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BlackpeakCFO Fractional Controller & CFO
Built for Healthcare

Your Practice Billed $2.4M Last Year.
You Collected $1.8M. Nobody Tracked the Gap.

Insurance reimbursements take 45–90 days. Denials pile up. Provider compensation is a black box. Your office manager enters claims but nobody reconciles expected vs actual reimbursement. You're leaving hundreds of thousands on the table and you don't even know it.

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No contracts · From $3,995/mo · ACMA CGMA · 24 years in professional finance

The 5 Finance Problems Every Growing Healthcare Practice Has

1. Revenue Cycle Blindness

Billed vs collected vs written-off isn't tracked at payer or procedure level. You billed $2.4M but collected $1.8M. Where did the $600K go? Denials? Write-offs? Timely filing expirations? You don't know because nobody tracks it. Your practice management system has the data. Nobody turns it into a financial report.

2. Provider Compensation Based on Production — But Nobody Verifies the Numbers

Your associate providers earn a percentage of production. But production is calculated from charges, not collections. One provider generates $800K in charges but only $520K in collections because their payer mix skews toward low-reimbursement plans. You're paying comp on revenue you never received. That math is costing you six figures a year.

3. Multi-Location Overhead Allocation Is Wrong

Shared staff, rent, equipment amortization — not properly split across locations. Your south office looks profitable because all the shared admin costs hit the north office's books. You think you've got one strong location and one weak one. In reality, the south office barely breaks even once you allocate overhead correctly. Bad data drives bad expansion decisions.

4. Insurance Contract Rates Not Monitored

Payers underpay against contracted rates and nobody catches it. You negotiated $185 per unit for CPT 99213 with Blue Cross. They've been reimbursing $162 for six months. Across 2,000 claims, that's $46K in underpayments you never noticed. Your billing team processes remittances. Nobody audits them against the fee schedule.

5. Equipment Financing & TI Amortization Buried in Overhead

That $380K digital imaging system is financed over 5 years. The $120K tenant improvement for your second location is amortized over the lease. Both hit overhead as a lump expense instead of being allocated to the locations and providers actually using them. Your per-provider and per-location P&Ls are fiction until this is fixed.

What Your Healthcare Practice Gets Each Month

Everything a full-time controller delivers — tuned for healthcare economics.

Revenue Cycle Dashboard

Billed, collected, and denied — broken out by payer and procedure code. See your collection rate by insurance carrier. Track denial reasons and aging. Know exactly where revenue leaks and fix them before they compound.

Provider-Level P&L

Revenue, direct costs, and allocated overhead by provider. See which providers generate profit and which ones cost you money after compensation. Tie production to actual collections, not charges. Make comp decisions based on real numbers.

Multi-Location Overhead Allocation

Shared staff, rent, equipment, and admin costs allocated to each location based on actual usage — not arbitrary splits. True per-location profitability so you know which offices to grow and which ones need restructuring.

Insurance Contract Rate Monitoring

Actual reimbursements compared against contracted fee schedules by payer and CPT code. We catch underpayments, flag rate changes, and give you the data to renegotiate contracts or drop underperforming payers.

13-Week Cash Flow Forecast

Rolling weekly forecast factoring in insurance reimbursement cycles, patient payment patterns, payroll, and equipment financing. Healthcare cash flow has a 45–90 day lag — we make sure you see what's coming before payroll hits.

Monthly Strategy Call

Not a status update. A working session where we review revenue cycle performance, provider profitability, and location economics. We pressure-test your growth plans — new providers, new locations, new equipment — with real numbers.

Further Reading for Healthcare Operators

Get Your Free Healthcare Financial Review

30-minute call. We'll review your revenue cycle metrics, check your provider-level profitability, and show you exactly what your monthly financial package should include. No pitch — just proof.

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Frequently Asked Questions

How does a fractional CFO improve revenue cycle management for a healthcare practice? +

We build a revenue cycle dashboard that tracks billed, collected, and denied amounts by payer and procedure code. You'll see your collection rate by insurance carrier, denial reasons and aging, and exactly where revenue leaks. Most practices we work with discover 15–25% gaps between what they bill and what they collect — and can't explain the difference until we break it down.

Can you handle financial data with HIPAA compliance requirements? +

Yes. We work within HIPAA-compliant systems and follow BAA (Business Associate Agreement) protocols. Financial data from your practice management system is handled through secure channels. We don't access or store protected health information (PHI) directly — we work with the financial outputs (claims data, reimbursement reports, production summaries) that your PMS generates.

How do you track provider compensation against actual collections instead of charges? +

We tie each provider's production to actual collections, not just charges billed. If a provider generates $800K in charges but only $520K in collections due to their payer mix, we calculate compensation on collected revenue — not the inflated number. This typically saves multi-provider practices $40K–$100K per year in overpaid compensation.

What does multi-location financial consolidation look like for healthcare practices? +

Each location gets its own P&L with shared costs — admin staff, marketing, centralized billing, management salaries — allocated based on actual usage (revenue, headcount, or square footage). We then produce a consolidated view with proper intercompany eliminations. You'll see true profitability per location so expansion decisions are based on real numbers, not inflated ones.

How do you catch insurance underpayments against contracted rates? +

We compare actual reimbursements against your contracted fee schedules by payer and CPT code on a monthly basis. Payers routinely underpay against negotiated rates — and most practices never catch it because their billing team processes remittances without auditing them. On a $2M+ practice, we typically find $20K–$60K in annual underpayments that can be appealed or used as leverage in contract renegotiations.

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