Medical + Dental Practice Master Playbook
Count what you produced against what you collected. Work the money you already earned. Help patients make the decision on the care you found. The business side of an independent practice, with the dental and medical parts kept separate where they really differ.
Everything in the Playbook
The Collection Engine: 7 systems, in order, each passing the Trade Spine Test (a practice unit, a leak you can pull from software you already own, and the words that move it). Then the practice money model, a dental part, a medical part, and new patients last.
The Problem
You know what you produced. Do you know what you kept? Most practices watch production and never compute the number that separates the write-offs they agreed to from the money they earned and lost: balances nobody chased, denials nobody resubmitted, an open schedule nobody counts, treatment diagnosed and never scheduled.
None of that is a marketing problem. It is money for work already done, and the book starts there.
In 30 days you will know your adjusted collection rate, how much of your AR is past 90 days, what your open hours cost a year and how many treatment dollars sit unscheduled, with one named person working AR every week and a call going to every unscheduled plan.
The Collection Engine
7 systems, in this order. New patients come last, on purpose:
- Measure collection. Production, collection and adjusted collection rate. AR aging as a decay curve, and days in AR.
- Front desk and billing. The estimate before the visit, the portion at check-in, clean claims, and AR worked every week from the 61-to-90 bucket.
- The schedule. What open time costs, reply-required confirmations, a short-notice list.
- Case acceptance. The 5 Beats, who else decides, phasing, and the 3-call sequence for unscheduled treatment.
- Recall. The next visit booked in the chair, and a human call for the ones who weren't.
- Your team. The front desk as a revenue role, and a provider hired only when counted demand covers the cost.
- Owner rhythm. A weekly 30 minutes, one decision, and the number that drove it.
Sample: The 20-Minute Quick Win
Write a guess first: out of every dollar your practice earned last quarter, how many cents reached the bank? Then pull 3 months of production, collections and contractual write-offs.
Collection rate = Collected / Production Adjusted collection rate = Collected / (Production - contractual write-offs) Illustration: produced $182,000, collected $139,000, write-offs $24,000 Collection rate 76%. Adjusted: $139,000 / $158,000 = 88%. Earned and not collected: $19,000 a month.
The first gap is the deal you signed with the plans. The second is money you earned. Put your guess beside your count. The gap between them is the first thing the book fixes.
The Legal Lines, Drawn and Sourced
A practice sits under rules a plumber never meets. The book marks every place a system touches one, and Appendix A says what the public source says, dated October 2026, and what to ask your healthcare attorney or compliance adviser: good-faith estimates for self-pay patients (CMS), lending rules on in-house payment plans (Regulation Z), anything of value offered to Medicare and Medicaid patients and copay waivers (HHS Office of Inspector General), paying for referrals, patient information in marketing (45 CFR 164), and health targeting in ads. It is a list of questions, not legal advice, and no script in the kit prints a payment-plan structure or a reactivation offer.
What This Book Will Not Give You
No benchmark collection rate, no industry-average overhead, no standard case acceptance or recall rate, no typical days in AR. None of those tables knows your payer mix, your contracts or your town. You get the calculation, and your own day one, re-counted at day 30 and day 90.
Questions Owners Ask
Does it tell me what collection rate I should hit?
No. It shows you how to compute your adjusted collection rate and AR aging, and compares you against your own day one.
Will it tell me how to code or bill a visit?
No. It tells you to measure your first-pass claim rate and sort your denials. What to do about a specific code belongs with a certified coder.
Does it tell me how to set up a payment plan?
It tells you why that is a legal question first, quotes the Regulation Z definition, and gives you the desk script with a blank your adviser fills.
Is there a membership plan in it?
A pricer: plan gross profit from your own costs, assuming every member uses every visit, the discount stress test, a procedure check, and members needed to cover the launch. The structure goes to a healthcare attorney in your state before you sell one.
I run a medical practice, not a dental one. Is it for me?
The 7 systems are shared. Part 12 is dental (hygiene, the benefit year, participating or not). Part 13 is medical (payer mix and concentration, coding, referral relationships, cycle time).
Are the examples real practices?
No. The 4 owners are labelled composites with round numbers, built to show decisions. One goes wrong on purpose. There are no client results in the book because we do not publish client results.
Who This Is For
Owners of independent dental, medical, chiropractic, physical therapy and optometry practices collecting $500K to $3M a year, who see patients and run the business. Business operations only: not clinical, coding, billing, HIPAA or legal advice.
Read it in your library.
This is included with The Standard, along with every other guide in the library. Your monthly re-audit tells you which one to open next. $497 to start, $297/mo to keep it running. Cancel any month and keep everything.
See The Standard →Not sure yet? Take the free Bucket Audit or tell us what's broken.
