Case Study 2: 4× Revenue Growth Through Operational Restructuring

Industry: Healthcare Practice (Year 3 Startup)
Engagement Type: Fractional Operations + Process Design
 

The Challenge

A growing practice lacked foundational systems. Payroll was misaligned with cash flow, contractors invoiced inconsistently, documentation turnaround was slow, and expectations were unclear across the team.
 

The RNR Approach

RNR rebuilt the operational backbone of the company:

• Restructured provider compensation and payment timing to align with insurance reimbursement cycles

• Standardized contractor invoicing and payroll schedules

• Introduced a staggered payroll model to protect cash flow

• Created SOPs for intake, scheduling, documentation, billing, and payroll

• Implemented weekly operational meetings to centralize communication

• Introduced administrative support for intake, eligibility, scheduling, and patient concerns

• Built a scribing workflow with a third-party vendor and internal communication tools

• Established a 48-hour turnaround standard for additional documentation requests

• RNR also implemented a third-party scribing solution that ensured clinical documentation was completed within 24 hours, allowing claims to be submitted without delay.

RNR also implemented dashboards in Monday.com to track:

• Cost per patient acquisition

• Revenue per CPT code

• Provider productivity

• Scheduling efficiency
   

Results

• Revenue increased 4×

• Patients scheduled within 24–72 hours

• Documentation delays eliminated

• Improved cash flow predictability

• Clear accountability eliminated “I don’t know what I’m supposed to do” gaps

• Leadership freed to focus on growth instead of daily oversight
   

Outcome: A reactive startup became a disciplined, scalable operation.