The MSO Platform

The infrastructure of an MSO — delivered fee-for-service.

Four disciplines, one partnership. The financial operations, dashboard, tax strategy, and advisory layer a private-equity MSO would install in your practice — built and run by our firm, without taking equity, control, or upside.

Schedule a Consultation See Partnership Tiers

MSO platform for healthcare practice owners

Why fee-for-service

The MSO model, without the MSO downside.

Private-equity-backed MSOs and DSOs deliver real operating leverage. They install close discipline, KPI reporting, payer benchmarks, and tax strategy. But they charge with equity — 60–80% of your practice in exchange for the infrastructure.

Practice Partner CPAs installs the same infrastructure — flat-fee, equity-free, year-round — delivered by a partner-led healthcare-only firm.

0% equity taken — the practice stays 100% yours
Flat monthly fee — transparent and predictable
Healthcare-only — specialty playbooks, not generic templates
Saves 3–5× the fee in year-one tax alone

Four Disciplines, One Partnership

Every engagement includes all four
from day one.

Most firms sell you bookkeeping and upcharge for everything else. The MSO Platform delivers the full stack, baked in.

Financial Operations

Monthly close by the 10th. Specialty chart of accounts. EHR + PMS + payroll integrations. Audit-ready GAAP books, run by the firm’s accounting team.

Practice Health Dashboard

Specialty KPIs in one view. Revenue per provider, payer mix, AR aging, schedule utilization, vs. specialty benchmarks. Reviewed with every close.

Year-Round Tax Strategy

S-corp optimization, retirement plan design, PTE election, cost segregation. Quarterly projections, multi-state nexus. Saves 3–5× the fee.

Strategic Advisory

A partner-led CPA + MBA in the room. Hiring, expansion modeling, DSO offer evaluation, partner buy-in/buy-out, succession planning.

Scope of Services

What the firm owns. What the practice owns.
No grey areas.

Every engagement follows the same scope architecture. The matrix below is what your service contract will look like — adapted to the specialty.

Legend **** Core Competency Defensible expertise — not easily replaced ** Under CPA Scope Routine work the firm performs under partner oversight

Service Area	MSO (Firm) Responsibilities	Practice Responsibilities	Miscellaneous Admin Tasks
Business Formation & Strategic Setup **** Core	Entity selection (PC / PLLC / LLC) per state EIN registration with IRS Secretary of State filings + annual reports S-corp election strategy & Form 2553 ** Insurance setup assistance (malpractice, GL, workers’ comp)	Organizational governance and bylaws decisions Ownership and equity split decisions Clinical scope of practice declaration	Bank account opening prep State business license applications Document collection and routing
Credentialing & Payer Enrollment	NPI applications (Type 1 + Type 2) Medicare / Medicaid enrollment (PECOS, state portals) Commercial payer credentialing (BCBS, UHC, Aetna, Cigna) CAQH setup and quarterly attestation Payer contract review & fee schedule analysis ****	Clinical license maintenance Continuing education and certifications In-network vs. out-of-network strategy	Credentialing portal logins maintenance Provider data update batches
Compliance Management	Policy & procedure development (HIPAA, OSHA, OIG) ** Annual internal compliance audits OIG / SAM exclusion screening (monthly) Credential tracking (licenses, BLS, NPI, malpractice) HIPAA Risk Assessment + Security Rule documentation **	Clinical and treatment documentation standards Supervision compliance for licensed staff Educational compliance oversight	Annual policy refresher distribution Compliance training attendance logs
Human Resources	Recruiting strategy + job description drafting Offer letters, employment agreements, contractor agreements Payroll administration (Gusto / ADP / Paychex) Benefits administration coordination Employee handbook drafting and annual update 1099 vs. W-2 worker classification analysis **** Multi-state employment compliance + nexus monitoring	Clinical supervision of licensed support staff Performance management of clinical team Day-to-day scheduling	Background check coordination I-9 verification document handling Anniversary and review reminders
Financial Management **** Core	Monthly close by the 10th business day ** GAAP-basis bookkeeping with specialty chart of accounts Bank, credit card, and merchant account reconciliation Accounts payable workflow + vendor management Accounts receivable aging and follow-up coordination Cash flow forecasting and 13-week rolling cash model Annual budget and quarterly re-forecast **	Strategic financial decisions (capital, distributions, debt) Owner-compensation level setting Budget approval and variance review attendance	Vendor bill forwarding to MSO inbox Receipt and expense report collection
Revenue Cycle Management	RCM vendor selection or in-house workflow design Claim submission monitoring and lag tracking Denial trend analysis with payer-by-payer breakdown ** AR aging by payer and provider Payer mix optimization recommendations ** Fee schedule analysis and annual rate negotiation support	Clinical documentation supporting billing codes Charge entry accuracy at point of care Patient-facing collections decisions	EOB and ERA document filing Insurance correspondence logging
Tax Strategy & Compliance **** Core	Year-round proactive tax planning (not just March) ** S-corp reasonable compensation analysis Retirement plan design (Solo 401k, SEP, Cash Balance, DB) QBI optimization and §199A planning PTE election and state tax workaround strategy Multi-state nexus and apportionment analysis Cost segregation studies for owned real estate Federal, state, and local tax return preparation Quarterly estimated tax projections + payment vouchers	Personal financial decisions tax planning informs Estimated payment funding and timing Retirement contribution funding	Source document collection (W-2s, 1098s, 1099s) K-1 distribution to partners Tax payment voucher delivery
Strategic Advisory & Fractional CFO **** Core	Monthly or quarterly strategy meetings with a senior partner New location ROI modeling and capital plan Hiring decisions: clinician break-even and ROI per FTE ** Partner buy-in / buy-out modeling and SPA support Succession planning and ownership-transition modeling DSO / PE offer review, valuation analysis, walk-away math ** Capital structure design (line of credit, term debt, owner notes)	Strategic vision and 3-year plan ownership Clinical leadership decisions Final go/no-go on capital deployment	Strategy meeting coordination Action-item tracking between sessions
Vendor & Technology Stack Management	EHR / EMR vendor liaison and integration design Practice management software stack assessment Bookkeeping integration (EHR → QuickBooks / Xero) Vendor contract review and negotiation support Annual technology spend audit and consolidation	Clinical platform selection authority User access governance Data privacy and patient communication decisions	User provisioning and deprovisioning License count tracking
Periodic Reviews & Governance	Quarterly Business Review (QBR) — financials, KPIs, action items Annual planning session with 12-month roadmap Board-ready reporting packages (for partnership groups) Year-end tax planning meeting (Nov / Dec) Mid-year insurance and benefits review	Attend and direct strategic conversations Distribute action items to clinical leadership Approve final plan and budget	Meeting scheduling and calendar holds Pre-read distribution Minutes and follow-up logging

What’s Inside the Platform

The deliverables, by cadence.

Same rigor every month. No surprises. No hourly billing.

Cadence

Monthly

Cadence

Quarterly

Cadence

Annual

Financial Operations

Close by 10th

Review & tune

Year-end pack

Practice Health Dashboard

KPI refresh

Benchmark review

Annual scorecard

Tax Strategy

Position monitoring

Estimate + plan

Return + projection

Strategic Advisory

On-demand

Working session

Strategic plan

Outcomes That Matter

What year one typically returns.

The platform is designed around four numbers that compound for a practice owner.

$25K–
$120K+

Typical year-one tax savings per practice

10–15

Hours of owner time returned per month

30 days

From signed contract to live partnership

Equity taken in your practice. Ever.

See What Year One Looks Like

The MSO infrastructure, without the MSO catch.

Book a free 30-minute consultation with one of our healthcare partners. We’ll map what would change — in your books, your taxes, and your week — in the first 90 days.

Schedule a Consultation Compare Partnership Tiers

Or call (925) 320-0309 · [email protected] · Replies within 24 hours

Book a Free Call

Before you go