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Alderbrook Family Medicine

A six-provider family medicine practice billing insurance and patients across two offices.

Two questions are waiting on you, the oldest since Sunday. The November close pauses at these.

Your part of the November close

Your books close on the 5th. These need you first; everything else is on us.

Sign off on the appeal for the three denied claims from Continental Health Plan

Due Nov 4

Send July's supply invoices from Crestline Medical Supply

Due Nov 7

Your numbers today

Cash today$188,661Up $38,722 over the last month
RunwayCash-flow positiveThe bank grew over the last three months
Cash generated$5,632A month, averaged over the last three
Revenue$282,813November, against $305,899 the month before
Net income$53,637November
Owed to you$213,700$115,700 of it is past due
Then and now

Your books, graded with the same 0 to 100 rubric on both dates.

When Luca arrived · Jun 202657/100131 open issues in the books
Today · as of Nov 202694/1004 open issues

Up 37 points since Luca took over. 127 issues cleaned up.

Revenue by service

What October 2026's billing is made of, from your invoices.

Commercial insurance visits
$146,83148%
Medicare visits
$82,59327%
Self-pay and copays
$45,88515%
Labs and vaccines
$30,59010%

Commercial insurance visits is 48 percent of the period's revenue. The top three lines cover 90 percent. Growth conversations start with which of these to push.

Cash, next 8 weeks
Week ofNov 9Nov 16Nov 23Nov 30Dec 7Dec 14Dec 21Dec 28
Opening balance$188,661$282,361$294,681$300,841$310,361$315,401$323,241$326,601
$115,700$21,560$10,780$16,660$8,820$13,720$5,880$20,580
$22,000$9,240$4,620$7,140$3,780$5,880$2,520$8,820
Net change$93,700$12,320$6,160$9,520$5,040$7,840$3,360$11,760
Cash at week end$282,361$294,681$300,841$310,361$315,401$323,241$326,601$338,361

Expected case: today's cash against open invoices and bills, paid on their due dates.

Cash flow

Ending cash
$188,661heading to $338,361 by Dec 28
This week's pulse

What your accountant would flag this week, straight from the books.

$24,560 is stuck in invoices over 60 days old

5 invoices have been out more than two months. Collection odds drop fast from here. Worth a personal nudge this week; reply here and we send the reminders for you.

Cash is trending up: $338,361 in sight

From $188,661 today to $338,361 in eight weeks if invoices and bills land on their due dates. A good stretch to decide what that surplus should do: taxes set aside, a cushion, or reinvestment. Happy to run the numbers on any of the three.

Action items

The moves that would help your numbers most right now, from your own books.

Chase Medicare$32,640 of their balance is past due. Money already earned; a direct note usually moves it.
Chase Bayshore Employee Benefits$27,708 of their balance is past due. Money already earned; a direct note usually moves it.
Chase Lakeside Health Partners$25,080 of their balance is past due. Money already earned; a direct note usually moves it.
Settle or schedule Apex Diagnostics Lab$7,392 to them is past due. If the delay is deliberate, fine; if not, it is the kind of thing that quietly costs goodwill.
Your October 2026 report
Revenue$305,899
Expenses$240,173
Net income$65,726
Cash at month end$149,939
From your accountant

October brought in $305,899 across insurance reimbursements and patient collections, against $240,173 of costs, leaving $65,726 of net income. Visit volume held steady, which is the part that matters most for staffing. The number worth your attention is receivables. There is $115,700 sitting past due, most of it tied up in claims still being adjudicated or appealed, and that is why cash moved less than the month on paper suggests. Following up on the oldest claims would turn a good month on the income statement into a good month in the bank.

Your accountant has 2 questions for you
Your accountantYour accountant
This $6,400 charge from Crestline Medical Supply isn't tagged to a location. Was this for the downtown office or the east side clinic?Waiting

2026-10-19 · Expense · Crestline Medical Supply · Uncategorized Expense · ($6,400.00)

Your accountantYour accountant
A $22,300 deposit came in from Continental Health Plan but I don't see a matching claims batch. Is this a bulk reimbursement for July's claims?Waiting

2026-10-09 · Deposit · Continental Health Plan · Undeposited Funds · $22,300.00

Your accountantYour accountant
Is the new vitals monitor a piece of equipment to depreciate, or a supply expense?

2026-09-27 · Expense · Crestline Medical Supply · Medical supplies and vaccines · ($3,850.00)

You
Equipment. It's a capital purchase for the east side clinic, not a consumable.

Money owed

Owed to you$213,700$115,700 past due
You owe$64,000$22,000 past due
Work on your books

What your accountant handled in the last 30 days.

9 bank statements checked line by line
8 vendor bills read and entered from their documents
214 transactions reviewed, categorized and posted
Your accountantYour accountant

A real person keeps these books. A question, an idea, something that looks off: write me directly and I answer personally.

Ask Luca

In your own portal this answers anything about your books. Here, try one of the questions below.

This could be your books.

Your numbers arrive here straight from QuickBooks, your monthly report is written for you, and the questions your accountant needs answered take seconds instead of an email thread.

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