Fractional CFO · COO · Controller
Fractional CFO for Dermatology Practices
We act as your part-time CFO, COO and Controller: we get your books clean and closed on time, run a 13-week cash forecast you can trust, and model provider compensation for a practice that earns both insurance reimbursement and cash-pay cosmetic revenue. You see exactly where the margin is going, every month, without hiring a full-time finance team.
Financial challenges dermatology practices face
Two revenue streams, two sets of problems
Dermatology lives on insurance reimbursement and cash-pay cosmetic work at the same time. Insurance revenue rewards fast, clean claims; cosmetic revenue rewards careful pricing and tracking. Most practices watch neither closely enough to know which side is carrying the margin.
Reimbursement that arrives slowly
Claims sit, denials pile up, and cash arrives late — while payroll and rent leave on schedule every month. Without a cash forecast, a slow month in the billing office becomes a real cash squeeze in the practice.
Provider compensation without a model
When comp is negotiated informally, physician by physician, you can't compare what each provider contributes against what they cost. [placeholder: how your current comp is structured], and that gap is where margin quietly leaks.
Growth decisions made on gut feel
Adding a provider, opening a second location, or expanding cosmetic offerings is a big bet on your numbers. Without a budget and a forecast, those decisions are made on instinct instead of a projection you can test.
What our CFO, COO and Controller bundles cover
Three bundles, one clear monthly fee. Take one or stack all three.
Controller
from $1,500/mo- Bookkeeping oversight and a clean, audit-ready ledger
- Monthly financial statements that arrive on time
- AP / AR management and bank reconciliation
CFO
from $3,500/mo- Monthly KPI scorecard built for your specialty
- Budgeting and a 13-week cash forecast
- Provider comp modeling for a mixed pay environment
- Monthly strategy call with your leadership team
COO
from $2,500/mo- Billing / RCM oversight and denial management
- Credentialing and the compliance calendar
- Front-office workflow and growth planning
How the 90-day process works
Days 1–30
Diagnose
We read your last twelve months of financials, your billing reports and your comp arrangements, then score where the margin is leaking — in plain language, with a list of what to fix first.
Days 31–60
Stabilize
We build the monthly baseline: clean statements on a fixed schedule, a 13-week cash forecast, and a KPI scorecard you can actually read. [placeholder: items specific to your practice's starting point].
Days 61–90
Build
With the numbers stable, we move to decisions: budget targets, provider comp models, billing-office fixes and a growth plan tied to the forecast — reviewed with you every month.
Pricing
Starting points. Final pricing scales with your collections and provider count.
Frequently asked questions
Do you replace our bookkeeper or billing company?
No. We work alongside them and hold the work to a standard: books that close on time, statements that reconcile, and billing output you can verify. If someone in that chain is underperforming, you'll see it in the numbers we hand you.
How does the engagement actually work month to month?
On a fixed monthly cadence: your financial statements and KPI scorecard arrive on schedule, your 13-week cash forecast is refreshed, and we meet on a standing call to walk through what changed and what to do next. Between calls you have direct access to us for questions and special projects.
What does it cost?
Controller starts at $1,500/mo, COO at $2,500/mo and CFO at $3,500/mo — take one bundle or stack all three. Final pricing scales with your collections and provider count, which is exactly what the package builder prices for you.
Is my practice the right size for this?
We work with independent physician-owned specialty practices with $1M–$20M in annual collections and 1–15 providers. That's the range where senior finance leadership pays for itself — big enough to need it, small enough not to have it in-house.
See where your margin stands
Take the scorecard for a quick read, or book a discovery call and we'll walk your numbers with you.