Operations Management
Your practice gets an
operations department.
You keep the practice.
Every practice past a certain size needs an operations department. The question is whether you build and staff one inside your walls or install one that already exists. We run the department. You keep 100% of the equity, full clinical authority, and direction of your team.
The choice every owner makes
The non-clinical work gets done one of three ways.
Somebody does the books, watches the numbers, manages the vendors, runs the marketing, holds the team accountable, and plans the growth. The only question is who does the work, and what that costs.
The owner runs the business side
Nights, weekends, and the hour between the last patient and dinner.
A team member runs the business side
Someone gets promoted into a management role, learns on the job, and stops doing the job you hired them for.
You install an outside operating partner
A firm that already has the systems, the reporting, the vendor relationships, and the reps.
Where XpoNential fits
You already own the practice. XpoNential installs the executive operating layer around the business.
In a group practice there is a management company between the doctor and the operation. In a solo or small group practice that seat is empty, so every decision that does not belong to the front desk lands on the owner. XpoNential fills that operating seat.
Clear roles. Greater results.
Your clinical expertise transforms lives.
We help everything else run exceptionally.
Owner / Doctor
Ownership and clinical authority
Clinical judgment, diagnosis, treatment planning, standards of care, and every patient-care decision.
Same ownership.
More freedom.
A stronger practice.
Operating Partner
Installs the executive operating layer across the nonclinical business, and is accountable for how that business performs.
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Practice Operations
- Office manager oversight
- Daily operations
- Scheduling systems
- Facilities, supplies and vendors
- Compliance
- SOP execution
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Growth & Business Performance
- New patient acquisition
- Marketing and phone conversion
- Retention and reactivation
- Capacity utilization
- KPI performance
- Growth initiatives
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Revenue Cycle & Finance
- Insurance verification
- Claims and denials
- Insurance and patient AR
- Collections and payment posting
- Financial reporting
- Budgeting and profitability
- Membership plans
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People & Organizational Performance
- Recruiting and onboarding
- Training
- Role clarity and accountability
- Performance management
- Compensation structure
- Culture
-
Systems & Execution
- Operating cadence
- Scorecards and meetings
- Project management
- Technology and vendor stack
- SOP design and implementation
- Quarterly and strategic priorities
- Follow-through
Clinical judgment and patient-care decisions remain exclusively with the licensed clinician.
XpoNential does not take practice equity, a governance seat, or control over clinical decisions. These five areas are how the eleven XpoNential Business Systems get managed week to week. Clinical delivery is the one system with no area of its own, because the doctor owns it. See the eleven systems.
The five accountabilities
Five areas inside every business.
One strategic partner for each.
Accountable means a named person owns the number, reports on that number monthly, and answers for the result in the room. Not advice delivered quarterly.
Practice Operations
The office manager has a boss who is not you. The day runs to a standard, and the standard is written down.
Growth & Business Performance
Every marketing dollar has a number attached, and capacity is planned before it is needed.
Revenue Cycle & Finance
Claims, AR and collections get worked to a cadence, and the financial package arrives reviewed, not just sent.
People & Organizational Performance
Roles are defined, accountability is built in, and compensation follows a structure instead of a negotiation.
Systems & Execution
One operating partner makes all five functions operate as one business. Cadence, scorecards, projects and follow-through.
How the engagement works
A schedule, not a phone call when something breaks.
The work runs on a schedule whether anything is wrong or not. A fixed operating cadence catches problems while they are still small.
The huddle
Numbers against target, what is blocked, and this week's priorities with the people who execute them.
The scorecard
The financial package and KPI dashboard, walked through with you instead of emailed.
The plan
Goals reset against the trend, vendors reviewed, spend challenged, next ninety days scoped.
The reset
The budget, a fresh valuation, compensation and staffing, and the year planned around your schedule.
The operating rhythm closes back on itself. Every cycle produces a deliverable, and the next cycle starts from what the prior cycle revealed.
What stays with the owner
Your practice. Your authority.
XpoNential does not take decisions that belong to the owner and does not insert itself between the owner, the clinical team, or the patient relationship. That boundary is written into the agreement before you sign.
- Vendor calls, renewals, and contract terms
- Chasing the marketing company for last month's numbers
- Reconciling why collections and production disagree
- Building the schedule template again
- Figuring out what a report is actually telling you
- Deciding whether a price increase is reasonable
- Clinical direction, treatment, materials, labs, and standard of care
- Final hiring and termination decisions
- Every patient relationship. We do not make patient calls or present treatment
- Whether to add an operatory, a provider, or a location
- How much you want to work and when
- Anything that changes the ownership of the business
Scope is written down before the engagement starts. Anything outside that scope gets a statement of work before anyone begins, and legal, tax, investment, and brokerage work goes to licensed professionals, in writing.
Expected outcomes
What is different a year in.
No promises about percentages. These are the things that exist after twelve months that did not exist before the engagement.
- Within 30 daysNumbers you can read
A monthly financial package and KPI scorecard, walked through with you.
- Within 90 daysA plan with dates on it
A ninety-day plan, an owner for every line, and a huddle that checks it weekly.
- Within 90 daysVendors held to their numbers
Marketing, labs, supplies and software each report against what they were sold on.
- Within 6 monthsAn office manager with a boss
Roles, standards and accountability in writing, and someone other than you enforcing them.
- Within 12 monthsA current valuation
What the practice is worth today, measured the way a buyer would measure it.
- OngoingFewer decisions on your desk
The decisions that reach you arrive with the analysis attached and a recommendation up front.
Your investment
One monthly fee for the whole platform.
The full operations department. Financial, operational, and marketing oversight, procurement savings, KPI reporting, and growth planning.
First practice
Same platform, same access
Earned Incentives for Performance. Part of XpoNential's compensation is tied to predefined operating benchmarks rather than billed as a guaranteed fee. We set fixed dollar amounts against those benchmarks during scoping, write the amounts into the engagement agreement, and settle the calculation before work begins.
If a benchmark is not reached, nothing additional is owed. When a benchmark is reached, the agreed fixed incentive becomes payable. The amount is set in advance and does not increase as a percentage of growth. That structure puts our economics on the same side of the table as yours.
Groups of three or more locations are quoted to scope.
Every management relationship is documented separately with a defined scope, term, economics, responsibilities, and performance expectations.
Elective add-ons
Add-ons, priced separately.
None of the services below are included in the monthly fee and none are required. Each carries its own price, quoted when we scope the work against your volume.
- You elect each add-on in writing and release it with sixty days’ notice
- We price it at scoping and state that price in the engagement agreement
- Anything outside a defined scope receives a written statement of work before any work begins
- Every add-on reports into the same weekly huddle and the same monthly scorecard as the core program
XpoNential manages functions like payroll and credentialing. The work itself is performed by vetted, experienced resource partners we engage directly. Some partners charge a setup or deployment fee. Those fees are separate from the XpoNential fee, and we tell you what they are before anything is deployed.
Revenue cycle management
- Billing, claims, and collections management
- AR cleanup and recovery, patient payment processing, financial policy enforcement
AP, payroll, and credentialing
- Accounts payable and payroll, including tax registrations and filings, managed through contracted providers
- Provider credentialing and fee schedule negotiation, managed through contracted providers
Marketing execution
- Fractional CMO at three levels of engagement
- Media operations by channel with ad spend at cost, and projects scoped separately
Real estate and facilities
- Lease abstraction and critical date tracking
- CAM review, landlord negotiation support, and refinance coordination
On-site and special projects
- In-office team training and custom on-site work
- Hiring support, additional practice evaluations, and coordination with counsel engaged by the client
For practices with substantial federal healthcare program revenue, revenue cycle management converts to a monthly fee at fair market value. Brokerage, legal, tax, and investment work is referred to appropriately licensed professionals, including vetted partners when needed, so you are not left to assemble that bench yourself.
The questions everybody asks
Fair questions. Straight answers.
No. There is no equity component, no option, no buy-in, and no structure under which XpoNential acquires any part of the practice. This is a management agreement with a defined scope and a defined term. You own 100% of the practice on the first day and 100% on the last.
Yes. We do not propose an ongoing relationship until both parties can see what they would be agreeing to. If the Review says an engagement does not make sense, we say so, and nothing obligates either side to continue.
Fixed dollar amounts tied to specific operating benchmarks, agreed in writing before the work starts. Not a percentage, not open-ended, and not a share of your growth, so the number cannot run away from you. If the benchmark is not hit, nothing additional is owed.
The term, notice period, and termination provisions are written into the agreement before signature. Add-ons release with sixty days’ notice. Nothing is designed to be hard to leave, and everything we build stays with the practice.
Less than the work takes now. A weekly huddle and a monthly review is the standing rhythm. The point of the arrangement is that decisions arrive at your desk already worked, with a recommendation attached.
The first practice is $7,450 per month and a second location is $5,500 per month, covering the same platform and the same access. Groups of three or more locations are quoted to scope. Add-ons are elected per practice or across the group depending on which makes sense.
Start here
You built the practice.
Now let the practice run without you in every decision.
Book a call to walk through what the engagement would look like for your practice. Thirty minutes, no obligation.
Thirty minutes, no obligation. Nothing you share goes anywhere else.