ApproachHow we work

Look at the numbers first, then propose the work.

Most practices have been sold a service before anyone read their A/R aging. We do it the other way round: a diagnostic first, a written scope second, and a measurement plan that exists before the first invoice.

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First call: 30 minutes, no charge
Diagnostic: 5–10 working days
Onboarding: 3–5 weeks
Reporting: Monthly, fixed date
Exit: 90 days, no fee

01The sequence

Five steps, each with a document at the end.

Discovery

Thirty minutes, no charge, no deck.

We ask what the practice looks like: providers, sites, specialties, systems, payers and the last three months that did not go as planned. You do not need to prepare anything. If we are not the right fit, we say so on this call and point you somewhere better.

You receive

A short written summary of what we heard.

Diagnostic

The numbers, before the proposal.

With read-only access we pull the A/R aging, charge lag, denial reasons, the ledger trial balance, the payer mix and the staffing plan. We read them back plainly — including the parts that are working — and identify where the leakage actually sits.

You receive

A diagnostic note: five findings, ranked by dollars at stake.

Design

A scope you could hand to another vendor.

We propose the specific work: which desk, which deliverables, which systems, which cadence, which measures, what it costs. Every item is written down, including what we are deliberately not doing, and what stays with your team.

You receive

A written scope, a fee structure and a start date.

Operate

Parallel run, then handover.

We onboard over three to five weeks: access, workflow design, a parallel run alongside your current process, then a clean cutover. Nothing is dropped at the handover, and your team keeps everything that touches a patient.

You receive

A live workflow, documented, with a named owner on each side.

Review

Monthly close, quarterly reset.

A monthly report on a fixed date: the five core numbers, the variance note, and the decisions we need from you. Every quarter we reset against the plan and agree whether the scope should change.

You receive

A monthly report pack and a quarterly review session.

02Engagement shapes

Three ways to start.

The scope matters more than the label. These three shapes simply describe how most practices begin, and any of them can change at a quarterly review.

Single desk

Best when one function is failing and everything else is fine.

One service, scoped tightly
Fixed monthly fee or performance fee
Monthly report on that desk's measures
Quarterly check-in

Review cadence · Monthly

Fractional back office

Best for practices between five and twenty providers.

Two to four desks combined
One named practice manager across all of them
Consolidated monthly report
Quarterly strategy session
Annual planning input

Review cadence · Monthly + quarterly

Full back office

Best when replacing several vendors at once.

All nine services as required
Single invoice, single escalation path
Board-ready reporting
Monthly operating review
Annual strategic planning

Review cadence · Monthly operating review

03Onboarding

Five weeks, in the open.

Handovers fail quietly. We run in parallel first so the discrepancy shows up while both processes are still live.

What we need from you

Read-only access to the practice management system and EHR
Accounting file access (or exports, if you prefer)
Payer list and current fee schedules
A named internal contact with authority to decide
One hour a week during onboarding

Week 1

Access and inventory

System access, document inventory, payer list, credentialing status, and a walkthrough of the current workflow.

Week 2

Workflow design

We draft the target workflow with your team, agree the handoffs, and document who owns each step.

Week 3–4

Parallel run

Our desk works alongside your existing process. Discrepancies are reconciled in the open rather than discovered later.

Week 5

Cutover and first report

Clean handover, the old process retired, and the first monthly report delivered on a fixed date.

04Governance

The reporting is the product.

A service you cannot see is a service you have to trust. We would rather you checked. Every month you get a fixed-date report, and every number in it is defined in your scope.

Monthly report

Delivered by the fifth working day: the five core numbers, a variance note in plain language, and the decisions we need from you.

Quarterly review

A working session against the plan, not a status update. Scope changes are agreed here.

Escalation path

Your practice manager first, then the desk lead, then a partner. Named in the engagement letter, with response times.

Access and audit

Named access only, logged, reviewed quarterly, and revoked on the day someone leaves the account.

05Questions

The commercial questions, answered.

Is there a minimum contract length?

Most engagements run on a twelve-month term because the work compounds — denial prevention and A/R recovery do not show up in thirty days. There is a documented exit with ninety days' notice, and no exit fee.

Who actually does the work?

Our own team, on our own desks. We use a vetted transcription network for dictation and a consultant network for specialist advisory work, and both are disclosed in the scope.

What if we already have a billing company?

Then the diagnostic is more useful, not less. We will show you what the current arrangement is producing. If it is performing, we will tell you, and you can spend the money elsewhere.

How is performance measured when the fee is fixed?

The same way it is on a performance fee: the measures are agreed at scoping, reported monthly, and reviewed quarterly. A fixed fee changes the pricing, not the accountability.

→Next step

The first call is genuinely free.

Thirty minutes, the real numbers, and a straight answer about whether we can help.

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