What to Measure When Nothing Is Outstanding

Why is there no days-in-A/R number to run?

Because nothing is outstanding. Money moves at the visit, so the interval a revenue-cycle dashboard exists to measure never opens. Days in A/R, first-pass yield, denial rate and point-of-service collection rate all describe the distance between doing the work and being paid for it. Close that distance and the whole set reports the same figure every month, which is another way of saying it reports nothing.

The payer-side numbers are still worth holding onto, because they show what the old dashboard was for. In MGMA's 2026 benchmarking, practices collected roughly 72% of patient copayments at the time of service and only about 27% of other patient-due balances 1Ref 1Chris Harrop / Medical Group Management Association (MGMA) (2026).Days in A/R holds steady for most practices, but payer pressure persists in 2026.The payer-side benchmarks named here as the numbers a cash-pay dashboard has no equivalent of: roughly 72% of copayments collected at the time of service against about 27% of other patient-due balances, and first-submission claim denials of roughly 7% to 8% across the past four years.. The same benchmarking puts first-submission claim denials at roughly 7% to 8% across the past four years 1Ref 1Chris Harrop / Medical Group Management Association (MGMA) (2026).Days in A/R holds steady for most practices, but payer pressure persists in 2026.The payer-side benchmarks named here as the numbers a cash-pay dashboard has no equivalent of: roughly 72% of copayments collected at the time of service against about 27% of other patient-due balances, and first-submission claim denials of roughly 7% to 8% across the past four years.. One figure measures money left on the desk after the visit. The other measures work that has to be done a second time.

A cash-pay practice closed that gap on day one, which leaves it measuring things a billing report was never built to print.

What the deposit total leaves out

Gross deposits overstate revenue in any practice that takes cards, and the overstatement is bigger than it looks. Processing fees, refunds and chargebacks all come out of the total, and a chargeback can arrive months after the visit that earned the money. The figure worth tracking is net collected: what reached the operating account and stayed there, reconciled each month against the processor's own gross total.

The tax form makes the difference concrete. A payment processor has to issue a Form 1099-K once a practice passes the reporting threshold, which the December 2026 instructions set at gross reportable payments above $20,000 together with more than 200 transactions in the year 2Ref 2Internal Revenue Service (2026).Instructions for Form 1099-K (Rev. December 2026).The Form 1099-K reporting threshold a payment processor applies (gross reportable payments above $20,000 together with more than 200 transactions in the year) and the instructions' own definition of the reported gross amount as computed without adjustment for credits, cash equivalents, discounts, fees or refunded amounts.. That threshold prints on the instructions themselves, so read the revision you are filing under rather than a figure remembered from an earlier season.

But the form reports the raw total. The instructions define that gross amount without regard to adjustments for credits, cash equivalents, discount amounts, fees, refunded amounts or any other amounts 2Ref 2Internal Revenue Service (2026).Instructions for Form 1099-K (Rev. December 2026).The Form 1099-K reporting threshold a payment processor applies (gross reportable payments above $20,000 together with more than 200 transactions in the year) and the instructions' own definition of the reported gross amount as computed without adjustment for credits, cash equivalents, discounts, fees or refunded amounts.. The practice receives a document stating a number it never held, and the books have to bridge the two. Track both figures monthly. The gap between them is what it costs to take money by card, and it is the first thing a tax preparer will ask about.

How fast does the money land?

Days to settle is the closest replacement for days in A/R, and it runs in two legs under different rules. The first leg goes from the card swipe to the processor's payout. The second goes from the deposit to the moment the bank will let the practice spend it. Only the second leg has a published legal floor, so measure the two separately and never average them into one figure.

The first leg is a contract term. Payout timing sits in the processor's merchant agreement, varies with account history and reserve status, and the processor can change it on notice. No public benchmark exists to compare it against, so the number to hold is your own: pull ninety days of payouts and record the median lag from transaction date to arrival in the account.

The second leg has a floor written into federal rule. Under Regulation CC a bank must make cash deposited in person and funds arriving by electronic payment available for withdrawal on the next business day, and must release the lesser of $275 or the whole of a day's ordinary check deposits on the same schedule 3Ref 3Board of Governors of the Federal Reserve System (2026).12 CFR § 229.10 — Next-day availability (Regulation CC).Regulation CC's next-day availability rules: cash deposited in person and electronic payments available in full the next business day, plus the lesser of $275 or the aggregate of a day's ordinary check deposits, used only to frame the regulatory floor for when deposited funds become available and never as a statement about card-processor payout speed.. The general schedule allows up to two business days for an ordinary local check and up to five for a nonlocal check or an ATM deposit 4Ref 4Board of Governors of the Federal Reserve System (2026).12 CFR § 229.12 — Permanent (general) availability schedule (Regulation CC).Regulation CC's general availability schedule: up to two business days for an ordinary local check and up to five business days for a nonlocal check or an ATM deposit, framed as bank deposit availability rather than processor settlement.. Those are ceilings on the delay, and a bank is free to release funds sooner.

But Regulation CC governs deposits at a bank. It says nothing about how long a card processor holds funds before sending them, and reading a two-day check-availability rule as a two-day payout promise makes the settlement number look better than it is.

Measure the whole span, visit to spendable balance. That is the figure a lender asks for when it wants to know how fast the business turns work into cash.

What an hour of clinical time returns

Collected per clinical hour does the most work of any number in a solo practice, because the owner is the capacity. Divide net collected for the month by the hours spent in session, not by the hours on the schedule. The result prices every decision competing for those hours: a lower fee, a longer intake, a Friday given to paperwork, an added evening of availability.

Two schedule numbers sit underneath it, and neither has a published benchmark for cash-pay solo practice. The kept-visit rate is the share of booked appointments that happen, with no-shows and late cancellations counted against it, and many practices watch it weekly because a bad stretch shows up in the deposit total before it shows up anywhere else. Time to third-next-available is the common access measure, and it reads differently with no payer in the room: a long wait says the fee or the capacity can move, and a short one says the marketing is the constraint.

Held together these make the solo dashboard: five numbers, monthly, small enough to fit on one screen. They also settle the two expensive questions ahead of a growing practice. Collected per clinical hour is the figure the first hire has to move, and holding that same figure flat across a second full schedule is the whole case for clinician #2.

Prepaid plans are work the practice already owes

A membership fee or a prepaid package arrives as a deposit and a liability at the same moment. The cash is in the account and the sessions are undelivered. Counting the whole deposit as this month's revenue flatters this month and starves every month that follows, which is an easy way for a growing cash-pay practice to misread its own books.

Federal tax law recognizes the timing problem, and how it applies depends on the accounting method. A practice on the cash method reports income when it receives the money and deducts expenses when it pays them 5Ref 5Internal Revenue Service (2022).Publication 538 (01/2022), Accounting Periods and Methods.The cash method (income reported when received, expenses deducted when paid) against the accrual method, and the advance-payment rule under which an accrual-method practice may postpone part of a prepayment for services not yet performed no further than the next tax year.. A practice on the accrual method that takes an advance payment for services not yet performed can elect to postpone part of that payment out of the current year's income, and the postponement cannot run past the next tax year 5Ref 5Internal Revenue Service (2022).Publication 538 (01/2022), Accounting Periods and Methods.The cash method (income reported when received, expenses deducted when paid) against the accrual method, and the advance-payment rule under which an accrual-method practice may postpone part of a prepayment for services not yet performed no further than the next tax year..

Which method a practice uses, and whether any election is worth making, is a conversation for its CPA. What the owner can track without any election is the unearned balance: prepaid dollars collected, less the value of sessions already delivered against them. That balance is a forward obligation measured in hours, and it belongs on the dashboard beside cash.

A practice can be flush and behind at the same time, and the unearned balance is the line where that shows.

The five numbers and where each figure comes from

Each number has one source document and one cadence, and pulling a figure from anywhere else is how a dashboard drifts. Net collected comes from the operating account. Days to settle comes from the payout report and the deposit record together. The two schedule numbers come from the calendar. The unearned balance comes from the membership roster and the session log.

Reconcile net collected against the processor's gross at least once a year, because the 1099-K arrives carrying the gross figure and the return will show less. The rest of the list answers to the calendar and the bank, which are two records a solo practice already keeps.