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Helping Health and Wellness Business Owners (Medical Spas, Private Practices, Therapists, Medical Practices, Day Spas) Fall Dangerously in Love With Finance 💰✨
https://tr.ee/hbof

09/08/2026

Andre’s group therapy practice had a full caseload, with clinicians booked throughout the week as completed sessions moved into billing.

By the time payroll came due, the cash in the bank was lower than he expected. The schedule was packed, and care was being delivered, so Andre wanted to know what happened after those sessions left the calendar and entered the revenue cycle.

He followed the claims into A/R and found some still waiting on payer processing, while reimbursement for others had not reached the bank. The practice had delivered the care, but collections had not caught up with the volume of completed sessions.

The schedule was not wrong. It showed strong utilization, while A/R and reimbursement timing showed Andre why the cash looked different.

Once he saw the lag, Andre stopped treating a full caseload as proof that collections should be strong and started watching how long completed care took to become collected revenue.

If your caseload is full but cash still feels tight, it may be time to trace what is happening between completed sessions and collected revenue.

PracticeCashFlow

She is just a girl who loves to dance and enjoy a summer block party in Brooklyn.Give me music spilling into the street,...
09/07/2026

She is just a girl who loves to dance and enjoy a summer block party in Brooklyn.

Give me music spilling into the street, neighbors catching up, people laughing, and a beat that makes it hard not to dance.

There is something about a Brooklyn summer block party that has its own rhythm. The street becomes part dance floor, part reunion, and part neighborhood gathering place.

You hear the music. You hear the laughter. You feel the community around you.

And somewhere in the middle of all of it, there I am dancing like the DJ personally accepted my request.

Just a Brooklyn girl enjoying the music, the neighborhood, the people, and one of those summer memories that feels like home.

08/26/2026

You pull the discount-by-user report and realize the last management review was eight months ago.

Who was supposed to notice the pattern before $14,000 got your attention?

A report sitting in the system is not financial oversight. Discount activity needs to be examined while the client interaction and reason for the adjustment are still fresh.

Months later, the medical spa is trying to reconstruct why those adjustments were made instead of seeing the activity as it happens.

Who in your medical spa is responsible for reviewing discount-by-user activity each month?
Name the role in the comments and tell me how often that review actually happens.

08/25/2026

A $14,000 discount-by-user report tells you what revenue was reduced, but it does not tell you whether those reductions were appropriate.

If the same employee can apply courtesy discounts in the POS and prepare the daily deposit, I am looking at where the coordinator’s approval authority stopped and where segregation of duties entered the financial process.

Even with a clean bank reconciliation, I still want to know who had the authority to reduce collected revenue in the first place.

In an established practice, more of the financial process can end up with the person who knows how everything works until one role holds more than anyone intended.

So I would not start with, “Do I trust my patient care coordinator?” I would ask whether the practice could explain the $14,000 without that employee in the room.

In your practice, who can reduce collected revenue, and who reviews that activity? Tell me in the comments.

Monday, for me. ☕️I’m drinking my coffee before I give the rest of Monday to the practice.When you own a health and well...
08/24/2026

Monday, for me. ☕️

I’m drinking my coffee before I give the rest of Monday to the practice.

When you own a health and wellness practice, an open spot on the calendar can start looking like available capacity. There is always something in practice operations waiting for your attention.

I’m learning not to treat my own capacity like it automatically belongs to the business.

Sometimes I want to drink a good cup of coffee while it is still hot and mind my business for a minute. 😂

The practice can have me when I’m done.
Follow along Lozelle Mathai | Health & Wellness Accountant if you own a practice and want the financial side of it handled with the same intention you give the clinical side.

08/21/2026

You’re reviewing payroll for your medical spa and see a productivity bonus for one of your aesthetic providers.

The bonus itself does not make you stop. The amount does.

If the provider’s compensation arrangement includes a productivity bonus, I want to be able to trace that amount back to the productivity bonus calculation behind it.

Then I want the compensation approval or payroll authorization to support the payment showing on the payroll register.

The payroll register tells me what the aesthetic provider was paid. It does not tell me how the medical spa arrived at that bonus amount.

The bonus may belong on payroll, but I still want to know how you got to the amount.

08/20/2026

You’re reviewing payroll for your medical practice and see a productivity bonus beside a clinician’s name.

The bonus may fit the clinician’s compensation arrangement. What I want to know is whether the amount does.

Seeing “productivity bonus” on the payroll register tells you how the payment was recorded. It does not tell you what compensation approval or payroll authorization supports that amount.

So I would not stop at the payroll label. I would trace the bonus back to the compensation decision behind it.

The payroll register tells me what the payment was called. I still want to know what supports the amount.

08/19/2026

Two payments to the same clinician can both move through your payroll platform.

The second payment is where I want the documentation to support the transaction.

In the Adam Gentile embezzlement case, the DOJ says he worked for two different medical practices at different times. At both, he handled payroll and issued himself additional payroll payments. Some were recorded as bonuses.

For a group therapy practice using Gusto or another payroll platform, seeing the second payment on the payroll register tells the practice owner that it was recorded in payroll.

It does not tell you whether that second payment agrees with the clinician’s compensation arrangement or what compensation approval and payroll authorization support it.

There is a financial consequence when those two pieces do not connect.

The second payment can leave the practice through payroll even when the practice owner cannot connect it to an authorized compensation decision.

If I were reviewing that payroll, I would want to trace the additional payroll payment back to the compensation approval behind it. Does the approval explain why the second payment was made and support the amount paid?

Management review needs to help the practice owner see that connection.

Internal controls become useful when they give the practice owner enough financial visibility to connect the second payment on the payroll register to the authorization behind it.

I do not want that distinction lost in the payroll fraud conversation.

The payroll platform can show me the second payment.

I still want to know what authorized it.

Source: U.S. Department of Justice, U.S. Attorney’s Office for the District of Massachusetts, March 31, 2026.

A little theater, some magic, and mischief managed. ⚡️Harry Potter and the Cursed Child. What a production!!! The stage,...
08/17/2026

A little theater, some magic, and mischief managed. ⚡️

Harry Potter and the Cursed Child. What a production!!! The stage, the effects, the whole experience was worth getting out of the office for.

And yes, there is, in fact, life outside of work 😂 I plan on enjoying mine.

08/11/2026

Your group therapy practice hires a new therapist to help with the waiting list and plans an insurance-based caseload from the clinician’s start date. Credentialing with one of the clinician’s payers is still pending.

What happens to the hiring plan when payer enrollment extends past the clinician’s start date?

Clinician compensation can begin before the therapist’s payer enrollment takes effect. The insurance-based sessions planned for that caseload may not generate payer reimbursement when you expected them to.

The financial plan for the hire has to account for the time between clinician compensation starting and payer reimbursement beginning.

Build the clinician’s insurance caseload from payer enrollment status and effective dates rather than the employment start date alone.

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