Finance & FP&A

How to prepare audit and tax workpapers as Independent Clinic Owner-Operators

Finance & FP&AFor Independent Clinic Owner-Operators3 apps12 steps~24 min to set up

Every January and April, your billing person pulls double duty as an impromptu bookkeeper, exporting CSVs from your practice management system and manually cross-referencing them against your bank statements in QuickBooks. Your CPA charges by the hour and keeps asking for the same three reconciliations you thought you sent last week. Payroll from ADP or Paylocity lives in one place, insurance payments live in another, and your contractor agreements for the PT who covers Fridays are in a Google Drive folder nobody has organized since 2023. By the time your accountant has what they need, you've spent six evenings on it and you're still not sure the depreciation on the X-ray unit is right.

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Finance & FP&AFor Independent Clinic Owner-Operators3 apps12 steps~24 min to set up

Outcome

What you'll set up

A live workpaper dashboard that pulls transactions from your bank (via Plaid), payroll runs (via ADP or Paylocity), and invoices (via QuickBooks) into one reconciled view your CPA can actually read — no more emailing CSVs back and forth

Automated anomaly alerts that flag unusual vendor charges, missing insurance payment deposits, or payroll runs that deviate from the prior period before your accountant finds them first

A searchable contract and document log so the contractor agreements, equipment leases, and payer credentialing paperwork your auditor will ask for are findable in under two minutes

The Starch recipe

Apps, data, and prompts

The combination of Starch apps, the data sources they pull from, and the prompts you use to drive them.

Apps used

Transaction Insights Budgeting Knowledge Management

Data sources & config

Starch syncs your Plaid bank and credit account data on a schedule (transactions, balances, institutions) and connects directly to QuickBooks for invoices, bills, vendors, and journal entries on a scheduled sync. ADP or Paylocity payroll runs also sync on a schedule. For EHR-side payment data — if your system is web-accessible but lacks a direct API connection — Starch automates it through your browser, no API needed. Notion connects via Starch's scheduled sync to pull in any existing doc library you've already built.

Prompts to copy

Pull all transactions from my Plaid-connected business checking and savings accounts for Q1 2026. Group them by category — payroll, medical supplies, rent, insurance, contractor payments. Flag any transaction over $1,500 that doesn't match a recurring vendor I've paid before.

Build me a quarterly budget-vs-actual view using my Plaid transactions and QuickBooks data. Show me where I'm more than 10% over budget by category, and give me a plain-English summary I can paste into my CPA's workpaper template.

Create a knowledge base that stores all my contractor agreements, equipment lease terms, and payer contract summaries. Let me search by vendor name, expiration date, or dollar amount. Alert me 60 days before any contract expires.

Run these in Starch → or paste them into your favorite agent

Walkthrough

Step-by-step

1 Connect your business checking, savings, and any clinic credit card accounts through Plaid — Starch syncs transactions and balances on a schedule so you're not exporting CSVs before every CPA call.

2 Connect QuickBooks so Starch can pull invoices, bills, vendor records, and journal entries. Note: QuickBooks report-level views (P&L, Transaction List) are temporarily unavailable; entity-level data syncs normally — this is usually enough for workpaper prep.

3 Connect ADP or Paylocity so payroll runs, employee records, and benefit deductions are in the same place as your transaction data. Starch syncs this on a schedule.

4 Open the Transaction Insights app and tell Starch: 'Show me all vendor payments in the last 12 months, grouped by category, with month-over-month variance. Flag any vendor that appeared in fewer than 3 months or had a charge more than 50% above their average.' This becomes your accounts-payable workpaper base.

5 Use the Budgeting app to build a budget-vs-actual schedule for the audit period. Give Starch your prior-year actuals from QuickBooks and this year's Plaid transactions, then ask it to produce a variance schedule by expense category.

6 For any insurance remittance data your EHR holds on a web portal, Starch automates the export through your browser — no API required. Ask Starch to pull the remittance summary for the audit period and match deposits against your bank records.

7 Reconcile payroll: ask Starch to compare total payroll disbursements from ADP or Paylocity against the corresponding ACH debits in your Plaid-connected account for each pay period in the audit window. Surface any gaps.

8 Set up the Knowledge Management app as your document repository. Upload contractor agreements, equipment leases, and payer contracts. Ask Starch to extract the vendor name, effective date, expiration date, and contract value from each document so they're searchable and sortable.

9 Build an anomaly alert: 'Every Monday, compare last week's transactions against the same week in the prior three months. Slack me if any single vendor charge is more than 40% above their average or if a recurring charge didn't appear this period.'

10 Generate the workpaper package: ask Starch to produce a summary document with (a) the reconciled transaction schedule, (b) the payroll reconciliation, (c) the budget-vs-actual variance schedule, and (d) a list of all open questions flagged for your CPA — formatted as a table with account, amount, and question.

11 Share the output with your CPA directly from Starch. When they come back with follow-up questions, you can run targeted queries rather than re-exporting everything from scratch.

12 After filing, archive the workpaper snapshot in your Knowledge Management app tagged by tax year so next year's audit starts with last year's reconciled data already in place.

See this running on Starch

Connect your tools, describe what you want, and the agent builds it. Closed beta is free.

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Worked example

Q1 2026 workpaper prep — three-provider physical therapy clinic

Sample numbers from a real run

Payroll (ADP, 12 pay periods)	187,400
Medical supplies — recurring vendors	22,100
Medical supplies — new/flagged vendors	4,800
Rent and occupancy	31,500
Insurance credentialing & billing fees	8,900
Contractor PT (Friday coverage)	14,400
Equipment lease (ultrasound unit)	3,600
Unmatched insurance remittances (flagged)	2,300

In this clinic's Q1 2026 close, Starch synced 847 Plaid transactions across two checking accounts and one business credit card. The anomaly scan flagged a $4,800 cluster across three new medical supply vendors — two turned out to be a legitimate one-time order, but one ($1,100 charge) was a duplicate that had never been caught. The payroll reconciliation matched all 12 ADP pay runs against ACH debits in the bank account; one $200 discrepancy traced to a benefit adjustment that hadn't been posted in QuickBooks yet. The contractor PT's Friday coverage payments ($14,400 over 13 weeks) were in the transaction data but the underlying 1099 agreement was missing from the file — the Knowledge Management app flagged it as an expiring contract with no renewal on record, which the owner-operator had completely forgotten. The insurance remittance pull via browser automation surfaced $2,300 in deposits that hadn't been categorized in QuickBooks, which would have shown up as unexplained income on the draft P&L. Total time from 'connect the accounts' to 'hand the CPA a package': one afternoon instead of the usual week of back-and-forth.

Measurement

How you'll know it's working

Time from period-end to completed workpaper package delivered to CPA (target: under 5 business days)

Number of auditor follow-up questions that require a new data pull vs. answered from existing workpapers (lower is better)

Unmatched insurance remittances as a percentage of total deposits — should be under 1%

Flagged anomalous transactions resolved before CPA review (catches costly surprises early)

Contractor and vendor agreements with expiration dates logged and tracked (should be 100% of active contracts)

Comparison

What this replaces

The other ways teams handle this today, and how the Starch version compares.

QuickBooks + manual CPA prep

QuickBooks holds your ledger well, but generating reconciled workpapers from it still means your CPA or a staff member exporting reports, matching them by hand, and emailing files — Starch replaces the manual assembly layer, not QuickBooks itself.

Practice management system reports (Jane, SimplePractice, Kareo)

EHR-side reports are good for payer-specific revenue data but don't see your bank accounts, payroll system, or vendor payments — you still need something to pull all three together.

Spreadsheet-based workpapers (Excel / Google Sheets)

Free and flexible, but every period you're rebuilding the same reconciliation from scratch; there's no anomaly detection and the file history is not an audit trail.

Accounting firm-managed close (outsourced bookkeeper)

Offloads the work but costs $500–$1,500/month for a small clinic and you still have to gather and send the source documents; Starch handles the data assembly so your CPA's time goes to judgment calls, not gathering CSVs.

On Starch RECOMMENDED

One platform — transaction insights, quarterly budgeting, knowledge management all running on connected data. Setup in plain English; numbers stay current via scheduled syncs and live agent queries.

Try it on Starch →

FAQ

Frequently asked questions

Can Starch pull directly from my EHR for payment data?

It depends on the EHR. If your system (Jane, SimplePractice, Kareo, etc.) has a web portal you can log into, Starch can automate data extraction through your browser — no API required. If it's in Starch's integration catalog of 3,000+ apps, the agent queries it live. Either way, your bank-side transaction data comes from Plaid's scheduled sync, which is the most reliable source for reconciliation purposes.

QuickBooks is where my accountant lives. Will Starch replace it?

No — Starch syncs from QuickBooks, it doesn't replace it. Your ledger stays in QuickBooks; Starch reads the invoices, bills, vendors, and journal entries from it on a schedule and combines them with your Plaid bank data and ADP/Paylocity payroll data to build the workpaper view your CPA actually needs. One honest caveat: QuickBooks report-level views (like the built-in P&L or Transaction List report) are temporarily unavailable pending a connector fix; entity-level data syncs fine.

Is my financial data stored securely in Starch?

Starch handles your synced data seriously, but it is not SOC 2 Type II certified today. If your CPA, hospital system contract, or payer agreement requires SOC 2 Type II compliance from any vendor that handles your financial data, that's worth flagging before you connect your accounts.

My contractor PT's payments are in cash or Venmo sometimes. Can Starch track those?

If the payments went through your Plaid-connected business bank account, they'll show up. Venmo business transactions should flow through if your Venmo is linked to that account. Cash payments won't appear in Plaid — you'd need to log those manually in QuickBooks and they'd sync from there.

What about the Contract Lifecycle Management app I saw mentioned for tracking agreements?

Contract Lifecycle Management — including AI-powered drafting, e-signature workflows, and renewal alerts — is coming soon; you can request beta access to be notified when it launches. In the meantime, the Knowledge Management app (available today) handles the document repository and searchable contract log well for audit prep purposes. You'd ask Starch to extract key terms and expiration dates from your uploaded PDFs and surface them on a schedule.

How long does it take to go from 'nothing connected' to 'workpapers ready for my CPA'?

For a three-provider clinic with Plaid, QuickBooks, and ADP or Paylocity already set up: connecting the accounts takes 20–30 minutes. The first time you run the reconciliation and anomaly scan, expect another hour to review flagged items and decide which to include in the workpaper package. After the first period, you're mostly reviewing rather than building from scratch.