Introduction
Acquiring a physician group can unlock growth—or reveal unexpected headaches. Financial diligence is critical, but operational realities often hide the deal’s biggest surprises. Here’s how to truly assess operational risk and avoid post-close regret.
What Most Due Diligence Misses
- Frontline Bottlenecks: Inefficiencies in scheduling, front desk, or intake create patient backlogs and lost revenue. High front desk turnover and lack of strong, ongoing training are often underestimated as root causes.
- RCM & Billing Gaps: Denials, underpayments, or AR drifting over 90 days, and often, with no one accountable for follow-up. Too many providers pulled into denial processing instead of eliminating the upstream causes.
- Fragmented Tech: Multiple EHR, billing, or workflow systems complicate enterprise visibility and hide key trends. If your team still relies heavily on spreadsheets, there is a fundamental data management problem.
- Under-the-Radar Changes: Be alert to pending system migrations, payer contract shifts, and staff churn.
- Compliance/Documentation Blind Spots: Ask if coding is regularly reviewed and whether credentialing and documentation are up to date.
Practical Assessment Tips
- Walk end-to-end through actual patient and billing workflows; look for manual workarounds.
- Request AR aging reports by payor and by provider—not just overall totals.
- Review the most recent coding audit and its action items.
- Interview business office and clinical leads about their pain points.
Why Unified Data Helps
Fragmented systems make thorough reviews difficult. Consolidate reports or data (using tools or outside help if needed) to create one reconciled set of numbers. Real-time, daily dashboards are critical for post-purchase to measure productivity, denial management, and keep leadership focused on what matters most.