One team for your books, payroll, tax — and your medical billing.
Bookkeeping, payroll, tax and medical billing run by one senior US-based team. Books closed by business day 5, claims out daily, and a flat monthly fee published before you sign.
Certified QuickBooks ProAdvisor — Gold · HIPAA-compliant · BAA signed before any PHI · BBB A+ · IRS e-file · Cancel with 30 days' notice
Outsourcing Value Estimator
See what your finance function is really costing you
Slide to input your team size and monthly transactions to instantly reveal how many operational hours you can reclaim this month.
- Monthly hours saved
- 55
- Est. monthly cost saved
- $3,410
- Productivity lift
- 35%
Systems fluency
Built around the platforms you already use
ADP
Gusto- MS 365
Xero
QuickBooks Online
Intuit ProConnect- Keeper
- Epic
- Kipu
- Office Ally
- TheraNest
- Avea
- ICANotes
- BestNotes
NEXACC works within the listed systems. Platform names identify compatible software and do not imply endorsement.
Proof at a glance
- Companies and practices served
- 100+
- Of claims processed
- Millions
- States served
- 50
- Founded
- 2021
Across every industry
Since 2021
From Phoenix, AZ
Certified QuickBooks ProAdvisor practice
Margin diagnostic
Three leaks quietly costing you money right now
Most owners don't lose money on one big mistake. They lose it in the gap between what the books say and what's actually happening.
- LEAK 01
Books that are always a month behind
You're pricing jobs, hiring, and drawing owner pay off last quarter's numbers. By the time the ledger catches up, the decision is already made.
Cost signal
18–30 days
Average decision lag on stale books
How NEXACC closes it
Five-day close with weekly flash reporting
Decision lag drops to under 7 days
- LEAK 02
Compliance you find out about late
Multi-state payroll registration, sales tax in every state you owe it, and 1099 deadlines don't send warnings. The first signal is usually a notice with penalties attached.
Cost signal
5% + interest
IRS late-filing penalty, per month, capped at 25%
How NEXACC closes it
Deadline calendar, state sales-tax tracking, and we answer every IRS and state notice for you
Zero missed statutory filings across our book
- LEAK 03
A finance hire you can't justify yet
A full-time controller runs six figures loaded with benefits, software, and PTO coverage. Your problem is ten hours a week of senior judgment — not a headcount.
Cost signal
$118k+
Loaded annual cost of an in-house controller
How NEXACC closes it
Fractional senior review at a flat monthly fee
Typically 60–75% less than an in-house seat
- 96%
- First-pass claim acceptance
- 5 days
- Median monthly close
- 100%
- Books reconciled every month
- 1 day
- Response-time commitment
End-to-end management
One team. Every financial function. No handoffs between vendors.
Most growing companies stitch together a bookkeeper, a payroll app, a billing service, and a tax preparer who meets them once a year. NEXACC replaces that stack.
Everything included
One team for the entire financial back office.
The books, the monthly close, payroll, tax filings, medical billing, and the reporting that tells you how the business is actually doing — plus support when it counts: IRS and state notices, dispute resolution, and lender-ready files.
Why | NEXACC
Why growing companies move their accounting to NEXACC
Not sure which service you need? That's exactly what the consultation is for — senior review, certified systems, fixed pricing, and specialists on the hard parts.
Book a Free Consultation- 01
Senior judgment, not just data entry
Every account is led by an experienced accountant who reviews the work and flags what looks wrong before it becomes a problem.
- 02
Flat monthly pricing, scoped up front
A fixed monthly fee based on transaction volume and scope — agreed before we start. No hourly billing, no surprise invoices for a phone call.
- 03
Specialists for the hard parts
Medical billing, multi-state payroll tax, and startup compliance each get a dedicated specialist instead of one generalist guessing.
Who we serve
Built for the businesses that outgrow DIY bookkeeping first
We work best with owner-led companies at the stage where transaction volume has outpaced spreadsheets but a full finance department is still years away — from first books to multi-entity consolidations. Pick your world below to see exactly what we run.
Engagement fit
Flat monthly fee · Cancel with 30 days' notice · Your file, logins and admin access handed back within 5 business days · US-based lead accountant
Investor-grade books from the first wire, not the first diligence request
Sound familiar?
- A lead investor asked for monthly financials you don't have
- Runway is tracked in a spreadsheet nobody trusts
- Deferred revenue and SAFE/note treatment were never booked properly
5 days
Typical close after month end
ASC 606
Revenue recognition applied
What we run for you
- Accrual books on GAAP-aligned revenue recognition (ASC 606)
- Burn, runway and cash-out-date reporting refreshed every close
- R&D payroll-tax credit coordination (up to $500K/yr offset)
- Delaware franchise tax, 83(b) tracking, cap-table-ready equity entries
- Board and investor reporting pack: KPIs, variance, cohort view
Onboarding | Timeline
Getting started takes about two weeks, not two months
A fixed, transparent sequence — you always know what happens next and what it costs.
- 01Day 0
Free consultation (30 minutes)
We look at where your books stand today, what's actually broken, and what compliance exposure you're carrying. You leave with a clear read whether or not you hire us.
- 02Day 2
Scope and flat-rate proposal
Within two business days you get a written proposal: exactly which services, exactly what it costs monthly, exactly what we need from you.
- 03Week 1
Onboarding and cleanup
We take over your ledger, reconcile any backlog, migrate or clean up your chart of accounts, and set the close calendar.
- 04Ongoing
Monthly rhythm
Books closed on schedule. Financials delivered with a written summary of what changed and what to watch. A standing call whenever you want one.
Free review
Not ready to switch? Start with a free Books Health Check.
Send us read-only access to your accounting file and we'll return a written review of what's clean, what's exposed, and what it would take to fix.
- Reconciliation gaps & unmatched transactions
- Misclassified accounts and chart cleanup
- Aging receivables and collection risk
- Payroll tax and compliance exposure
No cost, no obligation, and you keep the findings whether you work with us or not.
Credentials | Verified, not claimed
NEXACC is a Certified QuickBooks ProAdvisor practice.
Every badge below links straight to Intuit's directory — click any one and confirm it yourself. No screenshots, no claims you have to take on faith.
ProAdvisor Gold tierJulius Ndahiro — Gold / Advanced tierVerify on Intuit →Opens Julius Ndahiro's verified profile on Intuit's ProAdvisor directory (profile username: julio-ndahimana).
Leave a ProAdvisor reviewInt. Class 35 · December 5, 2023Verify on USPTO
Certification register
5 active certifications- 01
QuickBooks OnlineCertified — Level 2Cloud ledgers, bank feeds, month-end close - 02
QuickBooks DesktopCertifiedLegacy files, job costing, clean migrations - 03
QuickBooks EnterpriseCertifiedInventory, advanced reporting, user roles - 04
QuickBooks WorkforceCertifiedPayroll records and employee self-service - 05
Intuit Enterprise SuiteCertifiedMulti-entity groups and consolidations
NEXACC is an independent accounting firm and a member of the QuickBooks ProAdvisor Program. QuickBooks and Intuit are trademarks of Intuit Inc.
What clients actually say
“Our Organisation Family Bond has been working with NEXACC for the past two years and it has been a tremendous journey of improved operations and decision making both on Financial side and operations side, we are grateful to have worked with NEXACC and their amazing team for both Accounting and medical Billing services.”
FamilyBond TreatmentCenter
Trustpilot verified review“Working with Nexacc has been the most rewarding decision my company has ever made. Their professionalism, knowledge about the healthcare industry, and technology are all top-tier. They have been responsive to our needs and have been able to collect insurance payments on time. Also, they have always advised us on how we can increase our revenues despite all the changes in the healthcare industry.”
Dushime Ines
Trustpilot verified review“I highly recommend NEXACC to any business looking for reliable and professional accounting support. Their team consistently provides outstanding service, demonstrating exceptional attention to detail, accuracy, and expertise in every aspect of our accounting and tax needs. They are responsive, knowledgeable, and always willing to take the time to answer questions and provide valuable financial guidance. Their thorough approach has given us confidence that our financial records are accurate, compliant, and well-managed. The level of professionalism, dedication, and customer service they provide is truly exceptional. Thanks to NEXACC, we can focus on growing our business, knowing that our accounting is in capable hands. We sincerely appreciate all of their hard work and highly recommend their services to anyone seeking a trustworthy and experienced accounting firm.”
MERCY M
BBB customer review5.0 on TrustpilotA+ on BBB8 verified reviews
Security & compliance you can audit
- HIPAA Business Associate Agreement — signed before any PHI is exchanged
- Written Information Security Program (WISP) per IRS Publication 4557 and the FTC Safeguards Rule — available on request
- AES-256 encryption at rest · TLS 1.2+ in transit · six-year append-only audit logs
- Authorized IRS e-file Provider · EFIN 868369
- Trust center — policies, sub-processors and how to report a security concern
Phoenix, Arizona · Live desk
Local enough to visit. Cloud enough to scale.
We know Arizona TPT filing, state withholding, and exactly what local lenders and landlords want to see in a financial package — and we run the same close calendar for clients three time zones away.
- Live
Phoenix, AZ
Scottsdale · Mesa · Tempe
- Live
AZ TPT license active
License 21416089 · valid through Dec 31, 2026
- Live
Same close calendar
Books closed by business day 5
100% cloud, every time zone
Same close calendar whether you're local or remote
Questions worth asking
8 answersStop guessing what your numbers mean.
Bring your current setup and your biggest frustration — we'll tell you exactly what we'd do about it.
- 30 minutes
- No obligation
- No pitch deck