OB-GYN Practice Owner Checklists

1. Monthly owner dashboard

Reconcile cash, deposits, receivables, plus major ledger balances.
Review net collections by payer, location, plus service category.
Track claim denials, underpayments, days to payment, and aged balances.
Compare scheduled capacity, filled sessions, cancellations, plus open slots.
Review provider FTE, leave, call distribution, and recruiting status.
Compare payroll, overtime, vacancies, plus temporary labor with budget.
Identify capital needs, cash commitments, and debt covenant dates.
Assign an owner and due date to every material variance.

2. Quarterly governance meeting

Confirm decisions requiring owner vote and review prior commitments.
Examine location contribution with consistent cost allocation.
Review payer concentration and contract renewal calendar.
Discuss provider retention, succession coverage, and leadership workload.
Review major vendor, lease, plus technology commitments.
Refresh downside assumptions and working-capital needs.
Record conflicts, abstentions, decisions, plus follow-up owners.

3. Payer contract review

Retrieve executed agreement, fee schedules, amendments, plus manuals.
Confirm term, renewal, notice, assignment, plus termination provisions.
Rank payer by net revenue, volume, denial burden, and payment speed.
Compare expected reimbursement with a sample of actual remittances.
Separate Medicare-linked provisions from independent commercial rates.
Identify authorization, audit, data, plus unilateral-change clauses.
Estimate the effect of rate and non-rate changes by service category.
Set negotiation priorities and an approved fallback position.

4. Revenue-cycle review

Trace a sample from schedule through claim, remittance, plus deposit.
Check credentialing, eligibility, authorization, plus timely filing queues.
Group denials by root cause, payer, provider, plus service line.
Validate contract loading and code-to-rate mapping.
Review appeal overturns and collections recovered net of fees.
Assign backup coverage for key billing and posting tasks.
Confirm access controls for cash posting, adjustments, plus bank changes.
Separate one-time account cleanup from ongoing revenue improvement.

5. Hiring a physician

Define the clinical schedule, services, call, plus leadership expectations.
Confirm rooms, support staff, hospital access, and coverage capacity.
Set compensation inputs, benefits, leave, plus review process in writing.
Budget recruitment, credentialing, onboarding, plus ramp time.
Track payer enrollment and start-date dependencies.
Establish mentorship and operational orientation.
Model low, expected, plus mature capacity contribution.
Review the employment agreement with qualified counsel.

6. Staff retention

Review turnover, vacancy duration, overtime, plus work backlog by role.
Conduct consistent stay conversations with employees.
Identify single-person dependencies and train a backup.
Publish role expectations, advancement criteria, and training options.
Compare local wage offers and total employer cost.
Address workflow friction raised by frontline staff.
Review supervisor span, scheduling predictability, and relief coverage.
Document changes management commits to make and check completion.

7. New location assessment

Define the strategic reason for the site and target service mix.
Estimate provider availability, patient demand, and payer participation.
Model rent, build-out, equipment, staffing, plus working capital.
Identify lease options, renewal terms, guarantees, plus exit costs.
Confirm credentialing, technology, utilities, plus vendor readiness.
Include recruiting lead time and ramp assumptions in cash projections.
Test downside utilization and delayed opening scenarios.
Set a review date and objective expansion or closure triggers.

8. Sale readiness

Confirm ownership, approval authority, and assets in the transaction perimeter.
Reconcile financial statements, tax filings, payroll, plus bank records.
Document normalized physician compensation and any earnings adjustments.
Map provider, payer, hospital, referral, staff, plus location concentration.
Inventory debt, leases, guarantees, consents, plus renewal dates.
Resolve related-party rent and management arrangements.
Decide what cash, autonomy, transition, plus employee outcomes matter.
Engage seller-side legal, tax, accounting, plus transaction advice.
Prepare a controlled data room and disclosure sequence.

9. Private equity proposal review

Draw the PC, MSO, real estate, and subsidiary structure.
Separate enterprise value, equity value, cash at close, and deductions.
Inspect debt-like items, working-capital definitions, escrows, plus fees.
Review rollover security, capitalization, dilution, plus liquidation waterfall.
Test earnout measures against buyer control over operating decisions.
Read employment, management services, and restrictive covenant terms.
Identify clinical authority, reserved matters, and dispute escalation.
Model downside, base, plus upside outcomes with independent advice.

10. Associate buy-in

Share a consistent financial package and explain definitions.
Separate clinical compensation, management pay, and ownership return.
Set objective eligibility and staged transition milestones.
Agree on valuation method, date, assets, debt, plus working capital.
Model seller financing, bank debt, and staged purchase alternatives.
Define voting, information, distributions, capital calls, and transfer rights.
Specify default, termination, disability, plus employment exit outcomes.
Update buy-sell, entity, employment, plus lender documents together.

11. AI workflow pilot

State the business problem and current process owner.
Record baseline time, throughput, corrections, plus cost.
Limit the pilot to a defined workflow and authorized data set.
Review vendor retention, training use, security, audit, plus exit terms.
Define human review, escalation, plus pause criteria.
Measure error correction, adoption, plus net benefit after implementation cost.
Collect staff feedback and document workflow changes.
Approve expansion only after the agreed review gate.

12. Annual continuity review

Name interim decision-makers for owner absence or departure.
Confirm access to banking, payroll, payer portals, and essential systems.
Review key-person tasks and named backups.
Test contact trees and vendor escalation procedures.
Review insurance, debt guarantees, and contract notice periods.
Confirm succession timeline and buy-sell document consistency.
Identify records that require secure retention or controlled transfer.
Document unresolved risks and the next review date.

13. Monthly close review

Close bank and credit accounts to statements.
Reconcile deposits to remittance and posting records.
Review payroll, benefits, provider compensation accruals, and bonuses.
Identify unusual journal entries and related-party payments.
Reconcile accounts receivable by payer and age.
Review unposted charges and unresolved claim edits.
Update cash forecast, debt, plus capital commitments.
Distribute a version-controlled close package to authorized owners.

14. Provider onboarding

Confirm signed employment terms and compensation definitions.
Track license, credentialing, enrollment, plus hospital privileges.
Assign mentor, schedule template, rooms, plus support team.
Provide system access at minimum necessary levels.
Explain call, coverage, leave, escalation, plus billing workflows.
Review payer effective dates before projecting collections.
Schedule 30, 60, and 90 day operational check-ins.
Record open items and the accountable manager.

15. Ancillary service business case

Define service scope, ownership entity, and intended operating site.
Validate payer coverage, coding, plus contract treatment.
Estimate demand, utilization, room time, and staffing.
Include supplies, equipment, maintenance, plus replacement capital.
Reconcile professional and facility revenue streams.
Review referral and ownership arrangements with counsel.
Test low-volume, downtime, plus reimbursement scenarios.
Set a post-launch margin and compliance review date.

16. Vendor and privacy review

Identify data elements accessed, stored, transferred, plus returned.
Review security controls, breach notice, subcontractors, plus audit rights.
Confirm permitted use, retention, deletion, plus model-training terms.
Check service levels, support escalation, and business continuity.
Review fees, renewal, price changes, assignment, plus termination.
Confirm export format and transition assistance at exit.
Limit user access and document internal vendor ownership.
Record legal and technical review outcomes.

17. Location performance review

Compare actual revenue with schedule capacity and payer mix.
Allocate shared expenses consistently and show direct costs separately.
Identify avoidable versus stranded costs if volume changes.
Review rent, renewal options, occupancy, plus maintenance needs.
Track staff coverage, vacancies, plus travel between sites.
Examine referral and hospital dependencies without assuming permanence.
Model improvement, relocation, consolidation, plus closure cases.
Assign the next decision gate and required evidence.

18. Partner transition communication

Agree on what has been decided and what remains open.
Confirm legal, employment, plus governance review before announcement.
Identify audiences and sequence, including owners, staff, vendors, plus facilities.
Name the spokesperson and approve consistent business facts.
Prepare answers on roles, schedule, reporting, plus operational continuity.
Protect confidential transaction and employee information.
Provide a channel for questions and track unresolved commitments.
Review follow-through after the transition date.

19. Hospital call agreement review

Compare the written coverage schedule with the last six months of actual assignments.
Identify who supplies replacement coverage when a physician is unavailable.
Reconcile hospital stipends to staffed hours and any service-level deductions.
Confirm the record for after-hours work; check that approval and payment follow the agreement.
Ask counsel to flag exclusivity and notice periods, then explain the early termination provisions.
Set a review trigger for repeated vacancies or a material change in scope.
Give one partner responsibility for the hospital relationship and meeting notes.

20. Owner compensation and distribution review

Separate clinical compensation from management pay and ownership distributions.
Match each payment method to work performed or capital at risk.
Review changes in call coverage, administrative time, and clinical sessions.
Compare the proposed allocation with the governing documents.
Model the effect on each partner before changing the formula.
Record conflicts of interest and confirm the required approval process.
Keep the adopted formula and effective date with the financial packet.

21. Denial and underpayment escalation

Select a recent sample of high-dollar denials and trace each to its source record.
Separate contract underpayments from missing documentation or filing errors.
Assign an appeal owner and calendar the payer deadline.
Record recovered dollars net of vendor fees and staff time.
Escalate recurring contract discrepancies to the payer-relations lead.
Recheck the issue after the next remittance cycle before closing the item.
Bring unresolved balances and the proposed write-off to the monthly close review.

Completion record

For each review, record the date, participating owners, reporting period, evidence location, assumptions, decision, unresolved question, accountable person, and next review date. Keep sensitive financial, employee, plus transaction material in approved restricted locations. The completion record should help a future owner understand what was decided and why without requiring access to unnecessary patient information. Store the signed minutes beside the supporting report, and limit access to partners and managers who need the material for their role. File the final decision promptly.

This resource provides general business information only. It does not provide medical, clinical, patient, legal, tax, accounting, financial, investment, or professional advice. Consult qualified advisers before acting.