Your closed-month engine is strong, but the practice is leaking in three places that dwarf any vendor bill: 33% broken appointments, 20% fee acceptance, and over half your $210K AR sitting past 90 days. New patients fell to 26 in May with attrition higher at 31, the early warning for the production that has to carry your $750K office loan. If you do one thing today, put someone on the over-90 AR and broken appointments, then sweep cash at the 24% card.
What changed since last run
Evening run, nothing material moved since this morning. QuickBooks still shows only $5.3K of June posted against $59.6K collected on Divergent, the same posting lag. Tonight's balance sheet confirms ex-practice debt at $77,878: Chase 0871 $51,586, Chase 8837 $4,862, IRS $15,000, SBA down to $6,430, plus the $750K office loan, and your Profit account is sitting on $17,425 ready to sweep. No new Divergent daily since Jun 19, so AR holds at $113,456 over 90. The over-90 AR and the 33% broken-appointment rate are still the two biggest levers.
Top 5 focus areas
Work the over-90 AR $113,456 stuck
53.8% of your AR is past 90 days. Assign someone to work everything over 90 this week, refile or appeal stale insurance claims, 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, set a cancellation policy.
33% toward 20% could add tens of thousands per month, see What’s Next
Reverse the new-patient drop and attrition leading indicator
May new patients 26 versus attrition 31, a net loss, June pacing 18 of 60. Audit marketing source and phone conversion, run reactivation.
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. 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), 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.
