The closed-month engine is healthy, but the practice is still bleeding in the same places that dwarf any vendor bill: over-90 AR near $113,456 (about 54% of $211K), a 33% broken-appointment rate, and only 20% fee acceptance. May new patients slid to 26 against 31 lost to attrition, a net loss, and that is the leading indicator for the production that has to carry your $750K office loan. Cards crept up too, Chase 0871 is now $55,616 at roughly 24%. One move this week: put a named person on the over-90 AR and broken appointments, pay the $15K IRS out of your $50K Taxes account to stop the penalty clock, and set a fixed principal payment on the 24% card.
What changed since last run
Evening run, Thursday Jul 2. Quiet since this morning. No new Divergent daily has landed, so July still reads day one: $7,289 produced, $1,293 collected, 3 new patients. QuickBooks still posts no July income, the normal lag, and June stays final at $96,241 income and $19,196 net income. I re-pulled the balance sheet and it lines up with actuals: high-rate cards $57,940 (Chase 0871 $58,128 plus a $188 credit on 8837), the SBA loan is paid off, IRS $15,000 carried, and cash is $78,658 with $50,000 already parked in the Taxes account, enough to clear the IRS whenever you say go. The over-90 AR, broken-appointment rate and fee acceptance are still the real leaks and still ride on the carried-from-May Divergent figures until the Monthly KPI PDF parses. What-If baselines stay on May.
Top 5 focus areas
Work the over-90 AR $113,456 stuck
About 54% of your $211K AR is past 90 days, your single biggest cash leak. Assign one named person to work everything over 90 this week, refile or appeal stale insurance claims, and put patient balances on statements or payment plans. Carried until the KPI file parses, refresh then.
Collecting even 25% of the over-90 is about $28,000 of cash
Cut the 33% broken appointment rate biggest production leak
A third of booked chair time evaporates. Tighten confirmations and reminders, build a short-notice fill list, and set and enforce a cancellation policy.
33% toward 20% could add tens of thousands per month, see What is Next
Reverse the new-patient drop and attrition leading indicator
May new patients 26 versus attrition 31, a net loss, with June pacing about 24 of a 40 goal. Audit your marketing source and phone conversion, and run a reactivation campaign on the lapsed list.
Each 10 recovered patients is real first-year and lifetime value
Lift case acceptance on fees from 20% implant dollars
You presented $463,508 and only $93,300 was accepted. Patient acceptance is fine at 77%, the gap is the big cases. Push same-day presentation and third-party financing.
20% to 25% on $463K is about $23,000 more accepted per month
Attack the Chase 0871 card and IRS balance cash leaks
Chase 0871 is now $55,616 at roughly 24%, plus $15,000 owed to the IRS accruing penalties. Pay the IRS now from the $50,000 Taxes account and set a fixed monthly principal payment on the card. The SBA loan is effectively paid off.
About $13,000 a year in card interest plus IRS penalties
I am your AI advisor, not a substitute for your filed-return CPA or attorney. Confirm anything binding, distributions versus basis, tax reserves, and staffing or expense changes, before you act.
