Dermatology runs two businesses under one roof: a same-day cosmetic business collected on a card, and a medical business that pays weeks later by EFT. They share a front desk and a bank account. Lemma keeps them separable in the ledger.
Book a demoOne side is receivables management, the other is retail with inventory. Reporting that blends them tells you nothing about either.
Card settlements from injectables and laser series are tagged separately from payer EFTs for biopsies and excisions, so each line of business has its own margin.
Vial orders are large and scheduled. Routine vendor payments run over free ACH, and flat-rate wires cover a device purchase that has to clear today.
Professional, facility, and pathology components of a Mohs case pay on different remittances. Line-level posting keeps each tied to the same case.
Each location and each PC gets its own routing number for EFT receipt and its own lockbox address, all visible in one dashboard.
The medical side bills claims for lesion removals, biopsies, and Mohs surgery, with pathology frequently billed on its own, and collects by EFT on each payer's cycle. The cosmetic side sells injectables, laser series, and skincare, and collects in full at the time of service by card. One side is accounts receivable management. The other is retail with real inventory sitting in a refrigerator.
Injectable inventory sharpens the point. You buy neurotoxin and filler by the vial ahead of demand, at cost, against vendor loyalty and rebate programs. The payable runs ahead of the cosmetic revenue it supports, which makes cash timing a scheduling decision rather than an afterthought.
Laser series and membership plans are collected up front. Tagging those drafts keeps unearned package revenue separable from treatments you have already delivered.
Vendor orders are predictable in timing and large in amount, which is exactly the case where a per-transaction fee or a wire tier stops being trivial.
Retail carries a cost of goods that clinical revenue does not. Separating those card settlements is what makes retail margin visible at all.
Yes. Card settlements from cosmetic services and payer EFTs from medical claims are tagged distinctly in the same account, so you can read the margin on each line of business without exporting to a spreadsheet.
Package and membership drafts are tagged as prepaid revenue and reported apart from delivered treatments, which keeps money you still owe treatment against from reading as profit. Prepaid balances and operating cash earn 1.75% APY on every account, not in a separate savings tier.
No. Dermatology consolidates fast, so multi-entity is normal: a professional corporation per state, a management company for the administrative side, sometimes a separate entity for cosmetic and retail. Each gets a dedicated routing number, a lockbox address, its own statements, and its own FDIC coverage, so a payer enrollment change at one never touches another. An automated cash sweep moves daily card settlements and periodic payer EFTs into the management entity that pays vendors and payroll.
Scheduled vendor orders run over free ACH at any volume. When a device purchase has to settle immediately, wires are flat rate regardless of amount.
