Financial Services for
Ontario's Physicians, Dentists & Clinic Operators.

What Practices & Clinics Actually Face.

Ontario's medical and dental practice base is one of the deepest and most active in Canada. The GTA alone hosts thousands of GP dental practices, hundreds of specialist dental practices (endo, perio, ortho, oral surgery, prosthodontics, pediatric), family medicine clinics, walk-in clinics, and specialist medical practices, plus the growing adjacencies of physiotherapy, chiropractic, massage therapy, optometry, veterinary, cosmetic and aesthetic clinics, IVF and fertility, long-term care and home care. Multi-location groups — professionally-owned mini-groups and DSO-affiliated practices — are one of the most active practice succession markets Ontario dentistry has seen in a generation.

Practice operators face finance realities that touch professional corporation planning, billing reconciliation, staffing economics and succession all at once. Medicine Professional Corporations (MPC) and Dentistry Professional Corporations (DPC) are the foundational operating vehicle for most practitioners. Corporate structure setup and reorganization (professional corp + holdco + family trust). Small business deduction planning. Dividend vs salary optimization. Income sprinkling within the strict CRA rules for professional corps — the TOSI (Tax on Split Income) rules materially limit who can receive dividends from a professional corp. RRSP and IPP (Individual Pension Plan) coordination. And the ongoing corporate compliance that keeps College and Royal College professional corporation status intact.

Billing reconciliation is core practice bookkeeping work. Physicians work with OHIP fee-code claims, remittance advice reconciliation, rejected claim tracking and resubmission, alternate payment plans (APP) and salaried arrangements where applicable, and coordination with the billing agent or software. Dental practices reconcile private insurance (Manulife, Sun Life, Green Shield, Canada Life, Desjardins, Blue Cross) against claims submitted through iTrans/CDAnet, insurance write-offs, coordination of benefits between primary and secondary insurers, and the newer Canadian Dental Care Plan (CDCP) — the federal program that came online in 2024 and has meaningfully changed the billing mix for many Ontario dental practices. CDCP claim submission workflow, remittance reconciliation, and the CDA fee guide vs CDCP fee schedule variance analysis all need discipline.

Associate and hygienist compensation is where practice economics actually live. Associate compensation structures vary widely — percentage-of-billings, percentage-of-collections, day-rate, base-plus-bonus — and the lab bill and materials deduction rules differ by structure. T4A vs T4 determination based on the actual working relationship is strict for associates under CRA independent contractor vs employee tests. Hygienist compensation and production-based bonus structures. And associate-level margin analysis showing which associates are actually profitable to the practice after occupancy, materials, hygiene support and admin allocation — most practices have never seen this analysis and are quietly subsidizing associates who look busy but aren't earning their keep.

Practice acquisition financing is one of the biggest single financial decisions any dentist or physician makes. All Big Five Canadian banks run dedicated healthcare specialty lending groups — RBC Healthcare, TD Healthcare, BMO Healthcare, CIBC Healthcare, Scotiabank Healthcare — that offer preferred terms to licensed healthcare professionals. Package includes practice valuation review, cash flow underwriting to service the debt, associate and hygienist bench analysis, patient chart retention forecasting, transition period modeling and the tax-efficient corporate structure to hold the practice long-term. Equipment capex — CEREC, CBCT and imaging, chairs and units, medical equipment, aesthetic devices — financed through bank equipment lines and specialty manufacturer financing (Sinclair, Henry Schein, Patterson).

Layered on all of that: DSO (Dental Support Organization) consolidation has created one of the most active practice succession markets Ontario dentistry has seen in a generation. Buyers including Dentalcorp, 123Dentist, Altima and private equity-backed platforms are actively acquiring practices at meaningful multiples. Sell-side preparation includes 3-year clean financial history, EBITDA normalization (owner add-backs, non-recurring items, associate compensation adjustments to market), buyer diligence data room, valuation review across buyer types, Section 85 rollover and tax-efficient sale structuring, and coordination with dental M&A advisors and tax lawyers. Multi-location groups face parallel discipline including site-level P&L, inter-location cost allocation, roll-up dashboards and multi-entity management co structures. What practice operators need is senior finance leadership at Fractional pricing, deep expertise across professional corps, billing reconciliation, associate economics and DSO succession, plus fluency with Ontario's healthcare bank lending and DSO buyer ecosystem. Ledgerive was built for exactly that.