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The moment there are two entities, one location’s habits become a liability. Money must move by rule, on paper, between accounts that match the org chart.

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The rules

Revenue lands where it’s earned. Payer EFTs and patient payments belong to the PC that delivered the care; every payer enrollment names that PC’s account (directory). The fee moves by invoice. The MSO bills its management fee per the MSA, monthly, and the PC actually pays it, sweeping “whatever’s left” is what regulators and fee-splitting rules punish. Nothing crosses without paper. If the MSO covers a PC expense, book it as an intercompany payable and settle it. Payroll follows employment. Clinicians in the PC, business staff in the MSO, separate payroll runs (setup).

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The layout

Per PC: operating (deposits) and payroll. MSO: operating, payroll, tax reserve, and any capex account. Extend the single-practice structure per entity rather than inventing a new scheme, and close each entity’s books monthly (month-end close) with a consolidated view for you. The audit test to hold yourself to: a stranger reading only the bank statements should be able to reconstruct the org chart.