Fractional CFO · COO · Controller
Fractional CFO for Orthopedic Practices
We act as your part-time CFO, COO and Controller for an orthopedic or spine practice: we get your books clean and closed on time, run a 13-week cash forecast you can trust, and model provider compensation around procedural revenue and implant economics. You see where the margin is going every month, without hiring a full-time finance team.
Financial challenges orthopedic practices face
Procedure revenue that's hard to forecast
Orthopedic revenue swings with surgical schedules, authorizations, and referral flow. Without a rolling cash forecast, one slow month of cases can leave you short while payroll and rent keep landing on schedule.
Implant and supply costs eating the margin
Implants and supplies are a large cost on every case, and reimbursement doesn't always keep pace. If you don't track cost per case against what you collect, you can't see which procedures are actually earning their keep.
Authorization and denial friction
Prior authorizations, global periods, and payer rules create delays and denials that stall cash. Billing-office performance needs to be measured every month, not discovered at year-end.
Provider comp and growth decisions
Adding a surgeon or opening a location is a major bet. A documented provider compensation model and a forecast let you test those decisions before you make them.
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 track implant and supply costs against collections?
Yes. We build a monthly view that puts cost per case next to what you collect, so you can see which procedures and which payers are carrying the margin and which aren't.
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
Text us instead
Prefer texting? Message us at (435) 200-5375 and we'll text you back.