Monday reset, and the story has shifted: cash collection is fine, the pipeline is not. June closed at 122.2% collections and $19K net income, but fee acceptance fell to 18.8%, patient acceptance to 60.2%, and attrition beat new patients 35 to 26 for the second straight month. Those three feed every future month, and they all sit in the same conversation: the treatment presentation. One move this week: run a 20-minute huddle on case presentation, require a financing option on every plan over $1,500, and keep the named person on the over-90 AR that is already coming down.
What changed since last run
Evening run, Wednesday Jul 8. The clinical side finally moved: the Jul 8 Divergent daily filed tonight after yesterday reading was missing, and two production days carried July to net production $33,540 (from $20,908), collections $29,220 at 87.1% (from $17,623 at 84.3%), and 10 new patients (from 5). Case acceptance is still the soft spot at 20.8% on fees and 73.8% on patients. Pace now annualizes to about $130K production and $113K collections against the $160K goals. On the books, QuickBooks finalized June: collections $100,557, operating expense $63,200, net income $18,578, and 62.9% overhead, a touch better than the 64.3% first posted. Cash eased to $76,266 and cards came down to $56,166 as a payment cleared, so total debt is about $821K and ex-practice debt about $71K. Still no July income posted in QuickBooks, the usual lag, not a slow month. My read: production is catching up on schedule, but nothing here changes the Top 5. Acceptance at 20.8%, the 32.7% broken rate, and $99,913 still over 90 days are the whole game. Monday morning run is the next full Top 5 rebuild.
Top 5 focus areas
Rebuild case acceptance 18.8% fees, 60.2% patients
June was the worst acceptance month in the trailing twelve: 18.8% of presented fees accepted (prior carry was 20%) and patient acceptance fell to 60.2% from the mid-70s. This is the treatment-presentation conversation, not marketing. Run the case-presentation huddle, present same-day, and attach a financing option to every plan over $1,500.
Each point of fee acceptance on roughly $450K presented is about $4,500 a month
Keep working the over-90 AR $99,913 of $216,844
Carried over, and the pressure is working: over-90 fell from $113,456 (Jun 19) to $99,913 (Jul 4), 46.1% of total AR. Keep the named person on it, refile or appeal stale insurance claims, and move patient balances to statements or plans. Do not let up because it improved.
Collecting 25% of the over-90 is about $25,000 of cash
Cut the 32.7% broken appointment rate biggest production leak
Carried over: a third of booked chair time still evaporates (32.7% in June, 33.0% May). Tighten confirmations, build a short-notice fill list, and enforce the cancellation policy. An AI voice agent that auto-fills cancellations is worth a 30-day pilot here before office two.
32.7% toward 20% is tens of thousands of production per month
Reverse net patient loss 35 lost vs 26 new
Second straight net-loss month (May 31 vs 26). July has 4 new patients on three days against a 40 goal. Audit phone conversion and marketing source, run a reactivation campaign on the lapsed list, and track where the 35 attritions went.
Each 10 recovered patients is real first-year and lifetime value
Attack the Chase 0871 card and IRS balance cash leaks
Carried over: Chase 0871 crept up to $58,128 at roughly 24%, and the $15,000 IRS balance keeps accruing penalties while $50,000 sits in the Taxes account. Pay the IRS now and set a fixed monthly principal payment on the card. SBA is effectively paid off.
About $14,000 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.
