Where Hospital Internal Audit Rigor Meets Private Clinical Practice.
Leigh Ann Garber, CIA brings 11+ years leading internal audit groups at Tenet Healthcare and Triad Hospitals to independent chiropractors, specialty physicians, and dental groups across North Texas. Reconciling EHR clearinghouses, eliminating lockbox timing float, and unlocking Section 179 equipment tax savings.
The 4 Clinical Blind Spots That Silently Drain Practice Cash Flow
Private clinical practices are neither standard small businesses nor corporate hospitals. They require bespoke accounting controls tailored to patient clearinghouses, third-party payors, and capital medical equipment.
EHR / PM to Bank Settlement Reconciliation
Practice management systems track gross patient charges and copays, but merchant processors (Stripe, Square, CardConnect) deposit net batches after deducting processing fees, interchange surcharges, and multi-day clearinghouse sweeps. Generic bookkeepers dump the discrepancies into unclassified sales or random 'discounts,' obscuring your true top-line collections and distorting your CPA's gross revenue figures on Form 1120-S.
Leigh Ann's Tenet Healthcare protocol ties out daily EHR day-sheet totals against merchant clearinghouse settlement reports batch by batch. We isolate interchange and card-not-present merchant fees to GL 4090 so your gross collections tie 100% to insurance remittances and patient ledger balances with $0.00 unexplained variance.
IRS $2,500 De Minimis Safe Harbor & Section 179 CapEx Inspector
Under Treasury Reg. § 1.263(a)-1(f), expenditures up to exactly $2,500.00 can be immediately expensed under the De Minimis Safe Harbor election. Single medical invoices exceeding $2,500.00 must be capitalized to GL 1520 Fixed Assets to capture Section 179 first-year bonus depreciation and prevent artificial dips in clinic operating income.
How Health Source Chiropractic Unlocked +13.9% MoM Revenue Insight and a $3,480 Section 179 Reclassification
Dr. Chris Phillips, DC stepped out of weekly receipt triage and into a 60-second mobile close—while Leigh Ann and Glen reconciled 412 patient insurance claims to the exact penny.
Separating adjustment fees from decompression rehab packages identified a 21.3% growth surge in high-margin clinical modalities.
Reclassified out of consumable clinic supplies into Fixed Assets, lifting reported October EBITDA to $34,900 and prepped for Section 179.
Five ambiguous Chase credit card charges resolved on Dr. Phillips' smartphone between patient adjustments with 1-click options.
"I have worked with Glen and Leigh Ann now for about a year and it has helped tremendously. Being a chiropractor, I like for my focus to be on patient care and that is exactly what they have created for me. Their timely work and attention to detail has straightened out my entire business while allowing me to focus on my care for patients. They communicate directly with my CPA to make sure we are all on the same page which streamlines everything for me. This has increased profits and quality of life drastically for me."
Health Source Chiropractic — October 2026 P&L Variance
| General Ledger Line Item | Prior Month (Sep) | Actual (Oct) | Target Budget | Leigh Ann's CIA Audit Note |
|---|---|---|---|---|
| 4010 · Patient Care & Adjustments | $68,400 | $76,250 | $71,000 | Strong patient retention + 18 new McKinney patient intakes |
| 4020 · Rehab & Decompression Therapy | $22,100 | $26,800 | $23,500 | High-margin decompression package utilization up 21.3% MoM |
| 4090 · Merchant Processing Fees | $2,410 | $3,190 | $2,500 | Effective merchant rate rose from 2.66% to 3.09% — flagged for audit |
| 5010 · Clinical & Rehab Supplies | $4,120 | $7,600 | $4,300 | Includes $3,480 Chattanooga traction table — move to Fixed Assets |
| 6100 · Clinic Payroll & Benefits | $38,200 | $39,100 | $39,000 | On budget (37.9% of gross collections) |
| 6400 · Facility Lease, EHR & Admin Overhead | $16,850 | $17,050 | $17,000 | Steady fixed overhead |
| 6420 · Digital Local Patient Acquisition & Marketing | $4,800 | $4,690 | $5,000 | McKinney search & community outreach campaigns |
| Net Operating Income (EBITDA) | $28,920 | $31,420 | $26,700 | +$4,720 ahead of October target (+$34,900 after Fixed Asset reclass) |
Engineered for High-Volume, Independent Clinics
We understand the clinical flow, equipment capitalization schedules, and merchant fee traps unique to each healthcare discipline.
Chiropractic & Rehab
ChiroTouch · WebPT · Genesis
Separating insurance copays, cash adjustment packages, and decompression therapy revenue with automatic Safe Harbor tracking for rehab modalities.
Specialty Physicians
Athenahealth · Epic · Kareo
Multi-site clinic P&L consolidation, malpractice insurance prepaid accruals ($14,200 TMLT schedules), and mid-level provider productivity tracking.
Dental & Orthodontics
Dentrix · Curve · CareCredit
Patient financing clearing tie-outs, dental lab COGS tracking, associate dentist commission splits, and 3D scanner Section 179 depreciation schedules.
Physical Therapy
Prompt PT · WebPT · Raintree
Medicare cap tracking, therapist billable hour ratios, commercial payor contract auditing, and equipment lease versus purchase analyses.
Hospital-Grade Internal Audit Controls for Your Private Practice
A graduate of Southern Methodist University, Leigh Ann gained foundational rigor early in her career with Arthur Andersen and KPMG. She spent more than seven years with the internal audit groups at Triad Hospitals and Tenet Healthcare before serving four years as Director of Operations Finance for Tenet Practice Resources—overseeing financial operations for physician practices across Texas, Tennessee, and Missouri and managing a staff of 15 accountants.
Together with Glen Garber's 30+ years corporate FP&A background at Texas Instruments and Compass Bank, Garber² Partners provides both sides of the coin: institutional audit-readiness from Leigh Ann, and strategic cash flow modeling, commercial lending packages, and practice expansion modeling from Glen.
HIPAA Privacy & Browser-Side CIA PII Shield
Client financial data processed in browser; zero EHR PHI transmitted to LLMs. All entity names, EINs, and bank accounts are masked locally before AI analysis. Depreciation subject to IRS Form 4562 and CPA tax election.
Ready for Hospital-Grade Accounting Precision in Your Clinic?
Let Leigh Ann Garber, CIA and Glen Garber audit your EHR clearinghouse drift, review your merchant processing fees, and identify missed Section 179 deductions.