How a 3-location mental health practice recovered $13-15K/month
Anonymization note: Mental health group — patient-adjacent data and ongoing payer disputes require anonymity.
The billing team said everything was fine
Three locations, eight clinicians, one consolidated P&L. Net profit had collapsed from $13,659 to $4,675 per month, a 1.8% margin on $3.2M in revenue, and the owner could not point to a single location, clinician, or payer as the cause.
Their billing company reported acceptable denial rates. Their accountant provided only consolidated financials. All three locations lumped into one P&L. Nobody could tell which location was profitable, which was bleeding, or where the money was going.
The owner asked their billing team. The answer: "The numbers are normal for mental health."
$17K/month, and three separate causes
No-show rate had roughly doubled
Appointments booked and never filled, concentrated at one front desk
Service mix had shifted away from higher-value programs
The same clinician hours producing materially less revenue
A broken front-desk process nobody had isolated
Training did not fix it; the role had to change before no-shows improved
No location-level financial visibility
One location was running at a loss — invisible in consolidated reports
Location-level visibility, and the operating data behind it
We separated the consolidated financials into location-level P&Ls. For the first time, the owner could see that one location was running at a significant monthly loss while another carried the entire practice.
Then we pulled the operating data the accountant never had: appointment and attendance records from SimplePractice, claims and payments from Availity. Service mix, no-show rates and volume became visible alongside the financial statements, which is what turned "revenue is down" into three separate, fixable problems.
Built location-level P&Ls from the consolidated financials
Integrated SimplePractice and Availity operating data with the accounting platform
Tracked no-show and cancellation rates by location and by front desk
Isolated the service-mix shift driving the revenue decline
Established a weekly operating review alongside the monthly close
Recovered $13-15K/month within 90 days
Monthly recovered revenue
$0 (losses undetected)
$13-15K/month
Monthly profit
$4,675 (down from $13,659)
Recovering, on a $13-15K/month run-rate of fixes
Financial visibility
1 consolidated P&L
3 location-level P&Ls
The short version
If your accountant only sees consolidated financials, you cannot tell which location is profitable. And 'revenue is down' is not a diagnosis: this practice had three separate problems - a doubled no-show rate, a service-mix shift, and a front desk that training could not fix - each needing a different remedy. The step-by-step diagnostic that produced this is walked through on our how-it-works page, which follows the same engagement from the other end.
Methodology
Methodology: Recovered revenue is the increase in collections against expected collectible revenue — charges less contractual adjustments — attributable to fixes identified and implemented during the engagement. It is not gross charges minus collections, which would count normal contractual adjustments as losses. Measured over the window stated in the case. These are anonymized engagement narratives: identifying details are altered, and figures are reported outcomes rather than predictions.
Think your practice has similar issues?
Take the 4-minute financial assessment. It is free, and it will show you where your practice is leaking money.