Fractional CFO

Fractional CFO

What a Fractional CFO Does — And Why It’s Game-Changing for DSOs & Dental Practices

A Fractional CFO is a senior financial leader who provides high-level financial strategy, planning, and oversight on a part-time or outsourced basis. Instead of hiring a full-time CFO (often $250K–$400K+ fully loaded), dental practices and DSOs get executive-level financial intelligence at a fraction of the cost — with better accuracy, better insights, and better decision-making.

Financial Strategy & Leadership

• Designs the financial roadmap to support growth, profitability, and liquidity

• Drives accountability around KPIs, budgets, forecasts, and targets

• Ensures owners and executives understand what decisions will create value — and what will destroy it

What a Fractional CFO Actually Does

Accurate, Actionable Financials

Cash Flow Optimization

A Fractional CFO provides strategic financial leadership — from accurate accrual-based reporting to cash flow management, profitability improvements, growth planning, and value creation. They ensure your DSO or practice has the clarity, systems, and guidance needed to make smart decisions and scale with confidence.

• Converts practices from cash to accrual accounting

• Ensures books close on time every month with clean, decision-ready financials

• Fixes broken accounting systems, misclassifications, and inconsistent location-level reporting

• Manages 13-week cash forecasting

• Helps navigate cash-tight environments, debt requirements, and capital allocation

• Ensures working capital (AR, AP, inventory) is fully optimized

Profitability & Margin Expansion

• Identifies cost drivers, waste, and margin leaks across all locations

• Improves provider compensation models

• Designs budgets and rolling forecasts to help leaders course-correct early

Growth & Scaling Support

• Builds 5-year financial models

• Assess acquisition opportunities (quality of earnings, valuation, integration impact)

• Ensures the financial infrastructure can support rapid practice expansion

Value Creation & Exit Planning

• Prepares DSOs for private-equity valuation (EBITDA normalization, addbacks, scalability)

• Designs roadmaps to maximize valuation 1–5 years ahead of a sale

• Supports lenders, bankers, and investors with financial due diligence

Operational & Leadership Support

• Works closely with your COO, Controller, accounting team, and RCM team

• Clarifies roles (bookkeeping → controller → CFO) so systems scale smoothly

• Mentors finance teams and helps hire/accountable top financial talent

1–3 Location Practices (Early Stage)

Biggest Struggles: chaotic numbers, poor cash flow visibility, lack of financial clarity

Why This Matters for DSOs and
Dental Practices at Any Size

A Fractional CFO’s impact depends on the size and complexity of the organization.
Here’s how the value changes as you grow:

What a Fractional CFO Delivers:

• Reliable monthly financial statements

• Budgeting, cash planning, and overhead control

• Provider comp structure guidance

• Help understanding breakeven and profitability drivers

• Early warning indicators before cash issues become crises

Bottom Line:
Owners get clarity, control, and the ability to make confident decisions.

4–10 Location Emerging DSOs (Scaling Stage)

Biggest Struggles: inconsistent financials, rapid growth stress, unclear margins by site

What a Fractional CFO Delivers:

• Standardized financial reporting across all locations

• 13-week cash forecasting to protect liquidity

• Rolling forecasts tied to operational KPIs

• Acquisition analysis (fair price, integration, payback)

• Financial infrastructure build-out: systems, roles, SOPs

Bottom Line:
The organization avoids “growing broke,” builds sustainable profitability, and gains a roadmap to reach PE-ready maturity.

11–25 Location DSOs (Established Stage)

Biggest Struggles: complexity, debt load, valuation targets, management accountability

What a Fractional CFO Delivers:

• Departmental budgets and variance analysis

• Executive-level reporting for lenders, investors, and boards

• EBITDA normalization and value-creation strategy

• Multi-scenario planning for debt, acquisitions, and equity

• Scalability planning for centralization (RCM, HR, finance)

Bottom Line:
Leaders gain strategic clarity, future valuation insight, and the ability to scale efficiently while protecting EBITDA.

25–50+ Location DSOs
(Private-Equity Transition Stage)

Biggest Struggles: hitting valuation thresholds, data integration, PE expectations

What a Fractional CFO Delivers:

• Robust FP&A (forecasting, modeling, sensitivity analysis)

• Support for recapitalization, minority/majority sale, or recap events

• Investor-grade reporting packages

• Leadership readiness and governance structure coaching

• Debt refinancing strategy

Bottom Line:
The DSO becomes a sophisticated, investor-ready platform with optimized value at exit.

Why a Fractional CFO Is Especially Valuable in Dentistry

Dentistry has unique challenges:

• provider-driven revenue volatility

• multi-location complexity

• collections timing and insurance mismatches

• high CapEx (buildouts, equipment, tech)

• complex provider incentive structures

A Fractional CFO specializes in turning these complexities into simplified decision-making tools.

And at AccruDent, your approach is even stronger:
Accrual Accounting + Advanced FP&A + Strategic CFO Leadership = Elite Financial Clarity