Fractional CFO for medical practices and what the service costs

Most physician-owned practices run on a practice manager, a billing team or outside biller, and a CPA who files the return. That works for a small group. It strains when you add providers, open a second site, take on more payer contracts or hear from a buyer. Charges look healthy in the practice management system, yet cash lags, and nobody can say whether the gap is denials, slow payers, contract rates or staffing.

Healthcare finance has its own mechanics. Billed charges are not revenue: contractual adjustments, denials, patient responsibility and payer delays sit between a visit and a deposit. Staff and rent are fixed while schedules and reimbursement move. A CFO who has worked with medical groups reads net collections, days in accounts receivable and cost per visit every month, and ties them to decisions about payer contracts, provider pay, new sites and the value of the practice.

• Builds a monthly dashboard with charges, net collections, collection rate, denial rate and days in accounts receivable by provider and by site
• Sets up a 13-week cash flow forecast covering payroll, malpractice insurance, supplies, equipment loans and physician distributions
• Analyzes payer mix and contract rates, and models which contracts to renegotiate or drop
• Reviews work with the billing team or outside biller on denials, aging claims and write-off policy
• Designs provider compensation models tied to collections, productivity and quality metrics
• Builds the case for a new site, a new service line or an equipment purchase, with payback and financing
• Prepares normalized EBITDA and add-backs for a hospital, private equity or partner buyout offer
• Coordinates with the healthcare CPA on entity structure, tax planning and partner pay

As a general US market range, fractional CFOs typically charge roughly $150 to $500 per hour, and monthly retainers for one to three days a week commonly fall between $4,000 and $15,000. A small group often needs a few hours a month plus a fixed project for a sale or expansion, while multi-site groups sit higher in the range. Each expert on ExpertMatcher sets their own rate and you see it on the profile before you book. You pay the expert's rate plus the platform fee of your plan, from 12 percent on Starter down to 4 percent on Enterprise, with no agency markup. The fractional CFO cost guide breaks down hourly, retainer and project pricing in more detail.

• Days in accounts receivable keep growing and nobody can pinpoint which payers or providers cause it
• Charges are up but net collections and cash are flat
• You run two or more sites and cannot compare their real profit side by side
• You plan to add providers, open a clinic or buy equipment and want a model before committing
• A hospital system or private equity buyer made an approach and you need to know whether the number is fair
• Partners disagree about compensation, and nobody has a model everyone trusts

These are commonly cited general reference points, not targets for every group. A CFO sets yours based on specialty, payer mix and market.

Collections come in batches from payers and card processors, so a CFO also checks that every deposit is matched to the right claims and the right month. Many practices also rely on board-ready financial statements built from a bookkeeping export so partners see a clean P&L and balance sheet every month.

Most growing practices keep the CPA, add a fractional CFO for the monthly and strategic numbers, and bring in an operations consultant when billing or scheduling is the bottleneck.

• Which practices or groups have you worked with, and what specialties and sizes were they?
• Which practice management, billing and accounting systems do you use, for example athenahealth, eClinicalWorks, NextGen and QuickBooks?
• How would you report collections, denials and days in accounts receivable to the partners each month?
• Have you modeled a new site or a provider compensation change, and how did the numbers hold up?
• Have you worked through a hospital or private equity offer, and what do you look for in the terms?
• How many hours a month do you expect this to take, and what would make it more?

You describe the practice in one sentence: number of providers, sites, specialty, annual collections, systems and the decision ahead. ExpertMatcher turns it into a match brief with weighted competencies such as healthcare revenue cycle analysis, provider compensation and acquisition modeling, then shows 3 to 15 verified CFOs depending on your plan, each with a fit score and the reason for the match. You can send an NDA, book a paid intro call of 30, 60 or 90 minutes and agree a retainer or a fixed project on the platform. The full process is on how it works, and the general fractional CFO page covers the role across industries. If your practice mainly needs a reliable monthly close, a fractional controller may be the first hire. Owners of dental offices face a similar mix of collections and overhead, as the fractional CFO for dental practices guide shows.