Dental Practice Cash Flow Template

Move to the 13-Week Cash Flow sheet and fill in projected insurance inflows week by week based on your current claim aging and your carriers' typical payment timelines. Most commercial PPO carriers pay within 14–30 days of clean claim submission; Medicaid and some HMO plans run 30–45 days. Patient portion collections are more predictable — co-pays collected at the chair on appointment days, billed balances spread over the following 30–60 days based on your statement cycle and patient payment rate. Enter your bi-weekly payroll dates and gross payroll amounts in the expense rows — this is the single most important item to get right because it's non-negotiable, and the weeks when payroll lands during a slow insurance payment window are where cash shortfalls occur. Add lab invoice payment dates (typically net-30 from the lab's invoice date) and supply order payment dates.

The metrics that matter most in dental practice cash flow are collection rate, overhead percentage, and AR aging. Collection rate — net collections divided by net adjusted production — should stay at 96–99% for a well-managed practice. Every percentage point below 99% represents real money that was earned but not collected; at $2M in annual adjusted production, the difference between 96% and 99% collection is $60,000 per year. Overhead as a percentage of collections should target 59–65% for a general practice; above 70%, the practice is typically unprofitable at current production levels. AR aging over 90 days is the early warning signal: once a balance ages past 90 days, the probability of collection drops to 60–70% for patient AR and even lower for disputed insurance claims. Lab fees deserve separate tracking because they scale directly with restorative production — as crown and implant cases grow, lab expenses should grow proportionally, and a lab cost ratio above 12% of collections typically signals either high-volume restorative (good) or a fee schedule problem (bad).