The invoice problem nobody could see
Sophia FinOps came in through a board recommendation. On the telecom side, there was skepticism about whether an external team could handle what they already managed. The reservations didn't last long. Francisco Maciel, Accounts Payable Director at HMH, remembers the early days clearly:
We found the team to be really good at what they were doing. They were concise. They provided all the details we needed. We gave them what we needed as far as invoices, and they took over to manage the accounts.
What they found was a billing environment that had grown well beyond anyone's ability to track manually. Francisco had seen HMH grow from a single hospital to a system of ten. The telecom estate grew with it, and so did the complexity of managing it. "We were just one hospital, and now we're growing to 10 major hospitals and a few hundred physician offices. Things got lost in the sauce."
In practice, that meant invoices arriving at different locations, routed to department heads focused on seeing patients. Bills paid without anyone verifying what they covered. Underneath it all, an inherited telecom estate in need of auditing. Lines from previous configurations, previous tenants, previous mergers. Still active. Still billed.
For Accounts Payable Manager Irene Errico, the operational reality was just as fragmented. Invoices arrived by mail, routed to individual locations with no central point of control. "As a manager, you want your processes automated, your vendors working in process, invoices out the door," she says. "Less headaches, less credit holds." Without that infrastructure, the AP team was always catching up.
Sophia FinOps centralizes the invoice, contract, and inventory data that, at HMH, was scattered across carriers, locations, and departments. As a carrier-neutral managed service, it processes and codes invoices. It audits against contracted rates and flags discrepancies before payment reaches the carrier.
The first audit: what the invoices revealed
Before any optimization, Sophia FinOps had to establish an accurate baseline.
Francisco remembers what the first inventory review turned up: hundreds of lines that had been active and billed for months, some for far longer. Fax lines. Network lines. Telephone lines. All running through the books every month, none of them in use.
That first inventory digitization surfaced disconnected services across the estate, cataloged carrier by carrier against contracted rates. The savings were immediate. More importantly, HMH now had an accurate picture of what they owned, what it cost, and who was responsible for it.
As Pure IP’s Clari Rosa-Garcia, Director of Sophia FinOps, explains: "When you multiply the number of locations, the number of vendors, the number of invoices, technology invoices are just inherently complex to understand. What Sophia brings is centralizing all of that information so we can really provide controls around it."
A number that kept climbing
By the time Meridian merged with HMH in 2020, the account had grown from 240 to nearly 300 accounts. The Meridian onboarding pushed that past 500. Today it stands at 1,000+. Annual spend climbed alongside it.
Each merger brought the same problems Francisco encountered in 2016: inherited lines, unfamiliar vendors, invoices arriving before anyone had set up proper routing. Sophia FinOps became part of the playbook. As soon as a merger was announced, the inventory went to the team.
"Whenever we have any kind of mergers, the Sophia FinOps team is always one of the first groups that we contact. Guys, we got another one coming."
New acquisitions are absorbed without disrupting existing operations. The process is structured and consistent:
- An Implementation Manager collects invoices, carrier data, and available contracts
- Cost centers, carriers, and approval rules are configured to reflect the organization
- Invoice processing goes live within 8 to 12 weeks
- If an invoice arrives for an account still mid-onboarding, the team handles payment to keep services live
- Unused services identified and removed from billing
- Billing errors caught and disputed before payment
- Contract renegotiations supported with accurate spend data
- Monthly audits against contracted rates across every carrier
For Irene, the priority through every onboarding is straightforward. When a new practice joins the network, her team is already working to get it set up before the go-live date. Any invoice that arrives in the meantime gets handled so nothing stalls.
"We don't want any shutdowns. We want their systems to work when they come into the office in the morning. We want their phones to be working when patients are calling in."
What $1.8 million in savings looks like
Seven months of auditing surfaced over $450,000 in annual recoverable spend. Over four years, total documented savings have reached $1.8 million.
Sophia FinOps clients typically reduce network expenses by 10 to 20 percent:
For Francisco, the value extends beyond direct savings. "New accounts don't get set up unless they're audited by us first or approved by us first. So when it comes to any kind of fraud, it mitigates that risk."
For Irene, it comes down to what her team no longer has to do. "The last thing any manager wants is to have an AP staff do manual processing." Today, 500 to 600 invoices upload in roughly 10 minutes from a weekly spreadsheet.
The work behind the savings report
Budget managers at HMH now receive proactive monthly reporting: spend allocated by cost center, with line-item detail behind each summary. Before Sophia FinOps, that reporting required valuable time and effort. Now the answers arrive before the questions do.
And physicians no longer lose service because an invoice got lost between a remote practice and the AP department. Francisco explains:
All those phone calls I used to receive from doctors saying that they had no service went away. Which is a real positive thing.
Clari describes this as governance built into the cost management process: controls that determine who sends invoices, who approves them, and who gets flagged when something doesn't match. "We know who is supposed to be sending us invoices and where we can accept an invoice from. There's that verification check."
A note for healthcare finance teams
Telecom estates don't get simpler as organizations grow. More locations mean more vendors, more invoice formats, more inherited lines, and more chances for billing errors to accumulate undetected. HMH's path from 240 accounts to 1,000+ shows what it takes to stay on top of it: a digitized, carrier-agnostic inventory audited monthly for cost changes and errors, a single portal for all carriers, and a managed service that absorbed a decade of mergers without losing track of a single invoice.
