Your closed-month engine is strong, but the practice is still leaking in three places that dwarf any vendor bill: 33% broken appointments, 20% fee acceptance, and over half of your $211K AR sitting past 90 days. New patients slipped to 26 in May against 31 lost to attrition, a net loss, and that is the early warning for the production that has to carry your $750K office loan. One focus this week: put a named person on the over-90 AR and on broken appointments, then sweep idle cash against the 24% card.
What changed since last run
Monday morning run, Jun 22. A fresh QuickBooks pull shows only $5.3K of June income posted against roughly $60K collected on Divergent, the same posting lag, with $5,930 of operating expense and $888 of interest booked so far this month. The balance sheet confirms ex-practice debt of $77,878: Chase 0871 $51,586, Chase 8837 $4,862, IRS $15,000, SBA down to $6,430, plus the $750K office loan, against $94,092 of cash. Your Profit account holds $17,425 and the Taxes account $51,550, so the $15K IRS balance is fully fundable today. No new Divergent daily since Jun 19, so AR holds near $113,456 over 90 (about 54% of $211K) and June is pacing about 19 new patients of 60. The Game Plan was refreshed for the week and last week's plan archived. The over-90 AR and the 33% broken-appointment rate remain the two biggest levers.
Top 5 focus areas
Work the over-90 AR $113,456 stuck
About 54% of your $211K AR is past 90 days. 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.
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, June pacing about 19 of 60. Audit marketing source and phone conversion, and run a reactivation campaign.
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 financing.
20% to 25% on $463K is about $23,000 more accepted per month
Attack the Chase 0871 card and IRS balance cash leaks
$51,586 near 24% plus $15,000 to the IRS accruing penalties. Sweep your Profit account ($17,425) and set an IRS payoff. SBA is down to $6,430.
About $12,000 to $14,000 per year in interest and 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.
