The Stack Cost Worksheet

What your practice actually spends every month — including the parts that never appear on an invoice.

Most practices have never added this up

Every system that touches a client, a claim or a clinician — itemised
The seam costs: double entry, reconciliation, manual eligibility, chasing notes
A blended hourly rate applied to the hours lost between systems
One number showing what share of your spend exists only because your systems don't talk

Get the worksheet

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STEP 1

What you pay

Monthly figures — if you're billed annually, divide by twelve.

EHR / practice managementBase subscription, all seats$

ClearinghouseOften billed separately from your EHR$

Telehealth platform$

e-Prescribing$

Client portal / intake forms$

Texting / appointment reminders$

Faxing$

Payment processing markupAnything above the processor's own rate$

Reporting / BI tools$

Biller seat licensesWhat outside billing staff cost you in seats$

Anything elseIncluding the one from 2019 you can't cancel$

Subscriptions$0

STEP 2

What the seams cost

Hours per week moving information between systems, or fixing what got lost in between.

Double entrySame data keyed into more than one systemhrs/wk

Payment reconciliationhrs/wk

Manual eligibility checksPhone calls and separate payer portalshrs/wk

Chasing unsigned noteshrs/wk

Building reports by handhrs/wk

Chasing support across vendorshrs/wk

Blended hourly costWage plus payroll burden. $30 is a fair default.$

Seam cost$0

Subscriptions

per month

Seam cost

per month · 0 hrs/wk

True total

per month

Annually that's $0 — of which 0% exists only because your systems don't talk to each other.

Now compare it. Bring these numbers and your actual invoices and we'll build the side-by-side. If consolidating doesn't save you money, we'll say so on the call.

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