One practice director, regular check-ins, and numbers that mean the same thing every month.
Most practices do not have an operations problem so much as a visibility problem that turned into one. This page explains exactly how an engagement runs — who does what, on what schedule, and what changes in the first ninety days.
Senior help, without a full-time salary.
You get a named practice director who knows your practice, your payers, your staff, and your numbers. Not a pooled support queue, and not a rotating account manager.
Your practice director is backed by a shared team that does the work — billing, front office, credentialing, recruiting — so you are buying operating leadership with delivery capacity behind it, rather than either consulting advice with nobody to execute it or execution with nobody thinking about it.
You are not paying for a full-time salary, benefits, and the risk of the hire. It does not mean part-time attention to your problems.
The first ninety days.
- Days 1–30 — Find it Financial and AR review. Payer contract inventory. Schedule and utilization analysis. Staff interviews, including the front desk, who generally know exactly what is broken and have never been asked. By day 30 you get a written findings document: what is costing you money, what is costing you time, ranked.
- Days 31–60 — Stop the bleeding We fix what is losing money now. Usually that is some combination of unworked denials, aged AR nobody has touched, a payer contract below market, a scheduling pattern leaving capacity unused, and an intake process losing calls. In parallel we start documenting what only lives in someone’s head.
- Days 61–90 — Install the system The monthly operating report goes live. The meeting cadence starts. Documented processes exist for the functions we have taken over. By day 90 you should be able to answer “how is the practice doing” with a number rather than an impression.
The rhythm you can expect.
| When | What | How long |
|---|---|---|
| Weekly | Check-in with your practice director. What moved, what is stuck, what needs you. | 30 minutes |
| Monthly | Operating report and review. Same metrics, same format, every month. | 60 minutes |
| Quarterly | Business review. Trends, payer mix, capacity, staffing, what to do next quarter. | 90 minutes |
| Annually | Planning. Targets, hiring, service lines, expansion. | Half day |
The point of a fixed cadence is that problems surface on a schedule instead of surfacing as emergencies.
One report, the same every month.
The monthly operating report is the core artifact of the engagement. It covers the four pillars, uses the same definitions every month, and shows direction rather than a snapshot.
- Remote front desk
- answer rate, phone conversion, no-show and cancellation rate
- Revenue
- collections against expected, days in AR, denial rate and top denial reasons, clean claim rate, payer mix
- Marketing
- new patients by source, cost per acquisition, payer mix of new patients
- Financials
- P&L by provider and service line, cost per visit, revenue per provider
It also flags what we are watching and what needs a decision from you. Three items, not thirty.
What we own. What stays yours.
- We own
- Execution and outcomes for the functions in scope. Hiring and managing the people doing that work. The reporting. Vendor relationships in scope. Documented process, which belongs to your practice and stays with it if we part ways.
- You own
- Clinical decisions, always and entirely. Final say on hiring and compensation. Strategic direction. Anything that requires an owner’s signature or an owner’s judgment.
- The line
- We do not practice medicine, set clinical protocols, or make coding determinations that belong to a provider. Where operations and clinical judgment meet — documentation standards, scheduling templates, provider productivity — we bring you the data and the options, and you decide.
Take one pillar, or all four.
- Remote front desk
- Phone calls, email, patient intake and routine admin, handled remotely. Fixed monthly fee.
- Revenue
- The revenue cycle, fully owned, and the monthly report. Percentage of collections. Where most practices start.
- Marketing
- Patient acquisition tied to real capacity and payer mix. Fixed monthly fee.
- Financials
- Monthly close and reporting by provider and service line. Fixed monthly fee.
- Practice Operations
- A senior practice director running the whole practice with you, beyond the pillars. Monthly retainer.
- Launch
- For practices not yet open. Fixed fee through to first paid claim, then whichever pillars the practice needs.
Each practice is quoted individually. Talk to us for numbers →
Who this works for, and who it does not.
- Works well
- Practices at any stage, from well-established clinics to those just starting up. Practices where the owner is still the operational escalation path. Practices growing faster than their admin structure. Groups adding providers or locations. Owners who want to work clinically rather than administratively but are not willing to hand over control blindly.
- Works badly
- Practices looking strictly for the cheapest billing rate — we will not be it, and that is a fine reason to go elsewhere. Owners who want a vendor to blame rather than a partner to work with. Practices in genuine financial distress needing a turnaround specialist rather than ongoing operational help.
We would rather say this on a website than in month three.
The assessment is the first step, and it stands alone.
Forty-five minutes on your financials, your AR aging, and your schedule, and a written summary of what we see. No obligation attached, and the findings are yours whether you engage us or not.