Be honest with yourself for a moment.
How do you check your practice’s cash flow?
You open the banking app. You look at the balance.
You do some quick mental math about payroll, rent, and that equipment lease you probably shouldn’t have signed in December.
Then you close the app and hope for the best.
That’s not a cash flow strategy.
That’s a coping mechanism.
And it’s the financial equivalent of diagnosing a patient by checking their pulse in the parking lot.
Why 90 Days Is the Magic Number
You don’t need a 12-month forecast.
Nobody updates those.
They sit in a drawer next to your practice’s original business plan and that gym membership you swore you’d use.
You don’t need a 30-day window either.
That’s not forecasting; that’s just watching the train while it’s already running you over.
Ninety days is the sweet spot.
It’s long enough to see what’s coming.
Short enough to stay accurate. And just wide enough to give you time to actually do something about what it reveals.
Hiring decisions.
Equipment purchases.
Owner distributions.
Estimated tax payments.
Every one of these choices improves dramatically when you can see 90 days into the future instead of reacting to whatever shows up on Monday’s bank statement.
What Actually Goes Into a 90-Day Forecast
This is not a spreadsheet built for your accountant’s accountant.
This is a working tool.
Think of it as a vitals monitor for your practice’s financial health.
Money Coming In
Expected patient collections based on your historical payer mix and average days in AR.
Insurance reimbursements adjusted for your actual collection rates.
Any ancillary revenue; lab fees, imaging, cash-pay services.
Key insight: don’t use billed charges.
Use what you actually collect.
Your billing system’s optimism is not a financial plan.
Money Going Out
Payroll and benefits.
Rent and occupancy costs.
Supplies, subscriptions, and vendor contracts nobody has renegotiated since the Obama administration.
Loan payments.
Malpractice premiums.
And the one most practices forget: tax reserves.
Yes, the IRS expects their money even when your collections are slow.
Shocking, I know.
The Projection
Plot your inflows against your outflows, week by week, for the next 90 days.
Where the lines cross is where you pay attention. Where they diverge is where you either celebrate or call your advisor.
What a Forecast Reveals That a Bank Balance Never Will
A bank balance tells you where you’ve been.
A forecast tells you where you’re headed.
A forecast shows you the cash crunch three weeks before it arrives so you can accelerate collections instead of scrambling for a credit line.
It shows you that the new hire you want to make in July actually pencils out if you wait until August; when two large payer contracts settle.
It shows you that your Q2 estimated tax payment is going to collide with your annual malpractice renewal.
Again.
Because it does every single year, and every single year it catches you off guard.
Patterns become visible.
Surprises become manageable.
Decisions become strategic instead of desperate.
The Real Reason Most Practices Don’t Do This
It’s not because forecasting is complicated.
It’s not.
It’s because you’re a physician running a business you were never trained to run, and on any given Tuesday you’re choosing between reviewing claim denials and seeing the next patient.
The patient always wins.
As it should.
But that’s exactly why the financial side of your practice needs a system that works without requiring you to become a part-time CFO.
A rolling 90-day forecast, updated monthly and reviewed with someone who understands the numbers, takes the guesswork out of the biggest decisions you’ll make this year.
You wouldn’t treat a chronic condition without a care plan.
Stop treating your practice’s cash flow like it’s going to manage itself.
Your Next Step
Flying blind on cash flow is a choice.
And it’s an expensive one.
If you’d rather have someone build, maintain, and review a 90-day forecast tailored to your practice; someone who speaks both tax and operations; that’s exactly what we do.
Let’s build your forecast together. Visit owingsllc.com/work-with-me and let’s get your practice’s cash flow out of the dark.