Optometrist bookkeeping: one storefront, two revenue engines, three HST rules

Run the exam lane and the dispensary as two profit centres

Exam revenue and eyewear revenue behave nothing alike: one is professional-fee income limited by chair time, the other is retail with inventory, supplier terms, and markup decisions. Blending them into a single sales line hides the number optometry lives on — how much dispensary revenue each exam generates. We split the practice into an exam segment and a dispensary segment, each with its own revenue, costs, and margin, so the monthly statements show which engine pulled and which coasted. It also puts real numbers behind capture rate — how much dispensary revenue follows each exam — the metric most practices quote but few can actually pull from their own statements.

Three GST/HST treatments in one storefront

Optometry may be the messiest GST/HST profile in health care, because all three treatments coexist at your front desk — and each has different consequences for input tax credits.

The apportionment line is the one that gets practices into trouble: claim everything and the return is wrong, claim nothing and you overpay. We set a defensible allocation method once, document it, and apply it every period. Registration itself is rarely optional, either: dispensary sales are commercial activity, and once taxable and zero-rated revenue passes the $30,000 small-supplier threshold the practice should be registered and claiming.

OHIP pays for your youngest and oldest patients

OHIP insures routine eye exams for patients 19 and under and 65 and over, plus those with qualifying medical conditions — so a typical day mixes insured exams, private-pay exams, and direct-billed vision plans. We book OHIP claims as a receivable when submitted through the Ministry's MC EDT channel and reconcile the monthly remittance against them, so rejected claims are corrected and resubmitted instead of quietly expiring. Private-pay exams and insurer direct billings each get their own stream, which keeps the exam segment's revenue mix visible month over month.

Direct-billed vision plans get the same rigour. Assignments to insurers become receivables, and matching remittances to claims catches partial payments that would otherwise linger as unexplained balances. When a patient splits payment between a plan and their own card, the entry has to keep both pieces attached to one sale — or the day simply will not balance.

Frames and lenses: inventory plus job costing

The dispensary is a real retail operation. Frame boards from suppliers like Luxottica and Safilo are inventory on the balance sheet, while lens and lab charges are the direct cost of a specific job. We match lab invoices to eyewear sales so each Rx job carries its frame cost, lens cost, and lab work — and gross margin per sale is a fact rather than a feeling.

• Board discipline — periodic frame counts catch shrinkage and identify styles that have sat long enough to discount or return.
• Supplier statements — monthly reconciliation captures volume credits and pricing changes that otherwise leak margin.
• Remake tracking — lab remakes are logged as their own cost line, since a rising remake rate is an operational problem the P&L should expose.
• Contact lenses as their own sub-stream — reorders often ship direct from the supplier, so lens sales and their costs are tracked separately with their own margin.

Equipment, the border, and the bigger picture

Optometric equipment is expensive and often sourced from US vendors — an OCT, a phoropter, an edger — so we capitalize each purchase at its full landed cost, including freight, duty, and the exchange rate on the payment date, keeping a clean asset ledger for year-end CCA claims. Financed purchases are split between the loan and the asset, so the balance sheet tells the truth about both. If your history includes US optometry school, US income years, or student loans from an American lender, our cross-border tax guide for optometrists covers the reporting side. And for what our monthly close includes for every client, see our bookkeeping services.