We know Dental Service Organizations -
and how to grow them
Cash reconciliation, customer payment application and reconciliations of EOBs
Cash Flow
Forecasting
Acquisition
Integrations
Lower
Operating Costs
We de-risk the long-term financials
of P&C Insurance
Policy Administration and Claims Handling System Reporting with Specific Experience in Silverline / PTS & Diamond
Program Profitability Analysis, Leakage Analysis, and Underwriting Profitability Improvements
Program Reporting and Related Reconciliations of Collected, Written & Earned Premium
Robust Knowledge with Trust Accounting & Trust Reconciliations
Flexible Managed Accounting Resources
We’re a team of CFOs and senior accountants delivering financial analysis and transaction processing for Dental Service Organizations.
Transaction Processing
Accounting
Support
CFO & FP&A
Augmentation
SPINE & ORTHOPEDIC MEDICAL DEVICE DISTRIBUTOR
Commission calculations were managed manually in spreadsheets, manufacturer invoices and credits were reconciled inconsistently, and stock-and-bill accounts receivable lacked structure. Although leadership could see revenue trends, they struggled to identify true case-level margins, determine which representatives were driving profitable growth, or quantify their exposure to specific surgeons or facilities.
To gain clarity from surgical case activity through invoicing, manufacturer payments, commission payouts, and final margins, a structured case-to-cash reporting framework was implemented.in collaboration with Surgicloud.
This framework aligned operational case data with financial oversight. It included standardizing manufacturer reconciliation, linking commission logic to actual margin performance, organizing stock-and-bill workflows, and creating dashboards that displayed profitability by surgeon, representative, product line, and hospital system. For the first time, leadership had disciplined, consistent reporting that connected revenue to contribution margin and cash flow timing.
One key insight quickly emerged: nearly 20% of total revenue was tied to a single spine surgeon operating within one hospital system. While leadership was aware that this surgeon generated significant volume, they had never assessed the concentration risk in relation to margin contribution and payment timing. With improved visibility, they could now see not only the concentration of revenue but also the true profitability profile associated with that surgeon’s cases.
Shortly after gaining this clarity, the surgeon left the hospital system, and revenue declined almost immediately. However, the distributor remained stable. Since exposure had already been quantified, leadership had modeled the financial impact and understood where margin strength existed across other product lines. They identified a higher-margin orthopedic segment with expansion potential and adjusted representative focus and incentive structures accordingly.
Although top-line revenue temporarily decreased, overall profitability remained stable. Cash flow forecasts proved accurate, commission payouts aligned with margin performance, and no reactive restructuring was necessary. Instead of responding with urgency or guesswork, the distributor made deliberate adjustments supported by clear financial data.
The outcome was not driven by an increase in sales volume but by disciplined financial visibility. With structured reporting and margin clarity in place before disruption occurred, the distributor was able to protect profitability, manage concentration risk, and continue operating from a position of control rather than reaction.
INSIGHTS
The Role of a Fractional CFO in Helping DSOs Scale Effectively
As a Dental Service Organization (DSO) owner, scaling operations can be quite challenging. That’s where a Fractional CFO comes in as a key player in
Accounting Data Security Risks in Dental Service Organizations
Due to significant technological advancements, Dental service organizations (DSOs) face increasing risks to data security, particularly in their accounting processes. DSOs handle lots of sensitive
Maximizing Profitability: Cost Management Solutions for Dental Organizations
Effective and actionable cost management strategies significantly impact the financial health of dental organizations, especially in a volatile and competitive business environment. Cost management emerges
Navigating the Major Challenges in DSO Accounting
The practice of accounting is a crucial aspect of managing a successful dental business. Expertise in finance and accounting is essential to optimizing cash flow,
Strategies for Excelling in the DSO Industry’s Financial Landscape
The Dental Service Organization (DSO) industry has been on the rise with an increasing number of dental practices opting to join DSOs for various benefits,
Why a group of Dental Practices should switch to accrual accounting
As a group of dental practices, managing finances is a critical component of ensuring the success of each individual practice and the overall group. One
How Fractional Accounting Simplifies the Finance Function for CFOs within Startups
What is Fractional Accounting? Fractional Accounting is the customized delivery of equivalent expertise, as full-time employees, on a variable basis. For startups, this can be
Biotech Silicon Valley $20m -> $90m startup
Implemented GL and initial financial infrastructure, established monthly accounting processes and reporting cadence for internal and external financial reporting. Set financial infrastructure for successful $70m additional capital raise 24 months after initial $20m capital raise. Timely and accurate monthly financial reporting package with expense and budget analysis exhibits; on regular cadence for a fraction of the cost of hiring/sourcing internally; scalable solution for high growth expectations.
Software technology $20m high growth, PE-backed
Played key financial strategy, FP&A, and accounting roles for SaaS company expansion into US from overseas where product development had begun. US sales went from $5m ARR to $20+m ARR in 3 years. Obtained credit facility through private non-bank financing partner. Helped get numerous term sheets for equity transaction, ultimately raised $20m in cash with a $30m deal at pre-money valuation north of $160m. Oversaw international expansion into Europe, LATAM, and APAC with scalable finance team able to manage complexities of tax, contracting/invoicing, and financing.
Software technology Equity raise
Started as fractional CFO firm for a SaaS company with ultra-high growth going from $100k MRR to $1.0M MRR in first 90 days of engagement. Complexities of a past reverse-merger and inadequate accounting support put the company behind in building much needed infrastructure to scale. Another major outsourced accounting firm chose to disengage leaving BBA in an easy position to be able to take up all finance/accounting responsibility. BBA cleaned up 6 months of history, accounting for the reverse-merger and implemented scalable infrastructure which allowed the company to go to market with a major investment bank within 4 months; seeing interest from institutional capital at valuations over $100m.
Enterprise SaaS company, equity raise
Provided the US finance and accounting support for a SaaS company that started in India expanding into US that had raised no institutional capital, but 100% operating cashflow financed from day 1. BBA provided guidance on best practice for operating the finance function, and prepared the company for potential equity transaction as it eclipsed $10m in revenue. The team implemented 606 for revenue recognition, accrual accounting, ME close process, and adequate infrastructure to report GAAP financial statements and prepare the company for its first financial audit.
P&C Insurance, non-standard auto
Held fractional CFO title for a managing general agency (MGA) in the non-standard auto business; streamlined carrier reporting, developed a weekly close process for all premiums, commissions and LAE for both accounting and cash settlement. After 6 months, the BBA operations team helped reduce the monthly cost of accounting by 70% through a faster, more efficient and lower cost close.
P&C Insurance, non-standard auto
BBA started out by augmenting the accounting team within a large MGA group and after catching up and cleaning up over 100 cash account reconciliations and streamlining the cash close, moved on to support other segments with similar transformative work.
UK Fin Tech launch of US operations
Advised CEO on startup of operations in the US including banking, HR/benefits, payroll, equity, tax, and accounting infrastructure. Developed loan book reconciliation process with operations, and a cost efficient and fast monthly close process.
Real estate asset and property manager
Holding around 35 properties in the Healthcare space; in need of CFO and accounting support at low cost.
A real estate asset and property manager
Holding around 40 multifamily properties ranging from a few dozen units to almost 1,000 units across the nation, the existing CFO and internal accounting team needed help maintaining cash on daily basis, reconciling timely, and giving better inputs into cash flow forecasting for properties.
Group of startup real estate companies
Which branched off of an established residential realtor operation; focus was construction of commercial projects, investment and remodel of multifamily and residential multifamily development. Needing low cost / fractional accounting and CFO/controllership support.
PE portfolio company turnaround
Private equity owned, $300m frozen foods manufacturer; high cost of labor in CA; low margin business had discontinued ¾ of business within 12mo in efforts to save profitable segment; BBA provided outsourced FP&A, controllership and support to the CFO. Was able to scale up and down as needs changed quickly; ultimately refinancing the company and successfully closing an exit for private equity.
CPG Food startup
A startup health food products company which manufactured, packaged and sold food products made from sunflower flour, direct to consumer as well as through wholesale/grocery channels. Minimal staff internally and needed help with accounting and regular monthly financial reporting.
Commission calculations were managed manually in spreadsheets, manufacturer invoices and credits were reconciled inconsistently, and stock-and-bill accounts receivable lacked structure. Although leadership could see revenue trends, they struggled to identify true case-level margins, determine which representatives were driving profitable growth, or quantify their exposure to specific surgeons or facilities.
To gain clarity from surgical case activity through invoicing, manufacturer payments, commission payouts, and final margins, a structured case-to-cash reporting framework was implemented.in collaboration with Surgicloud.
This framework aligned operational case data with financial oversight. It included standardizing manufacturer reconciliation, linking commission logic to actual margin performance, organizing stock-and-bill workflows, and creating dashboards that displayed profitability by surgeon, representative, product line, and hospital system. For the first time, leadership had disciplined, consistent reporting that connected revenue to contribution margin and cash flow timing.
One key insight quickly emerged: nearly 20% of total revenue was tied to a single spine surgeon operating within one hospital system. While leadership was aware that this surgeon generated significant volume, they had never assessed the concentration risk in relation to margin contribution and payment timing. With improved visibility, they could now see not only the concentration of revenue but also the true profitability profile associated with that surgeon’s cases.
Shortly after gaining this clarity, the surgeon left the hospital system, and revenue declined almost immediately. However, the distributor remained stable. Since exposure had already been quantified, leadership had modeled the financial impact and understood where margin strength existed across other product lines. They identified a higher-margin orthopedic segment with expansion potential and adjusted representative focus and incentive structures accordingly.
Although top-line revenue temporarily decreased, overall profitability remained stable. Cash flow forecasts proved accurate, commission payouts aligned with margin performance, and no reactive restructuring was necessary. Instead of responding with urgency or guesswork, the distributor made deliberate adjustments supported by clear financial data.
The outcome was not driven by an increase in sales volume but by disciplined financial visibility. With structured reporting and margin clarity in place before disruption occurred, the distributor was able to protect profitability, manage concentration risk, and continue operating from a position of control rather than reaction.
Analytics Consulting firm
$25m consulting firm growing quickly in the IT/Data space; in need of maturity in FP&A, budgeting, cashflow forecasting to set direction for organization and align cross-departmentally.
Contingency fee law firm
Law firm with strategy specifically in products liability contingency fee cases; scaling in personnel and docket; initially needed financial modeling/forecasting capabilities which bookkeeper did not have; later transitioned all accounting work to BBA once the firm outgrew the bookkeeper.
Contingency fee law firm
Law firm focused on financing contingency fee mass-torts cases; deployed capital into a couple hundred cases within a few case strategies, needed accounting and FP&A support as the operation was run by a small group of attorneys Litigation finance fund management – Fund manager for multiple closed-end litigation finance investment funds which started in 2019 and raised around $20m in capital; funds were run by a small team of attorneys; needed accounting support, modeling, FP&A and investment relations/fund administration support.
Litigation finance fund management
Fund manager for multiple closed-end litigation finance investment funds which started in 2019 and raised around $20m in capital; funds were run by a small team of attorneys; needed accounting support, modeling, FP&A and investment relations/fund administration support.
Let’s Talk
We specialize in helping small businesses manage their accounting and financial needs in an economical way that scales as fast as you do. If you’re interested in what an engagement looks like with us, just indicate that you’d like us to share a sample engagement with you in the form below.