When cash flow starts to pinch, most practice owners look outward—new marketing campaigns, new devices, even expansion plans. But the fastest way to boost cash flow isn’t out there. It’s inside your existing patient flow. The key is your Average Patient Charge (APC)—the amount you actually collect per visit.

All adjustments fall into two categories. Knowing which is which helps you separate what’s normal from what’s fixable. Contractual Adjustments These are the discounts you’ve agreed to with insurance companies. They’re built into your payer contracts and are part of the cost of doing business. They can’t be avoided—and they shouldn’t be feared. Think of them as the difference between your retail price and your contracted price. Write-Offs Write-offs are different

Many medical offices glance at their billed charges and assume that’s their income. It’s not. The real measure of your financial health is your Average Patient Charge (APC). Average Patient Charge tells you how much money you actually collect per patient visit, not what you billed. It’s the difference between thinking your practice is profitable and actually knowing it is.

Revenue growth should never come at the cost of morale or exhaustion. If average patient charge improvements are working, resist the temptation to also add days. Let one driver land before pulling the next. Clear cancellation policies and simple scripts turn chaos into just another variable to manage. Growth without burnout isn’t slow—it’s stable. That stability fuels a stronger team, happier patients, and a practice built to last.

Seasonality isn’t a surprise—it’s a system. The sooner you treat it as such, the sooner your clinic can win every month of the year.

Most practices chase growth by doing “more of everything”—more hours, more patients, more services. It feels busy but rarely produces sustained results. Instead, think of your practice as a dashboard with three levers of revenue. If you learn to separate them—and pull one at a time—you’ll grow faster, with less stress and greater clarity.

Beyond revenue and expenses, three often-overlooked factors tell a powerful story about a practice’s financial health: fee schedules, adjustment percentages, and patient cancellations.