Services
What does a fractional CFO actually do for a practice?
A fractional CFO turns your ledger into decisions: which services make money, how much cash you will have over the next 13 weeks, which KPIs to watch, and how to price, staff, and exit on your terms. Each service below is computed in code from your books and reviewed by a CFO, so you act on numbers, not guesses.
What does a fractional CFO actually do for a practice?
A fractional CFO is the forward-looking layer on top of your bookkeeping: profit by service line, a rolling cash forecast, a KPI scorecard, AR and AP optimization, a driver-based budget and hiring plan, peer benchmarking, and a monthly board or lender package. For an owner-operated practice doing $1M to $10M, that work usually surfaces six figures of recoverable cash, margin, or tax in the first 90 days. It is the part of finance your CPA does not do, because the CPA looks backward at tax time and the CFO looks forward at decisions.
- Core services: profit by service line, 13-week cash forecast, KPI scorecard, AR and AP optimization, driver-based budget and hiring plan, peer benchmarking, monthly board or lender package.
- Quality engagements often surface $100,000 to $300,000 in the first 90 days.
- Fractional CFO demand has risen sharply since 2020, per Business Talent Group.
| Service | Question it answers |
|---|---|
| Profit by service line | Which services and providers actually make money |
| 13-week cash forecast | How much cash will I have, week by week |
| KPI scorecard | Are the numbers that drive the practice trending right |
| AR and AP optimization | Where is cash stuck, and what do I collect or hold |
| Driver-based budget and hiring plan | Can I afford the next hire, and when |
| Peer benchmarking | How do my margins compare to similar practices |
| Monthly board or lender package | What do I hand a bank, a buyer, or a partner |
Takeaway: Each service is one deliverable computed from your ledger, not a vague retainer.
Top Practice CFO delivers all seven for owner-operated veterinary practices and med spas, with every number computed from your books and reviewed by a CFO.
Can you show me which services actually make money?
Yes. Profit by service line breaks revenue down to the procedure, treatment, or product level, then loads in the direct cost and provider compensation behind each one, so you see true contribution margin rather than top-line revenue. Most owners are surprised that their busiest service is not their most profitable, and that one or two lines quietly carry the practice. We rank every line so you can reprice, repackage, or retire the losers.
- Maps revenue to direct cost and production or commission-based provider comp per service line.
- Reports contribution margin, not just gross revenue, so high-volume low-margin lines are exposed.
- Provider comp tied to production is a common margin leak in appointment-based practices.
| Service line | Revenue | Contribution margin |
|---|---|---|
| Wellness and exams | $420,000 | 38% |
| Dental procedures | $310,000 | 44% |
| Retail and pharmacy | $185,000 | 11% |
Takeaway: Knowing margin by line is the fastest path to higher profit without more volume.
Top Practice CFO builds this view first, because it is usually where the recoverable margin in the guarantee comes from.
Can you build a 13-week cash forecast?
Yes. The 13-week rolling cash forecast projects every inflow and outflow week by week, so you know your lowest cash point before it arrives instead of after. It is the single most useful tool for an appointment-based practice, where revenue is steady but payroll, rent, and inventory hit on their own schedule. We update it on a regular cadence so it always reflects your real receivables, payables, and payroll calendar.
- Projects inflows and outflows for the next 13 weeks and rolls forward as time passes.
- Built from your real AR, AP, and payroll calendar, not a static annual budget.
- Surfaces the lowest projected cash balance and the week it occurs, in advance.
Takeaway: A 13-week view replaces the gut-check on whether you can make payroll.
Top Practice CFO maintains the forecast as a living model, so you never run a practice on last month's bank balance.
What KPIs do you track for a practice?
We track a short scorecard of the metrics that actually move an owner-operated practice: revenue per provider, average transaction value, provider productivity, payroll as a percent of revenue, gross and net margin, and days cash on hand. The scorecard is intentionally small, because ten numbers you watch beat fifty you ignore. Each KPI carries a target and a trend, so a number drifting the wrong way is visible while it is still cheap to fix.
- Tracks revenue per provider, average transaction value, provider productivity, payroll percent of revenue, margin, and days cash on hand.
- Every KPI shows current value, target, and trend, not just a raw figure.
- Payroll percent of revenue is the KPI most tied to margin in provider-comp practices.
Takeaway: A tight scorecard catches margin erosion early, before it shows up in the bank.
Top Practice CFO delivers the scorecard monthly, computed from your ledger and reviewed by a CFO before it reaches you.
Can you help me collect faster and pay smarter?
Yes. AR and AP optimization finds cash that is already yours but stuck: aged receivables, unbilled production, slow insurance or membership collections, and payables you can time to your advantage. We rank receivables by age and likelihood, set a collection cadence, and sequence payables to protect your lowest cash week. For most practices this is found money that needs no new patients and no price change.
- Ranks AR by aging bucket and collection likelihood, then sets a follow-up cadence.
- Times AP against the 13-week forecast to protect the lowest projected cash week.
- Recovers cash from work already performed, with no added volume required.
Takeaway: Faster collections and smarter payment timing improve cash without touching pricing.
Top Practice CFO treats stuck AR as the first place to find the recoverable cash behind the 90-day guarantee.
Can you tell me if I can afford to hire?
Yes. The driver-based budget and hiring plan ties your forecast to the things that actually drive it: appointment volume, provider capacity, and average transaction value, so a new hire is modeled against the revenue they can realistically produce. You see the break-even week, the cash dip during ramp, and the margin impact before you sign an offer. The same model tests price changes, a new service line, or a second location.
- Budget is built from operational drivers, not last year's numbers plus a percentage.
- Models a new hire against expected production, ramp time, and break-even week.
- Same model stress-tests price changes, new service lines, and expansion.
Takeaway: A driver-based model turns hiring and expansion into a decision you can see, not a hope.
Top Practice CFO runs the hiring case before you commit payroll, so the decision is grounded in your real capacity and cash.
How do my numbers compare to other practices, and what do I hand a bank or buyer?
Peer benchmarking sets your margins, payroll ratio, and productivity against similar owner-operated practices, so you know whether a number is normal or a problem worth fixing. The monthly board or lender package then turns all of it into a clean, written report a bank, partner, or potential buyer can read in minutes. If you are weighing an acquisition or private-equity roll-up offer, this package is also what tells you whether you are exit-ready and what the practice is worth.
- Benchmarks margin, payroll percent of revenue, and productivity against comparable practices.
- Monthly package includes a written narrative, the scorecard, and recommended actions.
- The same package answers whether a practice is exit-ready when roll-up offers arrive.
Takeaway: Benchmarks tell you what to fix; the monthly package proves it to anyone who matters.
Top Practice CFO produces a board-ready package every month, so you are always prepared for a lender, a partner, or an exit conversation.
Frequently asked questions
- Do I have to buy all the services at once?
- No. Most owners start with the 14-Day Financial X-ray, which delivers profit by service line, a 13-week cash view, and a KPI scorecard. The full set of services lives in the monthly retainer, and you move to it once you have seen the numbers and want them maintained.
- Do these services replace my bookkeeper or CPA?
- No. Clean books are the input to every service, so we work alongside your bookkeeper, and your CPA still handles tax and compliance. The CFO services are the forward-looking layer that neither of them provides: cash forecasting, margin by line, hiring decisions, and exit readiness.
- How do I know the numbers are right?
- Every figure in every service is computed in code directly from your ledger, then narrated and flagged by AI and reviewed by a CFO before you see it. No figure is generated by AI. That review step is also why the 90-day guarantee is possible.