Monthly management report
Brightleaf Family Health
Collection lag stretched to 56 days from 53 — the Medicaid share ticked up to 34% after two commercial contracts lapsed, and $74K is now past 90 days in the government-payer bucket. The revenue is earned; the cash just lands two to four weeks slower.
01 · Executive summary
Three conclusions, and the decisions they imply
- Collection lag stretched to 56 days from 53 — the Medicaid share ticked up to 34% after two commercial contracts lapsed, and $74K is now past 90 days in the government-payer bucket. The revenue is earned; the cash just lands two to four weeks slower.
- Net collection rate dipped to 94.5% from 96.1% — a coding-denial cluster on the new provider's E/M claims drove ~$11K of write-offs. The worker read it as ramp noise on a new hire; the supervisor flagged a denial pattern, so it routed to your inbox to decide on a coding review.
- Patient visits held at 4,120 for the month vs the 3,980 plan — the extended Saturday hours and the second nurse-practitioner added ~140 visits without overtime, lifting throughput at the existing fixed-cost base.
Scorecard
Scorecard
Cash status
Cash-positive
Revenue
$708,000
+$14,000 · +2.0% vs plan
Monthly outflow
$642,000
+$10,000 · +1.6% vs plan
Gross margin
54.0%
DSO / DPO (days)
56 / 19
P&L summary — vs prior month, last year and plan
P&L summary — vs prior month, last year and plan
Month over month — vs prior period — Apr 26 vs Mar 26
| Line | Apr 26 | Mar 26 | Δ | Δ% |
|---|---|---|---|---|
| Revenue | $708,000 | $694,271 | +$13,729 | +2.0% |
| Cost of revenue | $325,680 | $319,365 | +$6,315 | +2.0% |
| Gross profit | $382,320 | $374,907 | +$7,413 | +2.0% |
| Operating expense | $316,320 | $314,249 | +$2,071 | +0.7% |
| Operating profit/(loss) | $66,000 | $60,658 | +$5,342 | +8.8% |
| Ending cash | $392,000 | $326,000 | +$66,000 | +20.2% |
Year over year — same month last year — Apr 26 vs Apr 25
| Line | Apr 26 | Apr 25 | Δ | Δ% |
|---|---|---|---|---|
| Revenue | $708,000 | $559,740 | +$148,260 | +26.5% |
| Cost of revenue | $325,680 | $257,480 | +$68,200 | +26.5% |
| Gross profit | $382,320 | $302,259 | +$80,061 | +26.5% |
| Operating expense | $316,320 | $292,340 | +$23,980 | +8.2% |
| Operating profit/(loss) | $66,000 | $9,919 | +$56,081 | +565.4% |
| Ending cash | $392,000 | $205,769 | +$186,231 | +90.5% |
Next month forecast $722,000
Trends
Monthly revenue — last 14 closed months
Mar 25 — Apr 26 · $466,553 … $708,000
Ending cash at each month close
Mar 25 — Apr 26 · $172,375 … $392,000
03 · Cash & working capital
Cash & working capital
Opening cash $326,000 net for the month +$66,000 closing cash $392,000
$392,000 today → $471,152 in week 13 · lowest point $318,727 (week 3) · no cash-floor breach
View weekly schedule
| Week | Opening | Receipts | Disbursements | Ending |
|---|---|---|---|---|
| 1 | $392,000 | $163,510 | $187,935 | $367,576 |
| 2 | $367,576 | $163,510 | $187,935 | $343,152 |
| 3 | $343,152 | $163,510 | $187,935 | $318,727 |
| 4 | $318,727 | $163,510 | $148,268 | $333,970 |
| 5 | $333,970 | $163,510 | $148,268 | $349,212 |
| 6 | $349,212 | $163,510 | $148,268 | $364,455 |
| 7 | $364,455 | $163,510 | $148,268 | $379,697 |
| 8 | $379,697 | $163,510 | $148,268 | $394,940 |
| 9 | $394,940 | $163,510 | $148,268 | $410,182 |
| 10 | $410,182 | $163,510 | $148,268 | $425,425 |
| 11 | $425,425 | $163,510 | $148,268 | $440,667 |
| 12 | $440,667 | $163,510 | $148,268 | $455,910 |
| 13 | $455,910 | $163,510 | $148,268 | $471,152 |
What changed and why
What changed and why
Collection lag stretched to 56 days from 53 — the Medicaid share ticked up to 34% after two commercial contracts lapsed, and $74K is now past 90 days in the government-payer bucket. The revenue is earned; the cash just lands two to four weeks slower.
✓ second model confirmed · General ledger · AR Aging · Apr 2026 · QuickBooks · Payer Mix · April
Net collection rate dipped to 94.5% from 96.1% — a coding-denial cluster on the new provider's E/M claims drove ~$11K of write-offs. The worker read it as ramp noise on a new hire; the supervisor flagged a denial pattern, so it routed to your inbox to decide on a coding review.
second model disagrees — review · General ledger · Denials · Apr 2026 · QuickBooks · Claim Denials · April
Patient visits held at 4,120 for the month vs the 3,980 plan — the extended Saturday hours and the second nurse-practitioner added ~140 visits without overtime, lifting throughput at the existing fixed-cost base.
✓ second model confirmed · General ledger · Visit Revenue · Apr 2026 · QuickBooks · Schedule · April
04 · Decisions & follow-ups
Decisions & follow-ups
Collection lag stretched to 56 days from 53 — the Medicaid share ticked up to 34% after two commercial contracts lapsed, and $74K is now past 90 days in the government-payer bucket
Open · outcome pending · You · Review by 05 Jun 2026
move the two slow commercial payers to electronic remittance and add a weekly denials-rework block to pull collections forward.
Reviewed · Brightleaf RCM team · Review by 17 Jun 2026
Forecast reliability
Forecast reliability Inferred
Your revenue forecasts have run 10% optimistic over the last 6 months.
How we measure it: every past monthly forecast is scored against the month that actually closed — out-of-sample, never fit to the answer.
Sources & evidence
- General ledger · AR Aging · Apr 2026
- QuickBooks · Payer Mix · April
- General ledger · Denials · Apr 2026
- QuickBooks · Claim Denials · April
- General ledger · Visit Revenue · Apr 2026
- QuickBooks · Schedule · April