Across Texas, private equity firms are rapidly consolidating dermatology clinics. But for Dermatology Specialists of Fort Worth, independence wasn’t up for negotiation. The practice’s owners believed that being physician-led was essential to maintaining quality care, patient trust, and a culture rooted in autonomy.

Still, staying independent came with real challenges. Without a corporate back office, prior auths, denials, and appeals consumed valuable team time and energy. The administrative load was rising as the practice grew and every new biologic start risked pulling attention away from patients.

Cannon Brumley, the practice’s Director of Operations, knew they needed a way to match the efficiency of large PE-backed groups, without losing the personalized, physician-led spirit that made them different.

Staying Independent Meant Solving the PA Backlog

Before Tandem, the team spent countless hours buried in forms, calls, and payer follow-ups. Each biologic came with its own maze of step therapy rules, documentation requirements, and appeal templates. And when staff turned over, the institutional knowledge often walked out the door with them.

“It takes people a while to understand the ins and outs of any biologic or the PA process… Our two biggest issues before Tandem were time and knowledge.”

The result was a drag on efficiency and a slow creep toward burnout. The practice needed a better system to stay nimble without adding headcount.

A Healthy Skeptic Turns Process Discipline into Independence

One of the practice’s providers was the first to introduce Tandem to Cannon and the team. “She told us it was free, and I didn’t believe it,” Cannon shared. “Nothing’s ever free in healthcare.”

Rather than jump in, he spent weeks doing research and comparing notes with other clinics before finally deciding to give the platform a try. Before sending a single prescription through, Cannon built a clear internal workflow with defined roles and escalation paths so the team could roll back quickly if it failed – or scale fast if it worked.

“If we were going to disrupt our workflow, I wanted a plan so we could revert quickly if needed and understand how to make it easy for the team.”

Tandem Handles Administration, Providers Own the Clinical Decisions

This is how Cannon’s team runs the process:

1. At the visit – Providers document comprehensive clinical rationale (e.g., trials and failures) while MAs capture signatures and insurance data before the patient leaves.

2. Tandem handles the script – Tandem submits prior authorizations, drafts appeals, and ensures patient communication along the way. Providers' clinical support provides any necessary clinical decisionmaking throughout the process.

3. Centralized tracking – Tandem becomes the single administrative record, while ModMed remains the clinical record. Nothing falls through the cracks.

Faster Approvals With Clear Visibility

The first prescription the practice processed through Tandem was a Dupixent start. Within two hours of visit completion, the medication was submitted and on its way to the pharmacy.

“Our ‘Tandem moment’ was the first prescription. Within a few hours, it was already submitted to the pharmacy.”

Since then, results have been consistent:

• Speed: Same-day PA submission for prescriptions.

• Accuracy: Clear visibility ensures no patient gets missed.

• Morale: MAs now focus on patient education rather than chasing paperwork.

• Confidence: Providers know every decision is documented and traceable.

“We have seen an increase in medical assistant morale and happiness. They no longer struggle with having enough time in the day to be able to understand all the nuances that come along with every single prescription.”

Implementing Software as a Strategy for Independence

Cannon has since become one of Tandem’s most vocal advocates. For Cannon, Tandem isn’t just software—it’s a foundation for independence. By codifying their workflows, delegating administrative work, and maintaining a clean clinical record, the practice can run as efficiently as any large network while remaining fully physician-owned.

“Tandem’s overall impact has been immeasurable. Truthfully. It’s been nothing but amazing for us.”

Supporting Your Practice

If your gastroenterology or specialty practice is ready to streamline prior authorizations and accelerate access to therapy, sign up your practice for Tandem today or book a demo to learn more.