Expense tracking for a clinic: what to record and how to review it

Expense tracking for a clinic means recording every supplier invoice (rent, salaries, supplies, equipment, insurance) in the same place where you record what you take in, with its date, its category and how you paid it. That way, at the end of the month you know what has come in, what has gone out and what is left, without waiting for your accountant's month-end close.

Why track expenses alongside payments received

Because a month's result is only visible when what comes in and what goes out are in the same place. If in your practice the payments received live in the management software and the expenses sit in a folder of invoices, in your email or in the bank, your accountant puts them together when it is their turn and you see the result weeks later, when you can no longer correct anything.

The signs that you lack this control are familiar:

• You do not know whether a slow month in the diary covered the rent and salaries.
• You order supplies without knowing how much you spent on supplies the previous month.
• Supplier invoices turn up in your email when your accountant asks for them.
• A big purchase, such as a new piece of equipment, throws your figures off for several months and you do not know by how much.

You do not need to keep a parallel set of accounts. It is enough to record each expense the day its invoice arrives and to look at the summary once a month. Accounting and taxes continue to be handled by whoever handles them today.

The typical expenses of a clinic

Almost all of a clinic's expenses fit into half a dozen groups, and it is worth going through them once before you start recording so that none is left out.

Group	Examples	How it usually arrives
Premises	Rent, building service charges, electricity, water, telephone	Fixed, every month
Team	Staff salaries	Fixed, every month
Supplies and consumables	Treatment-room supplies, disposables, products used in the consultation	Variable, depending on activity
Equipment	Purchase, maintenance and repairs	One-off
Insurance	Premises insurance, professional liability insurance	Annual or in instalments
External services	Accountancy, cleaning, software, training	Fixed or one-off

Telling fixed costs from variable ones is the most useful part of this list. Fixed costs arrive even when the diary is empty; variable ones rise and fall with the number of patients. If you know what your fixed costs add up to, you know how much you need to take in each month before you start making money. That figure is specific to your clinic: there is no benchmark that works for all of them.

What to record for each expense

For each expense, record whatever lets you find it later and know what it relates to: who invoices it, what the invoice number is, what date it carries, what was bought, which category it belongs in, how much it was and how it was paid.

In Mi Clínica, expenses are in a tab of “Facturación” (Invoicing), next to invoices, payments received and quotes. The “+ Registrar gasto” (+ Record expense) button opens a form with these fields:

Field	What it is for
Supplier	Knowing who you pay and how much you pay them over the year
Description	The detail: “Treatment-room supplies”, “Laser service”
Category	Grouping expenses to see where the money goes
Invoice number and invoice date	Finding the invoice when your accountant asks for it
Invoice amounts	What the expense adds to the summary
Payment method	Card, bank transfer, direct debit, cash or Bizum (a Spanish mobile payment app)

The program will not let you save an expense without a supplier, an invoice number or a date. An expense that has been recorded can be corrected later, except for the supplier, which cannot be changed once entered. A practical tip: write the specific description. “Miscellaneous” will tell you nothing in six months; “Treatment-room disposables” will.

Categories: a few, always the same

A category is only useful if at the end of the month it tells you where the money goes, and a few are enough for that, used the same way every time. With twenty categories each person picks a different one for the same expense and the summary stops adding up.

Mi Clínica works with four fixed categories (others cannot be added):

• Compras y servicios (Purchases and services).
• Sueldos y salarios (Salaries and wages).
• Alquileres y primas de seguros (Rent and insurance premiums).
• Intereses y gastos financieros (Interest and financial costs).

Some expenses fit by name alone: the premises rent goes under rent and the payroll under salaries. For the rest, the detail is given by the description, not the category: “Treatment-room supplies” and “Laser maintenance” can go in the same category and still be told apart in the list. If you are unsure where an expense belongs in your accounts, ask your accountant once and always apply the same rule.

Seeing what each month leaves

What a month leaves you is what was collected minus what was spent, and it is worth looking at with the amount still owed to you alongside, because a month with a lot outstanding can look worse than it is.

In Mi Clínica, the “Facturación” summary puts it on a single screen:

• A chart of payments received against expenses for the last six months, month by month.
• A balance for the last 30 days with income collected, expenses, the result and the amount still owed to you.

Each expense counts on the date of its invoice, not the day you recorded it. That is why you should enter the real date even if you record the invoice late.

When reading the summary, three ideas:

1. Compare months, not a single month. A month with the purchase of a piece of equipment will come out negative; what matters is the trend.
2. Separate fixed from variable. If supplies rise faster than what you collect, you are either overspending or undercharging.
3. Look at what is outstanding. A low result with a lot still owed to you is not the same as a low result with nothing outstanding.

If what is outstanding comes from quotes that turn into an invoice once the treatment is carried out, we explain how to handle them in treatment quotes in a clinic.

Who tracks expenses and how often

Expenses should be handled by one or two people with a fixed routine: record each invoice when it arrives and review the month when it closes. If the whole team records “a bit”, nobody knows what is missing.

In Mi Clínica, by default, expenses are handled by “Dirección” (Management) and “Administración” (Administration). “Recepción” (Reception), which does handle the diary, patients and payments received, does not manage them, and neither do healthcare professionals. A routine that works:

1. Every day: record an invoice the same day it arrives, with its real date.
2. Every week: go through the bank and record any direct debits and card charges that are missing.
3. Every month: look at the income and expenses summary and compare it with previous months.
4. When the time comes: pass the original invoices to your accountant, as you do now.

Mi Clínica is management software: it helps you see what comes in and what goes out, but it does not replace accounting or decide how each expense is declared; that is a matter for your accountant. If you are starting to get the clinic in order, in what clinic management software should have we go over the other pieces. A summary of the features is on the Mi Clínica page (in Spanish).