Beyond the Front Desk
Strategic operations, analytics, and finance for owner-operated healthcare practices.
Owner-operated healthcare practices outgrow their bookkeeper before they can afford a CFO. Their EMR holds the answers but a BAA gate sits between the data and anyone who could analyze it. Their process is held together by one or two people who know where everything lives. We build the analytics layer, the financial visibility, and the operational diagnostic that lets the owner see the whole business at once.
Three Capabilities, One Engagement
Each pillar stands on its own. Together they give the owner a complete operational picture without exposing patient data.
HIPAA-Safe Analytics
Patient data stays protected. The numbers come out the other side.
Most practices cannot run real analytics on their own data because every analyst who touches it triggers a BAA requirement. We build a de-identification layer between the source systems (EMR, billing, clearinghouse) and the analytics layer. The 18 HIPAA identifiers get stripped or hashed. What remains is a Limited Data Set the practice can analyze freely, share with outside consultants, and build dashboards on without PHI exposure.
- Payer-level revenue analysis without member IDs
- Provider productivity without patient names
- Visit volume and denial rates from de-identified encounter data
- Analytics-ready warehouse separate from the EMR
Fractional CFO for Healthcare
Monthly financial visibility built for an owner-operator.
Most owner-operated practices learn their actual numbers from their CPA in March, a full year late. We rebuild the P&L from source data every month: bank deposits matched to ERAs, payer mix breakdowns, owner draws separated from operating costs, year-over-year apples-to-apples comparisons. The owner gets a board-quality monthly model. The CPA still files the return. We close the gap in between.
- Monthly P&L within five business days of month-end
- Bank reconciliation against ERAs and patient payments
- Payer mix and collection lag analysis
- Real EBITDA, real owner take, real free cash flow
Operational Diagnostics
A written diagnostic the owner can act on.
We map the practice end to end, from the first ad click to cash in the bank. Where leads die. Where revenue leaks. Where compliance risk hides. Where one person holds knowledge that the business depends on. The deliverable is a written diagnostic with specific findings, gap inventory, and a prioritized list of decisions the owner needs to make. Not a slide deck. A working document.
- End-to-end process map with named gaps
- Billing leakage and reconciliation variance analysis
- Front-desk and back-office time studies
- Decision-ready findings document, not a presentation
What Changes for the Owner
Generic outcomes drawn from the patterns we see across owner-operated healthcare practices.
| Area | Before | After |
|---|---|---|
| Bank reconciliation | Staff spends 15 to 20 hours per week manually matching payer deposits to remittances. A multi-thousand-dollar variance sits unexplained. | Automated matching of ERAs to bank deposits. Exceptions flagged for review. Variance drops to a known list, not a mystery. |
| Monthly financials | P&L lands 6 to 8 weeks after month-end with the bookkeeper lag. Owner reacts to old data. | Board-quality monthly model within five business days. Owner makes decisions on current numbers. |
| Patient data analytics | Any analyst who touches the data requires a BAA. Reports stop at what staff can pull manually from the EMR. | De-identified Limited Data Set in a warehouse. Dashboards and analysis without PHI exposure. |
| Payer performance | Gut feel about which payers are growing and which are slow. No structured comparison. | Quarterly payer scorecard with revenue, collection lag, denial rate, and year-over-year trend. |
| Owner financial visibility | Annual conversation with the CPA at tax time. EBITDA and free cash flow unclear during the year. | Monthly model showing real EBITDA, owner take as a percentage of revenue, and free cash flow. |
| Process knowledge | One or two long-tenured staff hold the institutional knowledge. Risk concentration if either leaves. | Written process map. Documented handoffs. Knowledge moves from people to systems. |
A Discovery Call, Then a Written Scope
Each healthcare engagement is shaped to the practice. We start with conversation, not a price sheet.
Discovery Call
A 45-minute conversation about the practice. What systems are in place. What questions the owner cannot answer today. Where the time and money are going. No deck, no pitch.
Written Scope
We send a scope document that names the specific deliverables, the timeline, and the fee. No surprises mid-engagement. If the scope changes, we rewrite it before any new work begins.
BAA If Needed
Analytics work on de-identified data does not require a BAA. Financial work that touches charge data or remittances does. We sign one before any in-scope data moves.
Build and Review
We build in the open. The owner sees progress every week. Diagnostics are written documents. Dashboards run on the practice's own infrastructure. The work belongs to the practice when we finish.
PHI Stays Where PHI Belongs
De-identification by default
Analytics work runs on a Limited Data Set with the 18 HIPAA identifiers stripped or hashed. We do not ask to see patient names, member IDs, or dates of birth.
BAA before any PHI access
If a scope requires charge-level data tied to identifiers, we sign a Business Associate Agreement before access. Most analytics work does not require this.
You own the infrastructure
Warehouses, dashboards, and code run on the practice's own cloud accounts. We do not host patient data on our infrastructure.
No training data, ever
Nothing from a client engagement ever feeds an AI training pipeline. Not ours, not anyone else's.
Owner-Operated Healthcare Practices
The sweet spot: big enough to have data complexity, small enough that a full-time CFO is not realistic.
- Physical therapy, dental, orthopedic, dermatology, and other owner-operated specialty practices
- Multi-location operators where data lives in different systems
- Practices doing $500K to $10M in annual revenue
- Owners who suspect the numbers their bookkeeper produces are not the full picture
- Practices where one or two staff hold most of the institutional knowledge
Frequently Asked Questions
Start With a Discovery Call
Each healthcare engagement is different, so we do not publish package prices. The first conversation is a 45-minute discovery call, no pitch deck, no commitment.