They keep 80%
The management fee is 20% — full stop. A full private practice runs 40–50% overhead. PSR cuts that in half and delivers more infrastructure than most private practices have.
How It Works
The Business Model
The deal for the assistant, the support model, and exactly how the money flows — for solo operators, keystones, and hospital partners.
The Deal for the Assistant
More than a paycheck.
Whether solo or on a keystone's team, every assistant gets the full package — not just a higher take-home.
Group malpractice — included
PSR carries a group malpractice policy that covers every assistant in the network. They never have to buy, manage, or worry about their own policy.
Retirement & tax setup
PSR helps operators set up Solo 401(k) / SEP-IRA, the right tax structure, and access to health insurance. The financial infrastructure most independents never had.
We teach them to run it
1099 structure, quarterly taxes, deductions, thinking like a business owner. Most assistants have never been taught any of this. We don't take a cut and disappear — we show up.
The core differentiator:PSR isn't a billing company that takes a cut and ghosts. We remove every downside of going independent and hand the assistant the upside. That's the whole model.
The Support Model
We build from the bottom up.
The test for everything we do is one question: did this set the operator up to win?
Free start-up consult
Every new operator gets one complimentary session with a tax advisor to set up their 1099 structure, quarterly taxes, and retirement — then a referral to a CPA we trust in their market.
Quarterly market workshops
When we open a new market, we fly in and run an in-market workshop once a quarter through the first year. A Saturday, lunch on us, run with the energy of a top medical-device sales meeting. Live sessions on taxes (a CPA in the room), insurance (an agent), and retirement (an advisor).
Vetted partner bench
We line up CPA, insurance, and retirement partners we trust — national where it's cleaner, local where it's better — so operators get real help, not a cold name off a list.
Benefits access (in development)
We're building access to health insurance and retirement for our 1099 operators. The exact vehicle is being finalized — this is a core part of what makes the independent model sustainable.
Provider advisory council
Like Ace Hardware's dealer councils, operators get a real voice in how the company runs and where it goes. This is a real partnership — not a volume grab.
A two-way fit
We watch retention and how each operator runs the model. We evaluate every relationship individually. If it's not working, we say so — because a model that traps people isn't a model worth building.
How the Money Works
No black boxes. No surprises.
Assistant Side
- The scrape is 20%. That's the number — solo or team.
- The profit-share flywheel: after expenses, ~10% of the region's net profit is split evenly across every practitioner on the regional team.
- Because it's split evenly, everyone wins by recruiting heavy hitters — bring in an ortho or spine specialist, the pie grows, and everyone's slice grows with it. The team recruits for you.
Hospital Side
- The hospital saves on every assistant: today they pay salary plus a 20–30% load for benefits, payroll taxes, and PTO. PSR takes the whole assistant off their books.
- The set rate is a formula, not a negotiation: the assistant's case count, the hospital's payer mix, and the FMV of an assistant in that market → a per-case rate charged only for cases PSR can't get reimbursed.
- FMV-anchored and recalculates as the payer mix moves. Never arbitrary, never a black box.
Billing Breakdown
- Commercial-insured: PSR invoices and collects; the assistant is paid their share.
- CSFA / SA-C on Medicare/Medicaid/TRICARE: not reimbursed by these programs — billed to the hospital at the set rate.
- PA / RNFA: bills the government program directly.
- Any denial: the hospital covers it at the set rate.
No case goes uncompensated.
Ready to see the numbers for your market?
Every assistant's situation is different. We'll walk you through exactly what the model looks like for your case count, payer mix, and market.
PARTNER · OWN · PROFIT · GROW