Clinic ERP Consultant, Canada

Fee splits and independent practitioners

In Canadian physiotherapy, chiropractic, massage therapy and dental clinics, many practitioners work as associates under a split arrangement: the clinic keeps a share of fees in return for space, administration and patients, and the practitioner keeps the rest. Some are employees on salary with bonuses; others rent space or pay a flat clinic fee. A group built through acquisitions can have several versions of each, with different splits for new and senior associates.

The questions that decide the system design are practical. Is the split calculated on amounts billed or amounts collected? Who absorbs an insurer denial or an unpaid patient balance? How are cancellation fees, assessments and products sold during treatment handled? Are clinic fees charged to the associate on a separate invoice? When answers vary by agreement, the monthly statement becomes a spreadsheet exercise that few people can check.

I gather the agreement types, express each as a rule, and base the statement on clinic software figures that finance has already reconciled. Employee or contractor status, and its payroll and tax consequences, belong with your accountant and lawyer. The system then has to carry the arrangement they confirm.

Direct billing, deposits and patient balances

Front desks in Canadian clinics often submit claims to extended health insurers on the patient's behalf, collect any remaining amount from the patient and wait for the insurer payment to arrive by electronic transfer. Accident claims, workers' compensation cases, public program billing and, for dental groups, public dental program claims add more payer types, each with its own timing and rejection reasons. The clinic software manages submission; finance has to make sense of what lands in the bank.

The common problem is that deposits arrive in batches covering many patients and several clinics, while card and debit settlements arrive net of fees. If the ERP only receives a monthly revenue total, unmatched amounts accumulate quietly. I design a summary feed by clinic, payer type and period, together with a matching routine for insurer deposits, card settlements and patient payments.

Packages and gift cards are handled in the same exercise. A package bought at one clinic and used at another should move revenue to the clinic that delivered the care, and unredeemed balances should be visible as a liability. Your accountant confirms the policy for expiry and breakage; I make sure the systems follow it.

GST/HST, provincial tax and taxable extras

Many health services delivered by regulated practitioners are exempt from GST/HST, but not every line on a clinic invoice is. Retail products, some braces and supplies, cosmetic treatments and certain services provided by practitioners whose profession is not covered by the exemption may be taxable. Provinces add their own layer: harmonized sales tax in some, separate provincial sales tax in others and QST in Quebec, each with its own rules on goods and services.

For a group operating in more than one province, the consequence is a tax code matrix: each service and product, in each province, with the treatment confirmed by your accountant. That matrix drives the clinic software settings, the ERP item master and the ledger codes. Exempt revenue also affects how much tax paid on purchases can be recovered as input tax credits, so purchase coding matters too.

I build the matrix with your advisor's input and turn it into test cases for UAT: an exempt treatment, a taxable retail sale, a package containing both and a sale in each province you operate in. Quebec clinics also bring French-language expectations for invoices and customer-facing documents, which I include in platform evaluation.

Supplies and the clinic opening template

Clinic supplies are rarely the largest cost, but they leak quietly: tape, needles for acupuncture or dry needling, exercise equipment, orthotic and bracing stock, dental materials, injectables and retail lines. Most are bought from Canadian medical and dental distributors, with some items sourced from the United States in US dollars. I set up an approved catalog, ordering limits per clinic, count routines and lot and expiry capture for products where your clinical lead wants traceability.

Groups that open or acquire clinics regularly benefit most from a template. Mine covers the clinic code and any new entity, the account mapping, provincial tax settings, the payers that clinic bills, the catalog and par levels, practitioner agreement types, the summary feed from the clinic software and a short closing checklist for the first month. The pilot clinic proves it, and every later clinic follows the same path.

Professional college registration, privacy compliance and clinical policies remain with the practitioners and your compliance lead. The template names who owns them without bringing regulatory records into the ERP.

Platforms, privacy and remote delivery in Canada

Clinic groups here often run QuickBooks Online or Sage with a separate payroll service, and practitioner statements built in spreadsheets from clinic software reports. I assess Zoho, Odoo, ERPNext and Business Central on your own scenarios, and sometimes conclude that better-connected accounting is enough for now.

Personal health information is protected under provincial health privacy laws and federal privacy law where it applies, so the integration design keeps it in the clinic software. The ERP receives clinic codes, payer types, practitioner references and amounts. Your privacy officer reviews the data flows and the hosting location of any platform you shortlist.

I work remotely, scheduling live sessions across Canadian time zones from Atlantic to Pacific and recording them for clinic managers. More context: ERP for clinics, the Canada healthcare ERP page for care homes, imaging and larger providers, my Canadian ERP consulting page, the Canada hub and testing and UAT for how scenarios are checked before go-live.