Preparing for a Slow Season: A Financial Checklist for Practice Owners

Patient visits dip every year around the holidays and again when deductibles reset in January, and that dip shows up in your collections a few weeks later. We have covered reserves, forecasting, fee schedules, and scenario planning this month. This post pulls them into one checklist you can work through before your practice hits its slower stretch.

Know when your slow stretch really starts

For most practices the dip has two parts: fewer visits around the holidays, then lower insurance payments per visit once deductibles reset in January. Because insurance pays weeks after the visit, the cash drop usually arrives later than the schedule drop. Look at last year's collections by week, not by month, to see when your low point actually hit the bank.

Make sure the books are current first

A forecast built on unreconciled books is a guess. Get the bank, merchant processor, and insurance deposits reconciled through last month before you plan anything else.

Size the reserve to your own low point

Add up your fixed costs for the slow stretch: rent, payroll for the front desk and associates, equipment leases, software, and insurance. Compare that to what is set aside today. If there is a gap, close it with a scheduled transfer while collections are still steady, not with whatever is left in December.

Forecast with your real payment timing

Build a 90-day cash forecast that uses how fast each payer actually paid you this year, plus your typical cash-pay volume. If one payer routinely takes 45 days, model it at 45, not 30.

Review care plan and cash-pay pricing

Prepaid care plans can smooth out a slow season, but only if they are priced to cover the visits they promise. Check your plan and cash-pay prices against this year's cost per visit before you promote them.

Plan associate and front desk schedules now

Decide ahead of time how you will adjust hours if visits drop, and talk it through with your team before the schedule thins out. Planned changes are easier on staff than last-minute ones.

Line up options before you need them

If the forecast shows a tight month, ask about a line of credit while your numbers look strong. Lenders say yes more easily to a practice that is not yet short on cash.

Working through this list before the slow stretch arrives is the difference between a slow season you manage and one that manages you.

Jeremy Brewer is the founder of 911 Bookkeepers LLC in Baton Rouge, Louisiana. 911 Bookkeepers partners with MBJA Accounting Service to give chiropractic and MDVIP practices clean, current financials. He is a Xero Certified Advisor.