Q1 Practice Review Checklist

The end of the first quarter is one of the best times to pause and take stock.  By now, you have enough information to see patterns. You can usually tell what is improving, what is slipping, and where strain may be building under the surface.

This checklist is meant to help you step back and evaluate the health of your practice more clearly, without getting lost in too much data. It is designed to be useful across a range of practice models, including insurance-based, cash-based, hybrid, concierge, telehealth, online, and capitated practices.

How to Use This Checklist:

Go section by section and mark each item:

• On track
• Needs attention
• Not sure

If you mark several items in one section as "Needs attention" or "Not sure" that area likely deserves a closer look in Q2.

1. Revenue Movement

This is the first question: Is revenue moving as it should for your model?

Review:

• Are charges, invoices, or visits being captured consistently and on time?
• If you bill insurance, are claims going out promptly?
• Is money coming in within a reasonable timeframe?
• Are patient balances, memberships, subscriptions, or recurring payments being collected reliably?
• Are write-offs, refunds, or missed collections increasing?
• Is older A/R growing, where applicable?
• Does actual revenue match what you would reasonably expect based on visit volume, panel size, membership count, subscriptions, or contracted arrangements?

Q1 reflection:
Did revenue move the way it should have this quarter, or did it feel slower, leakier, or less predictable than expected?

2. Denials, Errors, and Preventable Leakage

For insurance-based and hybrid practices especially, this is one of the fastest ways to spot hidden strain.

For other models, the equivalent question is whether preventable mistakes are creating lost revenue, missed renewals, failed follow-through, or unnecessary rework.

Review:

• Are denials, rejections, or avoidable write-offs staying contained?
• Are the same problems repeating?
• Are eligibility, authorization, documentation, coding, or front-end errors creating downstream issues?
• Are corrected claims or follow-up items being worked quickly?
• Are you seeing leakage from missed charges, missed renewals, missed follow-up, or poor financial communication?

Q1 reflection:
What revenue loss this quarter looked preventable in hindsight?

3. Access and Schedule Health

A healthy practice is not just producing revenue. It is also making it reasonably easy for patients to access care.

Review:

• Are new and established patients getting in within a reasonable timeframe?
• Are no-shows or cancellations increasing?
• Are open slots being filled efficiently?
• Are phones, online scheduling, portal messages, or patient communication channels supporting access well?
• Are delays, wait times, or rescheduling problems starting to create friction?
• For concierge, telehealth, online, membership, or capitated practices, are continuity, panel engagement, renewal patterns, and follow-through where they should be?

Q1 reflection:
Did patients experience your practice as accessible and responsive this quarter?

4. Backlog and Workflow Strain

This section tells you whether the practice is flowing cleanly or quietly getting heavier to run.

Review:

• Are unbilled encounters, unfinished documentation, inbox items, referrals, prior auths, or follow-up tasks starting to pile up?
• Is work moving from one step to the next without too much chasing?
• Are there repeated bottlenecks or handoff problems?
• Are people relying too much on memory instead of clear process?
• Is too much of the day being spent correcting, checking, or redoing work?

Q1 reflection:
Where did the practice feel heavier or more chaotic than it should have this quarter?

5. Visibility and Control

Owners often feel most stressed not because there are problems, but because they cannot see them clearly enough or early enough.

Review:

• Do you have a short set of numbers or indicators you trust?
• Can you spot issues before they become urgent?
• Do you know where money, work, or follow-through is getting stuck?
• Are you still learning about problems after they have already affected revenue, staff time, or patient experience?
• Are there areas of the practice that feel too dependent on guesswork?

Q1 reflection:
At the end of this quarter, do you feel informed and in control, or are there still too many surprises?

6. Team Capacity and Operational Stability

Even a strong practice model starts to wobble when the team is stretched too thin or carrying too much informally.

Review:

• Is the team spending too much time on interruptions and escalation?
• Are a few people carrying too much of the practice in their heads?
• Are training gaps showing up in errors or inconsistency?
• Could the practice keep moving if one key person were unexpectedly out?
• Are managers solving the same problems repeatedly instead of resolving them for good?

Q1 reflection:
Did your team look sustainable this quarter, or were they holding too much together by sheer effort?

7. Model-Specific Performance

The exact numbers may vary depending on whether your practice is insurance-based, cash-based, hybrid, concierge, online, telehealth, or capitated. But every model has a few truth-telling indicators.

Review:

• Insurance-based practices: claim flow, denials, A/R aging, net collections, and front-end accuracy
• Cash-based or concierge practices: collections, conversion, renewals, retention, panel growth, and visit utilization
• Hybrid practices: whether both sides of the model are being managed with equal discipline
• Telehealth or online practices: show rate, access, follow-up completion, conversion, and visit-to-revenue performance
• Capitated practices: panel health, access, continuity, utilization patterns, and the operational work required to support the population

Q1 reflection:
Did your model perform the way it should have this quarter, or are there weak spots hiding inside it?

Final Q1 Questions

Before you move into Q2, ask yourself:

• What improved this quarter?
• What slipped?
• What keeps repeating?
• Where are we losing time, money, or energy unnecessarily?
• What one to three issues would make the biggest difference if we addressed them next?

That is usually where the real value is. Not in reviewing everything, but in seeing clearly what matters most now.

Need Help Making Sense of What You’re Seeing?

If you’re reviewing the first quarter and you’re not quite sure what the numbers, patterns, or operational strain are telling you, schedule an appointment and we'd be happy to help.