Common Practice Pitfall & How to Fix it: Customizing Chart of Accounts

QuickBooks Online is powerful—but only when it's tailored to your business. One of the biggest mistakes I see chiropractors and health services providers make is sticking with the default chart of accounts. It’s quick to set up, but it’s not tailored for how your practice actually operates.

Here’s what can go wrong:

• All your revenue gets lumped into one “Sales” category—whether it’s services, products, or memberships.

• Key expenses like materials related to patient care, software subscriptions, or marketing spend get buried in catch-all accounts.

• Reports don’t give you real insight into what’s working (or where money is being wasted).

Fix this bye customing your chart of accounts to reflect how you actually run your business!

Ask yourself:

• What income streams do I want to see separately?
    → Create income sub-accounts for things like paid by insurer, memberships, or supplement sales.

• Which expenses do I need to track more closely?
    → Create expense sub-accounts for Facebook ads, Google ads, and business cards instead of lumping them all under “Marketing.”

• Do I need special categories for cost of goods sold, subcontractors, sales tax, or prepaid services?

  → If the answer is yes, be sure those categories have their own space on your chart.

A customized chart of accounts cleans up your books AND turns your numbers into useful tools for smarter decisions.

If it feels overwhelming, you’re not alone. Setting this up right is one of the smartest things a professional bookkeeper can help you with. Let’s make your numbers make sense. Schedule a call with me now.