As a private practice physical therapy owner, I would regularly anticipate the reports generated from our billing and collecting area. As a young business owner, I interpreted these reports as providing a vital pulse of the overall health of the practice. However, as I matured as a business owner and someone attempting to maintain oversight of the entire organization rather than just the delivery of services, I discovered that the actual pulse of the practice was best measured by the results of our marketing efforts. And the reports of the billing and collections area best measured the productivity of that area specifically and its ability to keep up with the pulse of the practice. As we all know, numbers and statistics can, and are, used to many different means. And I’m also sure that the vast majority of us have fallen prey to the many justifications used to explain why the numbers are what they are. That is why it is so vital to ensure that enough data is made available so that we can acquire an accurate picture of exactly what is really going on. The more information one has the fewer guesses one has to make. One of the key statistics which often times is not reported when discussing the area of billing and collections is the adjustments or write-offs. The category of adjustment is often times the path of least resistance which will nickel and dime a practice to cash flow nightmares. “It just doesn’t seem worth all the effort and expense to go after that one unit that wasn’t paid” is what one will often hear. Unfortunately, that is the collection personnel throwing away your money, not theirs. This can best be observed by looking at graphs rather than spreadsheets with many numbers on them. If charges being billed are going up and collections are remaining steady, I would begin to scrutinize the level of adjustments being taken. These adjustments won’t appear in large amounts singularly, but $10 here and $20 there will add up very quickly. I urge you to keep a close eye on the adjustments in the regular reports being provided to you. You may discover a large leak in your practice.