You Still Have a Quarter to Change the Year

Every December, practice owners have some version of the same conversation: How did we do? What happened to the margin? Why didn't we get to that sooner?

September gives you something December doesn't: time to do something about the answers. Schedules book weeks out, and a December insurance visit may not turn into cash until January. Adjusting October's schedule or clearing a financial obstacle now gives the work time to happen and the payment time to arrive before year-end.

You don't need a turnaround plan. A few well-chosen moves can make a meaningful difference.

Put your year-to-date financials next to the same months last year and this year's budget, if you have one. Compare revenue, operating expenses, and operating profit the same way for both years. A practice can grow its revenue and still have less left over.

Same months matter. Comparing a vacation-heavy August with a packed March may tell you more about the calendar than the business.

Then ask what's driving the difference. More patients, or more provider hours? A shift between medical, surgical, and cosmetic work? A new PA still building a schedule? Staffing costs growing faster than revenue?

Earnings are central to a defensible practice valuation, but they deserve your attention even if you never plan to sell. Growth should leave you with a stronger business, not just a busier one.

Pick one or two differences worth understanding. That's enough to start.

Your appointment book may look healthy today. Does it still look healthy after provider PTO, staff vacations, and holiday closures?

Have your administrator look through the remaining quarter with those constraints in view. Look for an underfilled laser block, a Mohs day without histotech coverage, or one clinician with openings while another's patients wait weeks.

Before adding sessions, ask whether you can make better use of the ones already open. Does a recurring procedure block need adjusting? Are appointments being offered with the right clinician for the patient's needs?

Our earlier piece, Your Most Valuable Hour Isn't in the Exam Room, makes the case for owners spending time on the business. Reviewing the remaining quarter's schedule is one useful place to put that attention.

Protect some breathing room for urgent needs and the unexpected. A strong finish shouldn't require everyone to limp into January.

A recommended procedure wasn't scheduled. A follow-up fell off the calendar. A patient missed a visit and never rebooked.

The relationship and the need for care already exist.

Unresolved biopsy results and recommended skin cancer treatment deserve attention year-round, not just at year-end. If you're not sure your follow-up process catches all of them, that's the first thing to check.

For routine outreach, keep the list short and clinician-reviewed. Find the openings first, give one person protected time to make calls, and lead with something simple: "You were due for a follow-up. Let's find a time that works." If someone needs to be seen sooner than the schedule allows, a clinician makes that call.

As we explored in why patients miss appointments, getting patients back takes attention to the barriers in their way.

Year-end benefits may be relevant, but verify coverage before promising savings. Meeting a deductible doesn't make every service free, and financial timing shouldn't determine whether care is appropriate.

A completed visit still needs a completed chart before billing can move forward. Finishing and locking charts a little sooner, with the documentation complete and accurate, gives claims a head start. Protect a short block of time to clear unfinished notes before they become next week's backlog.

Check existing patient balances before the patient arrives, too. Some patients return toward year-end hoping to use benefits after meeting their deductible. If they still owe an amount from an earlier visit, check-in is a natural opportunity to explain the balance and ask for payment.

Give the front desk a simple approach: "You have a remaining balance from your last visit. Would you like to take care of that today?" Have a clear next step for questions or payment arrangements so staff can handle the conversation comfortably.

Pick one habit to improve in October: closing charts sooner or consistently reviewing balances before visits. Both are within your team's control, and neither requires a new spreadsheet.

1. Make one schedule adjustment. Fix an underfilled block or a staffing mismatch before the holiday calendar gets tight.

2. Reconnect with one group of patients. Choose a short follow-up list and give one person time to offer appropriate openings.

3. Improve one cash-flow habit. Choose either closing completed charts sooner or reviewing patient balances before check-in.

1. Give yourself some runway. Acting in October leaves time to see results and adjust before December.

2. Start with what's already in motion. Open appointments, unfinished care, and completed visits give you somewhere practical to start.

3. Three moves, named owners, one check-in date. Pick again in November.

Next week in Part II: give January a head start. We'll look at vendors, staffing plans, equipment purchases, and the financial conversations worth having before December makes every decision feel urgent.

What's the one thing you wish your practice had tackled earlier last year? Hit reply. That may be the best place to start this October.

Clarity RCM manages revenue cycle for 200+ dermatology practices across 44 states. It's all we do. See how we work.