Monday reset, and the bottleneck has moved. For the first time in months the schedule is not the problem: August has $89,758 produced through the 13th with $76,562 already booked, $166,319 in sight against the $160K goal, and broken appointments have fallen three months running, 32.7% in June to 24.6% in July to 20.5% now, the best sustained stretch in your 13-month window. The chairs are filling. What is not working is what happens once a patient is in one. July closed at 18.0% fee acceptance on $672,476 presented, the worst read in the window, and you lost 57 patients against 44 new, a net minus 13 and also the worst in the window. August is already answering the first one at 25.6%, so whatever changed in the treatment room this month, name it out loud in the huddle and make it the standard before it drifts back. The second one needs a person: pull July's 57-name attrition list and have one named owner call every one of them this week. One more thing, and it is time-sensitive: today's brief prices SBA 7(a) at Prime plus 2.25 to 2.75%, roughly 6.75 to 9.75%, terms to 25 years, down payments as low as 10%. Your loan file has never looked better than it does right now with July and August both reading strong, so request term sheets from two dental specialty lenders this week while the numbers are on your side. I am your coach on the strategy, not a substitute for your filed-return CPA or an attorney on anything you sign.
What changed since last run
Morning run, Wednesday Aug 19, 5:31am. The Aug 18 daily filed and it carries one thing worth your attention. Collections climbed to $136,543 from $130,722, 133.2% of production, a good day. But net production went backwards, $103,448 down to $102,518, even though Aug 18 itself produced $10,357. The reason is adjustments: month-to-date write-downs grew from $18,505 to $21,204, with the Discount line alone jumping from $6,277 to $8,579 in a single day. That is roughly $11,300 of production erased off earlier days, more than a full day of chair time given away at the front desk. Worth a five-minute look at who approved that discount and why, because a month that produces $170,082 in sight against a $160K goal should not be losing ground on paper while the schedule is full. August now paces to about $176,559 produced and $235,157 collected with 32 new patients of the 40 goal, still a strong month; remember the collections figure carries the one-time $43,000 Proceed disbursement, so real patient and insurance cash is closer to $93,500 and the month is fundamentally a $160K produce, $160K collect month. Case acceptance softened, fees 24.9% to 23.5% and patients 71.2% to 69.4%; Aug 18 presented $67,131 and accepted 15.9% of it, so one weak presentation day moved the whole month. Reappointment holds at 83.5%. Money side is quiet, which is the good news. QuickBooks is unchanged overnight: August income $126,419, operating expense $28,832, net income $91,994 on the P&L and $92,599 on the balance sheet. Do not read the 22.8% August overhead as real, August payroll and rent have not posted yet, so I am leaving the August overhead, net income and owner pay cells blank in the history table rather than guessing. The balance sheet is also flat: cash $137,718, Taxes $50,000, Profit $37,000, Chase 0871 $17,522, Chase 8837 and the SBA at zero, Huntington $750,000, IRS $15,000 carried, ex-practice debt $32,495 and total debt $782,495. The fact that last night's $40,000 card drop survived an overnight sync is decent evidence it was a real paydown and not a reclass, but confirm it against the Chase statement before you spend against it. Receivables are unchanged and still read the Aug 15 weekly aging, $86,070 over 90 of a $212,209 book, 40.6%; the next weekly should land Friday or Saturday. Today's brief is on the Briefs tab and it lines up with your second-office file: negotiate your PPO fee schedules before you finance office two, because an 8% to 22% bump on your top 20 codes lifts the DSCR a lender underwrites, and it is far cheaper than the ads you would otherwise buy. Two process notes. This is a non-Monday run, so the coach note and Top 5 below still carry Monday's framing, and focus item five still quotes the card at its old $57,923 level; the Monday rebuild will re-rank on current numbers. Nothing was archived.
Rebuild case acceptance on fees July closed 18.0% on $672K presented
Back to number one on raw dollars. July was the worst fee acceptance in your 13-month window even with patient acceptance at a healthy 71.8%, which means patients are saying yes to something and no to the full plan. August is running 25.6% month to date, so the fix is already visible inside your own building. Codify it: present same day, attach financing to every plan over $1,500, and keep the case-presentation huddle on the calendar so this does not slide back in September.
Each point on $672K presented is about $6.7K a month; holding 24% instead of 18% is roughly $40K a month of accepted treatment
Stop the attrition bleed 57 lost vs 44 new in July
Carried over and still open. July's net minus 13 is the worst in the window and it quietly drains the recurring hygiene base that office two will lean on. Pull the July attrition list, assign one named owner to call all 57 this week, log the reason every single one gave, and fix the top recurring reason. Pair it with the 18-month dormant reactivation list. Today's brief also flags that acquirers now walk away from practices that lean on one producer and thin staffing, so retention depth is loan-file evidence too.
At roughly $300 of near-term monthly production per retained patient, July's net loss is about $4K a month of recurring production, compounding every month it repeats
Protect the $76,562 already on August's books $166,319 in sight vs $160K goal
Reframed from fill the chairs, because the chairs are full. $89,758 is produced and $76,562 more is scheduled, which clears the $160K goal if it holds. Broken appointments are at 20.5%, 15 of 73 appointments on the week-of-Aug-3 read, the best stretch in the window but still roughly double a healthy rate. Keep the confirmation discipline that produced the improvement, work a short-notice fill list against every cancellation, and start the two-week AI voice receptionist trial from today's brief so missed calls stop leaking schedule before office two opens.
Every broken-appointment point is chair time you already paid staff and rent for; this month is yours to lose, not to win
Keep working the over-90 AR $86,070 of $212,209, 40.6%
Carried over with a caution flag. After six improving reads the over-90 bucket has now drifted up two weeks running, $85,193 on Aug 8 to $86,070 on Aug 15, and the total book grew about $14K as the 31 to 60 bucket jumped from $19,386 to $30,344. That newer money is the warning: today's 31 to 60 is next quarter's over-90. Keep the named person on it, refile or appeal stale insurance claims, and collect the estimated patient portion at the chair with a card on file.
Collecting 25% of the over-90 is about $21,500 of cash, and stopping the 31 to 60 bucket from aging is worth more than chasing it later
Attack the Chase 0871 card and IRS balance $57,923 card plus $15,000 IRS
Carried over and unchanged, which is the problem. The card sits at $57,923 near 24% APR while $127,893 of cash sits on hand, including $50,000 walled off in Taxes and $27,000 in Profit, and the IRS balance keeps accruing penalties. Pay the IRS now from the Taxes account, set a fixed monthly principal payment on the card, and stop new spend on it. Chase 8837 is down to $1,414 and the SBA is paid off, so this is the last expensive money you touch. It also matters this week: a lender pulling your file for office two sees a maxed 24% card and prices you accordingly.
About $14K a year in card interest plus IRS penalties, and it directly affects the SBA 7(a) terms you are about to request
