Production is up. Collections aren't.
Accounting, controller and fractional CFO work for medical and dental practices, from a team that has closed these books before.
What we usually see when a practice adds its second provider
Production and collections diverge and nobody reconciles the practice management system to the bank. Payer mix shifts and the effective reimbursement rate drops without anyone noticing. Receivables age by payer while the front desk chases patients. Provider compensation runs on production while the practice runs on collections. The owner sees patients all day and the finances at night.
The numbers we watch
— Collections against production, monthly
— Adjusted collection rate by payer
— Receivables aging by payer and by patient balance
— Overhead ratio against benchmarks for the specialty
— Provider compensation against collections, not production
— Hygiene or ancillary production as a share of the total
— Supply and lab cost as a percentage of collections
— Cash against payroll and equipment notes
What we build
— Practice management system reconciled to the bank every month
— A monthly package with overhead ratio and payer-level collections
— Receivables discipline by payer
— Provider compensation calculated from reconciled numbers
— A 13-week forecast around payroll, equipment notes and the second provider's ramp
How the numbers connect
What the owner sees on Monday.
Everything to the right explains it.
Adds to cash
Collections
Production × collection rate, by payer
Takes from cash
Provider compensation
From reconciled collections
Overhead
Staff, supplies, lab, occupancy
Equipment notes
On their real dates
The tree shows how cash is built for this industry: what adds to it, what takes from it, and the measures behind each. It is the structure of the scorecard we build.
Related
