Fractional CFO · COO · Controller
Fractional CFO for Gastroenterology and Cardiology Practices
We act as your part-time CFO, COO and Controller for a gastroenterology or cardiology practice: we get your books clean and closed on time, run a 13-week cash forecast you can trust, and keep an eye on hospital-linked billing, authorizations, and payer complexity. You see where the margin is going every month, without hiring a full-time finance team.
Financial challenges GI and cardiology practices face
Hospital-linked billing is complicated
When your work touches hospitals, facilities, and in-office services, revenue arrives through several billing paths. Without clean reporting, it's hard to know which line of service is carrying the margin.
Prior authorizations and payer complexity
Procedures and diagnostic services often require authorizations, and payer rules differ. Delays and denials turn into slow cash unless billing performance is reviewed every month.
Equipment and capacity decisions
Endoscopy suites, imaging, and diagnostic equipment are significant investments. A forecast and budget let you test whether adding capacity will pay for itself before you commit.
Provider comp and referral-driven growth
Compensation tied to production, referrals, and call coverage needs a documented model. Without one, it's hard to compare what each provider contributes with what they cost.
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
- 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.
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
Can you help us evaluate a new piece of equipment or a new location?
Yes. We model the investment against your budget and your 13-week cash forecast, so you can see the impact on cash and margin before you sign anything.
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.
Book a call
Let's talk margin.
Pick the way that's easiest for you — a discovery call, or a quick text.
Book a discovery call
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Prefer texting? Message us at (435) 200-5375 and we'll text you back.