Niche Specialization
Built for healthcare. Extended to those who care.
PRIMARY
Healthcare & Medical Practices
We work with practice owners who want a financial partner who already speaks their language.
Dental Practices — Solo and group practices, DSO transitions, associate buy-ins.
Physician Groups — Partnership structures, provider compensation, multi-owner distributions.
Specialty Practices — Dermatology, ophthalmology, orthopedics, med spas, and surgical practices.
Practice Acquisitions — Buy-side analysis, deal structuring, and post-close setup.
SECONDARY
Home & Community Based Services
A field where the accounting is genuinely hard — and most CPAs don't touch it.
Home Care Agencies — Payroll-heavy operations, caregiver cost tracking, margin visibility.
Medicaid Waiver Providers — Cost reporting support, rate analysis, program-level P&Ls.
Behavioral Health & IDD Providers — Multi-program tracking, reimbursement timing, grant and contract accounting.
ALSO SERVING — Nonprofits & Service Businesses
The same discipline — clean books, proactive tax positioning — applied wherever it earns its keep.
Nonprofit Organizations — Fund accounting, grant and restricted-fund tracking, Form 990 preparation, and board-ready financial reporting.
Other professional service firms - Reach out to see if we can support your gaols
Services
Four ways we keep your finances ahead of you.
Bookkeeping & Accounting
Clean, current books you can actually make decisions from. Monthly close, reconciled accounts, and financials that tell you what's happening while you can still do something about it.
Tax Preparation & Compliance
Federal, state, and local filings handled accurately and on time. Entity returns, owner returns, and the coordination between them — done once, done right.
Tax Planning & Strategy
Most practices overpay because nobody looked at the numbers until April. We plan year-round — entity structure, compensation, timing, and elections — so your tax bill is a decision, not a surprise.
Fractional CFO & Advisory
The financial partner most practices can't justify hiring full-time. Cash flow forecasting, profitability by provider or program, acquisition analysis, and a plan you revisit every quarter.
A different kind of accounting relationship.
CPA-Led
Your work is directed by a licensed CPA — not handed to whoever's available.
Proactive, Not Reactive
We plan year-round. A tax return should confirm what you already decided, not reveal what you missed.
Remote-First, Genuinely Responsive
Based in Los Angeles, working with clients wherever they are. You get answers in days, not weeks.
Transparent Pricing
Package-based and agreed in advance. No surprise invoices for asking a question.
Packages
Choose the level of partnership you need.
Every engagement starts with a conversation about fit, not a contract.
Foundation
For practices that need their books right and their taxes handled.
- Monthly bookkeeping and reconciliation
- Monthly financial statements
- Annual business tax return
- Annual owner tax return
- Year-end tax planning session
- Email support
[YOUR FOUNDATION PRICE] /month
MOST POPULAR
Growth Partner
For practice owners who want a strategist, not just a preparer.
- Everything in Foundation
- Quarterly tax planning and projections
- Entity structure and compensation review
- Cash flow forecasting
- Quarterly strategy call
- Priority response
[YOUR GROWTH PARTNER PRICE] /month
Concierge CFO
For multi-provider practices, acquisitions, and complex structures.
- Everything in Growth Partner
- Monthly CFO advisory sessions
- Profitability analysis by provider or program
- Acquisition and buy-in modeling
- Multi-entity coordination
- Direct access when you need it
[YOUR CONCIERGE PRICE] /month
The Journey
Our Consultation Process
We know that choosing partners is a big decision. That’s why every engagement with ONCE Solutions starts with a genuine conversation about fit, not a contract. We take the time to understand your practice’s specific hurdles before we ever talk about numbers.
01
Discovery Call
A 30-minute deep dive. We discuss your current pain points, goals, and determine if our expertise aligns with your needs. Free
02
Assessment & Proposal
We review your books and prior returns to find what's leaking and what's fixable. Translate it into a clear scope and a fixed price. You get an honest read on where you stand and know exactly what you're getting before you commit.
03
Onboarding
We take it from here: records, systems, prior filings, and a clean starting point. Structured, not chaotic.
04
Ongoing Partnership
Regular touchpoints, proactive planning, and a CPA who knows your practice before you have to explain it.
About the Firm
The Los Angeles financial partner for those who prioritize patient care.
Headquartered in Los Angeles, ONCE Solutions was founded on a simple premise: medical practices deserve more than just seasonal tax preparation. You need a dedicated financial steward who understands the complexities of healthcare reimbursement, provider compensation, and the unique rhythms of a busy clinical practice.
We bridge the gap between clinical excellence and financial sustainability. By focusing exclusively on the healthcare niche, our CPAs provide more than clean books—we provide the strategic insight that allows owners to expand their impact without sacrificing their peace of mind.
Achille Fankem, CPA
Managing Partner
With over 15 years in medical practice finance, David specializes in tax mitigation strategies that keep providers focused on their clinical mission.
Quentin Johns, CPA (Inactive), MBA
Senior Advisory Partner
Elena leads our fractional CFO services, bringing deep expertise in healthcare reimbursement modeling and acquisition strategy.
Client Success
Stories from the Field
01
"ONCE Solutions got us audit-ready for our Regional Center audit, analyzed staff utilization to maximize revenue across our different revenue streams, and put a monthly close and billing cadence in place across our insurance payers. Their guidance lets me stay focused on clinical excellence and our families while we confidently scale."
Suely Johns, CEO - Compass Center, Inc.
02
"They cleaned up our books, amended our return, and helped us recover over $25,000 in refunds, catching errors our previous bookkeeper missed."
Herb Courtney, CEO - RSC
03
"The difference is staggering. Their automated systems saved us ten hours a week, letting us prioritize patient health."
Elena Rossi, Private Clinic Head