation choice, or we coordinate with your own CPA.

HIPAA-Aware Workflows, BAA Available

We never need access to PHI to do bookkeeping. We separate clinical and financial data by design and offer a Business Associate Agreement on request.

S-Corp Election and Reasonable Comp

Optometric services are SSTB so the QBI deduction phases out fast. The S-Corp self-employment tax savings still pencil out for most ODs. We benchmark reasonable comp against AOA and BLS optometrist wage data.

Bookkeeper and CPA, Coordinated

Day-to-day optometry bookkeeping is handled by your dedicated bookkeeper. The tax judgment calls, like inventory method, depreciation elections, and reasonable comp, sit with PizzelloCPA, PLLC under a separate tax engagement (or with your own CPA), and Surge adds a licensed CPA's review of every monthly deliverable. The books and the tax work are coordinated, so you are not chasing two vendors.

Your Practice Software, Connected

Crystal PM, RevolutionEHR, OfficeMate, Eyefinity, MaximEyes, Compulink, and similar platforms. We pull the financial data into QuickBooks Online cleanly so your software stays the system of record for clinical, and QBO is the system of record for finance.

Solo OD, exam books, basic optical, vision insurance

Optical inventory, multi-payer EOBs, equipment tracking

Multi-doctor, multi-location, partner draws, dashboard