
Navigate HIPAA compliance, complex revenue cycle management, and value-based care models with CFO partners who specialize in healthcare financial operations.
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Healthcare organizations face unique financial complexities from insurance billing to value-based care contracts.
From medical practices to health tech startups, we provide the financial infrastructure healthcare organizations need.
Monitor the operational and financial metrics that drive healthcare performance and profitability.
The average medical practice leaves 15-20% of revenue on the table due to billing inefficiencies, denials, and poor AR management. We help healthcare providers optimize every stage of the revenue cycle.
Our clients collect 98% of expected reimbursement vs. industry avg of 85%
Reduced from industry average of 50+ days through proactive management
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Client Success
"Rich and the aquifer team helped us significantly improve our financial infrastructure. This allows us to focus on scaling faster, while feeling confident we have the right financial systems in place."
"The Aquifer team has been incredibly insightful in approaching our finance stack, making them an invaluable partner for our business. They work with us rather than around us and continue to lend their expertise in the world of web3 accounting."
"Aquifer was instrumental in helping GDA scale by providing financial infrastructure & processes, financial advisory seed + Series A rounds, corporate accounting & tax support, and any other ad-hoc projects. The team brought a strong sense of co-founder ownership."
We don't just reconcile claims. We become integrated partners who understand your payer contracts, clinical workflows, and compliance requirements—speaking the language of modern healthcare.
We specialize exclusively in healthcare, understanding nuances from CPT coding to value-based care that generalist accountants miss.
All financial operations built with healthcare privacy and security standards, ensuring full compliance with regulatory requirements.
Maximize collections with proactive AR management, denial prevention, and payer contract analysis.
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Our experienced CFOs bring decades of expertise across various industries to help your business thrive







We reconcile ERA/EOB files daily against your practice management system, tracking every claim through submission, payment, denial, and appeal. We analyze aging AR by payer class, identify trends in denial codes, and implement proactive collection strategies. Our revenue cycle process includes claim scrubbing pre-submission, denial root cause analysis, appeals management, and patient balance follow-up protocols.
We manage accounting for ACOs, bundled payments, shared savings programs, and MIPS/MACRA reporting. This includes quality incentive tracking, risk pool reconciliation, stop-loss calculations, and upside/downside risk accounting. We prepare monthly variance analysis comparing actual vs. expected reimbursement under value-based contracts and model financial impact of quality measure performance.
Yes. We specialize in ASC financial operations including case costing by procedure and surgeon, implant tracking and billing, block time utilization analysis, facility fee vs. professional fee allocation, and joint venture accounting for physician-owned ASCs. We also handle Medicare ASC rate updates, commercial payer contract management, and profitability analysis by specialty.
All our financial systems are HIPAA-compliant with encrypted data transmission, access controls, audit trails, and business associate agreements (BAAs). We separate PHI from financial data where possible, implement role-based access to patient financial information, conduct regular security risk assessments, and provide staff training on privacy requirements. We also support HIPAA audits and breach response procedures.
We build comprehensive dashboards tracking days in AR by payer, collection rate percentage, clean claim rate, denial rate and reasons, production per provider (collections and RVUs), patient visit volume, payer mix analysis, overhead ratio, and working capital. We also provide MGMA benchmark comparisons and specialty-specific KPIs tailored to your practice type.
Absolutely. We maintain fee schedules for all payer contracts, perform reimbursement rate analysis by CPT code, identify underpayments through contract compliance audits, support contract renegotiation with financial impact modeling, and track contractual adjustments vs. expected reimbursement. We've helped clients recover over $2M in underpayments through systematic contract audits.
We consolidate financials across multiple locations while maintaining separate P&Ls for each site. This includes allocating shared overhead costs, tracking location-specific payer contracts, analyzing profitability by location and provider, managing inter-location transactions, and providing roll-up reporting for the organization. We also support expansion planning with pro forma financial projections for new locations.
We implement financial safeguards to support Stark Law and Anti-Kickback compliance including fair market value (FMV) analysis for physician compensation, documentation of commercial reasonableness for financial relationships, tracking of referral patterns and financial relationships, and preparation of disclosure reports. While we're not attorneys, we work closely with healthcare counsel to ensure financial arrangements are structured compliantly.
Get a free revenue cycle audit. We'll analyze your AR aging, collection rates, and payer mix to identify opportunities for improvement—no commitment required.