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Financial intelligence for independent practices · PHI-free

Most practices don't fail at medicine. They fail at money.

PracticePilot is your practice's finance department, your books kept by a healthcare-finance specialist on our platform, and turned into decision-grade intelligence: which payer is quietly eroding you, which service loses money on every visit, how many weeks of cash you really have, and what that equipment purchase is actually worth. Without ever touching a patient record.

See the platform
No patient data, ever Books that balance by construction A specialist on every ledger
From our CFO

Why most practice owners are wrong about their own numbers

It's not a knowledge problem. It's an emotional one.

Owners who built their practice from nothing are, understandably, attached to it, and that attachment quietly distorts the math. Profit gets overestimated. Expenses get underestimated. Not from carelessness, from hope.

The fix isn't trying harder to be objective about your own business. It's having a system that doesn't have the emotional attachment you do.

See it in action

Watch PracticePilot in about 75 seconds

The real product on real books: payer concentration, receivables aging past ninety days, a payer that loses money on every visit, and the capital call priced against your true cost of capital. All PHI-free.

PracticePilot
Financial intelligence for medical practices
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Found in a clean set of books

These numbers were hiding in books that balanced perfectly.

Our demo practice reconciles to the penny. It's also quietly bleeding. Balanced books tell you the money is counted, not that the money is safe.

41.5%of revenue from a single payer, one rate cut away from an existential problem
59.6%of receivables older than 90 days, sliding toward write-off
−$18.96lost per visit on one payer, hidden inside a profitable average
8×December denial spike vs trailing average, caught by an alert, not an audit

Figures from PracticePilot's demo practice, sample books, real math. Your numbers will be your own; the point is that clean bookkeeping alone would have surfaced none of them.

The serious problems

Five ways a healthy-looking practice loses money.

None of these show up on a P&L. All of them show up eventually, usually late, usually expensive.

One payer owns you

When a single insurer is 40% of revenue, their next contract renewal is a negotiation about your survival, and they know it.

The cost: a unilateral rate cut you can't refuse.

Denials quietly compound

Denied claims that nobody resubmits, and receivables aging past 90 days, are interest-free loans to insurance companies, made monthly, forgiven annually.

The cost: earned revenue you'll never collect.

Averages hide the losers

A profitable practice can lose money on every visit from one payer, or on a whole service line, cross-subsidized by the winners so the total looks fine.

The cost: growing the exact thing that loses money.

Profit isn't cash

The classic death spiral: the income statement says you're winning while receivables balloon and the account drains. By the time payroll bounces, it's history.

The cost: a profitable practice that can't pay rent.

Six-figure gut feel

Equipment gets bought on a rep's brochure and a good quarter. Nobody prices the machine against the practice's real cost of capital, or checks the forecast after.

The cost: capital locked in machines that never pay back.
Designed to stay out of HIPAA scope

Your EHR knows your patients.
We only know your numbers.

No patient identity, ever. No names, no DOBs, no member numbers, no claim IDs, there is no field to type them into.
No clinical codes. No CPT, no diagnoses, no notes. Volume is a visit count; payers are organizations; providers are your clinicians.
Out of HIPAA scope by design. The safest patient data is the data we never hold, no BAA required, nothing to breach.
Verified continuously. A PHI-presence check runs inside the reconciliation dashboard and must always read zero.

What an invoice holds

Invoice refINV-1013
PayerMedicaid
Gross charge$18,700.00
Contractual adj.−$10,700.00
Visit count118
Never stored: patient name · date of birth · member # · claim ID · CPT / diagnosis · clinical notes
From bookkeeping to judgment

Six decisions your books should be making better.

Every screen in PracticePilot exists to answer a question an owner actually asks, with the math a hospital CFO would use, sized for an independent practice.

"Should I sign this contract?"
The Contract Analyzer prices an offer on incremental margin, fixed costs are sunk, step costs and capacity are not. Accept, decline, or counter with numbers.
ACCEPT: +$3,840/mo inside capacity
"Which payer is eroding us?"
Payer mix, concentration (HHI), realized rate per visit vs your full cost, with below-cost payers flagged before renewal season, not after.
Medicaid: −$18.96/visit · below cost
"What does a visit really cost?"
Service-line costing (RVU or cost-to-charge), contribution vs full margin, cross-subsidy flags, and suggested prices at your target margin.
Telehealth: price $45 · full cost $47.69
"Can we afford the ultrasound?"
Every purchase becomes a project: NPV, IRR and payback against your practice's risk-adjusted cost of capital, ranked against everything else competing for the money.
NPV +$247 @ 13.4% hurdle · rank 2 of 3
"How much can I take home?"
Draw availability computes what's actually distributable, earned equity and the cash to fund it after your reserve, so owner pay never strips working capital.
Available today: $6,889
"Are we on plan?"
Budgets with an approval workflow, then monthly variance decomposed into volume, rate and spending, so you fix the lever, not the symptom.
NI +53% vs budget, rate-driven
Payer analytics screen: payer mix, HHI concentration index, days in A/R and margins by payer
Payer analytics, mix, concentration, pay lag and margin by payer.
Screenshot 1 of 2: Payer analytics screen: payer mix, HHI concentration index, days in A/R and margins by payer
The watchdog layer

Books that watch themselves.

You set the thresholds once. PracticePilot checks every one of them on every change, and tells you while the fix is still cheap.

The platform

Everything derives from one balanced ledger.

Real double-entry accounting underneath, so Assets = Liabilities + Equity always holds, and every analytic is computed from that same ledger. No side spreadsheets, no "adjusted" numbers, no drift.

The books

  • Double-entry ledger, auto-posted
  • Income statement, balance sheet, cash flow
  • Trial balance & reconciliation checks
  • A/R & A/P aging, 1099s
  • Automatic depreciation & amortization

Revenue & payers

  • Payer master: mix, HHI, pay lag
  • Denials by reason & payer, spike alerts
  • Write-offs, bad debt vs charity
  • Net patient revenue taxonomy
  • Collections-focused A/R views

Costs & pricing

  • Cost centers & overhead allocation
  • Cost per visit & per service (RVU/CCR)
  • Break-even & CVP solver
  • Contract & capitation analyzers
  • Provider scorecards

Plan & control

  • Budgets with approval workflow
  • Flexible-budget variance decomposition
  • Seasonal forecasts with assumptions
  • Owner-set alert thresholds

Capital & debt

  • NPV / IRR / payback vs your WACC
  • Project ranking & postaudit
  • Debt schedules & covenant alerts
  • After-tax income & tax depreciation

Insights

  • Benchmarks & multi-year trends
  • Strengths / weaknesses, with caveats
  • Configurable role-aware dashboards
  • Four-Cs coverage map
Revenue cycle screen with a denial-spike banner, collection KPIs and denials by reason
Revenue cycle, the December denial spike, caught the week it happened.
How it works

Onboarded in a week. Sharper every month after.

Hand us the books

One onboarding conversation: opening balances, payers, services, vendors. We never ask for a patient record, there isn't a field for one.

We run them on PracticePilot

Your specialist keeps the ledger, every entry balanced, period-end adjustments automatic, reconciliation continuous, alerts triaged before they reach you.

You get decisions, not statements

A monthly close that arrives pre-read: what moved, why, and what deserves a decision, renegotiate this payer, reprice that service, buy (or don't buy) the machine.

Pricing

Your finance department. One flat rate.

A fractional CFO runs $3,000 to $10,000 a month, if they'll take a practice your size. A bookkeeper alone hands you statements, not decisions. PracticePilot is both: books kept by a specialist, decisions delivered with them.

Most practices start here
Practice CFO
Your books, kept for you, and read for you. The full platform with a specialist accountable for it.
$1,295/mo
  • Monthly bookkeeping, close & reconciliation, done for you
  • All statements, A/R & A/P aging, 1099s, year-end CPA-ready package
  • Payer intelligence, revenue cycle, costing & budget tools, configured and maintained
  • Owner dashboard with alerts, triaged by your specialist
  • Quarterly financial review call
CFO Advisory
Everything in Practice CFO, plus a standing seat at your table for the decisions that move six figures.
$2,495/mo
  • Everything in Practice CFO
  • Monthly 1:1 working session on your numbers
  • Payer-contract & service-pricing analysis on demand
  • Annual budget built with you; monthly variance narrative
  • Equipment & expansion modeling (NPV vs your cost of capital), draw planning
  • Priority access to your specialist
Groups & Multi-Location
For practice groups and MSOs: consolidated oversight, per-location books.
Custom
  • Everything in CFO Advisory
  • Separate books per location, consolidated view
  • Location-level dashboards & margin comparisons
  • Dedicated review cadence

Founding rates. We onboard a limited number of practices each quarter so every ledger gets a specialist's attention. PracticePilot provides bookkeeping and financial-analytics services, not tax, audit or CPA services, and never medical advice.

FAQ

The things practices ask us first.

Do you ever see patient information?
No, structurally no. There is no field anywhere in PracticePilot for a patient name, date of birth, member number, claim ID, CPT or diagnosis code. Billing is recorded as opaque invoice references with payer, amounts and a visit count. A PHI-presence check runs continuously and must read zero. That keeps the platform out of HIPAA scope entirely.
How is this different from QuickBooks or a bookkeeping service?
QuickBooks is generic software you still have to run. Bookkeeping services hand you last month's statements. PracticePilot is a service built on the economics of medical practices, payer mix, denials, visit-level costing, capitation, prompt-pay rules, run by a specialist who tells you what the numbers mean and what to do about them. The closest substitute is a fractional CFO at $3,000 to $10,000 a month, and most won't take a practice under $2M in revenue.
Who actually does the books?
We do. A healthcare-finance specialist keeps your ledger on the PracticePilot platform, monthly close, reconciliation, statements, and reads it before you do, so what reaches you is already triaged. Your CPA stays your CPA: at year-end they receive a clean, lender-ready package instead of a shoebox.
I already have a bookkeeper. What happens to them?
We take the books over, that's the point of the service. Most generalist bookkeepers keep clean books; they can't tell you which payer reimburses below your cost per visit or whether the ultrasound clears your hurdle rate. If you'd rather keep them, the Groups & Multi-Location plan can be structured so they work inside the platform with us.
I'm a physician, not a CFO. Will I understand it?
That's the point. Every ratio ships with a plain-English definition, every alert says why it fired and what to look at, and the cash-flow statement comes with a guided reading. The judgment stays yours, the platform just makes sure it's informed.
What if my billing is unusual, capitation, locums, equipment-heavy?
Built in: capitation economics (PMPM, utilization break-even), 1099 locum tracking, prepaid malpractice amortization, equipment depreciation and NPV-based purchase analysis. If your books have it, the platform has a place for it, except patient data.
Can I get my data out?
Your books are yours. Statements and ledgers are always visible and exportable in the production platform, and there's no lock-in by obscurity, it's standard double-entry accounting your next accountant will recognize immediately.

Run the practice like it's your life's work.

Because it is. Fifteen minutes with your own numbers will tell you more than this page ever could.