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 program in place — BAA signed before any PHI, encryption, access controls and audit logging (see how) · BBB A+ · IRS e-file · Cancel with 30 days' notice
Outsourcing Value Estimator
Price your service mix, or price the cost of keeping it in house
Medical billing appears once you select a healthcare practice.
Choose a service from the dropdown to start building your estimate.
Where do you fit?
Pick the description closest to you and we'll show you only what applies.
I run a healthcare or behavioral-health practice
Billing, books and payroll under one team — claims out daily, denials worked, and a P&L that agrees with collected cash.
See practice servicesI run a growing business
Bookkeeping, monthly close, payroll and tax handled by a named senior accountant on a flat monthly fee.
See accounting servicesI'm starting or restructuring a business
Entity choice, registration, EIN and licences, then books and payroll set up correctly from day one.
See advisory servicesNot sure yet? Browse every service or see published pricing.
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+Across every industry
Count of companies and practices engaged since founding.
- Of claims processed
- MillionsSince 2021
Across claims submitted on behalf of client practices.
- States served
- 50From Phoenix, AZ
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.
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.
Secondary option · Free review
Not ready to book a call? Start with a free Books Health Check.
Prefer to talk first? The free 30-minute consultation is still the fastest route. Otherwise, send 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.
What clients actually say
Client testimonials
5.0 on TrustpilotA+ on BBB8 verified reviews
- Encryption, access controls and audit logging, with a BAA signed before any PHI. Security & compliance detail →
- Certified QuickBooks ProAdvisor — Gold, IRS e-file provider, BBB A+. Full certification register →
- Practices, trades, professional services, e-commerce and startups. Industry deep-dives →
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
5 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 pressure — you leave with a clear next-step recommendation