--- title: How to Build a Monthly Financial Review Process for Your Dental Practice description: A monthly review is a system, not a meeting. The close date, the five components, who owns which number, and how a decision turns into something that happened. image: https://reciprocityaccounting.com/hubfs/blog-images/post_59.png --- [Skip to content](https://reciprocityaccounting.com/blog/build-monthly-financial-review-process-dental#main-content) [![](https://reciprocityaccounting.com/hs-fs/hubfs/logo-horizontal-transparent.png?width=1298&height=290&name=logo-horizontal-transparent.png)Homepage](https://reciprocityaccounting.com) - [Services](https://reciprocityaccounting.com/services) - [Pricing](https://reciprocityaccounting.com/pricing) - [FAQ](https://reciprocityaccounting.com/faq) - [Blog](https://reciprocityaccounting.com/blog) - [About](https://reciprocityaccounting.com/about) [Book a Discovery Call](https://reciprocityaccounting.com/contact) - [Services](https://reciprocityaccounting.com/services) - [Pricing](https://reciprocityaccounting.com/pricing) - [FAQ](https://reciprocityaccounting.com/faq) - [Blog](https://reciprocityaccounting.com/blog) - [About](https://reciprocityaccounting.com/about) [Book a Discovery Call](https://reciprocityaccounting.com/contact) ![Building a Monthly Financial Review, Reciprocity Accounting](https://reciprocityaccounting.com/hs-fs/hubfs/blog-images/post_59.png?width=1200&height=630&name=post_59.png) How To # How to Build a Monthly Financial Review Process for Your Dental Practice ![Greg Hudnall](https://app.hubspot.com/settings/avatar/49dbd5c12b604f92786349ba17b92e2c) Greg Hudnall September 25, 2026 How To  ·  8 min read A monthly financial review is not a meeting you attend. It is a system with a date, a fixed set of inputs, and a named owner for every number. Build it once and it runs on about thirty minutes a month. Most practices do not have a monthly review problem. They have a monthly close problem wearing a review problem's clothes. The owner sits down with numbers that are three weeks stale, half-reconciled and missing the insurance deposits, concludes that the numbers are not telling them much, and stops sitting down. The habit did not fail. The inputs did. So this is a build post, not a run post. What to do once the numbers are in front of you is covered in [the three things to do with your monthly numbers](https://reciprocityaccounting.com/blog/dental-practice-monthly-financial-review). What follows is the system underneath it: when the close lands, what the review consists of, who owns which number, and how a decision made in the room actually turns into something that happened. ## Why monthly beats quarterly, and it is not close A quarterly cadence sounds disciplined and costs more than it looks. Three things go wrong with it. **The correction window closes.** Unworked insurance claims age past payer filing deadlines while you are waiting for the quarter to end. A claim you find at 45 days is still inside nearly every payer's filing window. By 135 days it may already be past a shorter payer or Medicaid deadline, and every week after that makes it harder to recover. That is money that existed and then did not. **The drift is small enough to hide.** The current squeeze in dentistry does not arrive as a crisis, it arrives as a point or two a year. No single month will show you a gap that size, but a trend line you read every month can, because twelve points a year show a slope that four points a year may hide. [The ADA Health Policy Institute reports](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/state_us_dental_economy_q22026.pdf) that since January 2021, dental staff wages and dental equipment and supply prices have each risen about 23%, while reimbursement averaged across all payer types has risen 19%, against 27% inflation. From January through June 2026 alone, staff wages rose 2.2% and reimbursement 1.1%, against 1.8% inflation. **You cannot attribute anything.** Review twelve weeks at once and four things changed. You hired, you raised fees, a payer repriced and one provider took vacation. Nobody can say which one moved the number. One month at a time, usually only one thing changed, so the number means something. ## The five components A review is worth doing when all five of these exist. Missing any one of them and you are guessing with better formatting. **1. A genuinely closed month.** Every bank, credit card and merchant account reconciled, nothing sitting in suspense, payroll booked to the right period and the insurance deposits matched to the production that earned them. Closed means closed, not "the bank feed imported." We target [the tenth](https://reciprocityaccounting.com/blog/dental-books-monthly-close-deadline) of the following month, and the date matters more than the speed: a predictable close is what lets everything else be scheduled. **2. The trend.** Production and collections for the month, against last month and against the same month a year ago. Year-over-year is the one that survives seasonality. A December compared to a November tells you about the calendar, not the practice. **3. The benchmarked ratios.** The handful with real published ranges behind them. [Collections](https://reciprocityaccounting.com/blog/dental-practice-collection-ratio) at 98% to 100% of net production. [Staff payroll](https://reciprocityaccounting.com/blog/dental-practice-staffing-percentage) at 25% to 30%. [Clinical supplies](https://reciprocityaccounting.com/blog/dental-supply-cost-percentage) at 5% to 7%, [lab](https://reciprocityaccounting.com/blog/dental-lab-cost-percentage) at 5% to 7%, and [total overhead](https://reciprocityaccounting.com/blog/dental-practice-overhead-percentage) at 55% to 65%, measured before owner compensation. Those ranges come from the [NSCHBC and Academy of Dental CPAs benchmark data](https://wa.nschbc.org/nschbc-benchmarks-report). Read your number against the range, then against your own last six months. **4. The diagnostic ratios.** The ones with no published benchmark and no honest way to get one, because they are set by where your building is, what market you are in and how you elected to be paid: [occupancy](https://reciprocityaccounting.com/blog/dental-practice-rent-occupancy-percentage), [marketing spend](https://reciprocityaccounting.com/blog/dental-practice-marketing-spend), [owner compensation](https://reciprocityaccounting.com/blog/dental-practice-owner-compensation) and [associate cost](https://reciprocityaccounting.com/blog/dental-associate-cost-percentage). These get read against your own trend only. If a dashboard shows you a national range for one of them, it was invented. **5. A decision record.** This is the component almost nobody has, and the one that converts the other four into money. More on it below. ## Put it on the calendar, and give every number an owner The habit question is really a scheduling question. Two recurring appointments, set once. The close lands by the tenth. The review is the same slot every month, within a couple of days of it, booked out twelve months in advance so it is never a thing anyone has to remember to schedule. Thirty minutes is enough once the inputs are clean. Then assign ownership, because a number nobody owns does not move. A workable default in a general practice: the office manager owns collections and accounts receivable aging, the hygiene coordinator owns re-care and the hygiene schedule, whoever handles ordering owns supply cost, you own fee schedules, provider schedules and anything about pay. Your bookkeeper owns the close date and the accuracy of the statements themselves, which is a real assignment and should be treated as one. The ownership map does two things. It tells you who is in the room, which is usually fewer people than you think. And it means an action item lands on a person by name rather than on the practice in general, which is the difference between a decision and a comment. ## What a decision looks like A review that ends in observations was a waste of thirty minutes. "Collections were soft" is an observation. The decision has four parts: what the number was, what you are doing about it, who is doing it, and by when. "Collections came in at 95% against the 98% to 100% range. Maria reworks everything in the aging report over 60 days by Friday." That is a decision. It gets written down, and the first item of next month's review is reading last month's list out loud and marking each one done or not done. That last step is the whole mechanism. A decision log nobody revisits is a diary. Reviewing it first, before any new number is discussed, is what makes the assignments real, and it takes about four minutes. It also surfaces the honest answer to a question owners rarely ask themselves, which is whether the things they decide actually get done. ## Connecting a ratio to an action The gap between a percentage and a decision is the part that stalls people, so here is the translation for the ones that move most often. **Collections below range.** The question is not "why is collections low," it is which of three things is happening: claims are not going out, claims are going out and not being worked, or patient balances are not being asked for. Those have different owners and different fixes. Split the aging report by insurance and patient before deciding anything. **Staff payroll above range.** Check the denominator before the numerator. A staffing ratio that drifts up in a flat month is usually a production signal, not a payroll one, and cutting hours in response to a demand problem makes the next month worse. In its Q2 2026 survey, fielded starting mid-June, the ADA Health Policy Institute found 26% of dentists were not busy enough and could have treated more patients, and a further 41% treated everyone who asked without being overworked. If you are in either group, the staffing line is telling you about the schedule. **Supplies above range.** Almost always timing or ordering behavior rather than price. Look for a stock order that landed in one month, then look at whether ordering is controlled by one person or by whoever notices a shelf is empty. **Overhead above range while every component is in range.** That is arithmetic telling you something is in the wrong account, most often [owner compensation or associate pay](https://reciprocityaccounting.com/blog/dental-practice-ebitda) sitting inside operating overhead. Fix the mapping before you act on the number. **A diagnostic ratio moving.** One month of movement is noise. Three months in the same direction is a trend and deserves a decision. Resist reading a single month of a number that has no benchmark, because there is nothing to read it against yet. **Every benchmarked ratio inside range while cash is still tight.** Then nothing is wrong with your cost structure and the problem is timing. Ratios are measured against production, and production is not cash. Go to the accounts receivable aging and the gap between the day you produce and the day you are paid, because a practice can sit inside every published range and still be short in the operating account. ## Start with one month You do not need the whole system to begin. Close one month properly, pull the five components, run thirty minutes, write down three decisions with names and dates on them. Next month, start by reading those three out loud. The practices that get value from their numbers are almost never the ones with the most sophisticated reporting. They are the ones where the same thirty minutes happens every month, on a closed set of books, and somebody reads last month's list first. *P.S.* [*Reciprocity Accounting*](https://reciprocityaccounting.com) *closes dental books by the tenth so the review has something current to work from, and delivers the statements and the ratios in the same place every month.* [*See how we can help your practice.*](https://reciprocityaccounting.com/contact) ## Frequently Asked Questions ### How long should a monthly financial review take? About thirty minutes, once the books are actually closed and the reports are in front of you. Most of the time goes to reading the ratios and deciding what to do about the one or two that moved. If your review is taking two hours, the problem is almost always that you are doing bookkeeping inside the review, which means the close is not finished when the review starts. ### What do I need before the review is worth doing? A closed month. Every bank, credit card and merchant account reconciled, nothing in suspense, payroll in the right period and insurance deposits matched to production. A review run on half-closed books produces conclusions you will have to withdraw, and doing that twice is how owners decide the numbers are not useful. ### Is monthly really better than quarterly? Yes, and the reason is timing rather than diligence. Unworked insurance claims age past payer filing deadlines while you wait for a quarter to end, so a recoverable problem becomes a permanent one. Cost drift in dentistry also runs a point or two a year rather than arriving all at once, and a trend line read every month can show a slope that four quarterly readings may hide. And with twelve weeks of changes bundled together, you cannot tell which change moved the number. ### Which numbers have real benchmarks and which do not? Collections, staff payroll, clinical supplies, lab and total overhead have published ranges behind them from the NSCHBC and Academy of Dental CPAs benchmark data. Occupancy, marketing spend, owner compensation and associate cost do not, and that is a property of those metrics rather than a gap in the research, because they are set by location, market and how you elected to pay yourself. Read the first group against range and the second against your own trend. ### Who should be in the review? Fewer people than most owners assume. You, and whoever owns the numbers most likely to need a decision, which is usually the office manager for collections and accounts receivable. Your bookkeeper owns the close date and the accuracy of the statements and does not need to attend every month. The test for inviting someone is whether an action item could land on them by name. ## Share this post [mailto:https%3A%2F%2Freciprocityaccounting.com%2Fblog%2Fbuild-monthly-financial-review-process-dental](mailto:https%3A%2F%2Freciprocityaccounting.com%2Fblog%2Fbuild-monthly-financial-review-process-dental) ## Keep reading ### [![Owner Pay in the Books, Reciprocity Accounting](https://reciprocityaccounting.com/hs-fs/hubfs/blog-images/post_58.png?width=1200&height=630&name=post_58.png) How To Owner Pay in a Dental Practice: How to Account for It Correctly](https://reciprocityaccounting.com/blog/dental-practice-owner-compensation-bookkeeping) ### [![Associate Cost Percentage, Reciprocity Accounting](https://reciprocityaccounting.com/hs-fs/hubfs/blog-images/post_57.png?width=1200&height=630&name=post_57.png) How To Associate Cost Percentage: How to Know If Your Associate Is Profitable](https://reciprocityaccounting.com/blog/dental-associate-cost-percentage) | ![Reciprocity Accounting](https://reciprocityaccounting.com/hubfs/logo_horizontal_dark_transparent.png) Accounting built for dental practices. 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Most of the time goes to reading the ratios and deciding what to do about the one or two that moved. If your review is taking two hours, the problem is almost always that you are doing bookkeeping inside the review, which means the close is not finished when the review starts." }, "name" : "How long should a monthly financial review take?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "A closed month. Every bank, credit card and merchant account reconciled, nothing in suspense, payroll in the right period and insurance deposits matched to production. A review run on half-closed books produces conclusions you will have to withdraw, and doing that twice is how owners decide the numbers are not useful." }, "name" : "What do I need before the review is worth doing?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Yes, and the reason is timing rather than diligence. Unworked insurance claims age past payer filing deadlines while you wait for a quarter to end, so a recoverable problem becomes a permanent one. Cost drift in dentistry also runs a point or two a year rather than arriving all at once, and a trend line read every month can show a slope that four quarterly readings may hide. And with twelve weeks of changes bundled together, you cannot tell which change moved the number." }, "name" : "Is monthly really better than quarterly?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Collections, staff payroll, clinical supplies, lab and total overhead have published ranges behind them from the NSCHBC and Academy of Dental CPAs benchmark data. Occupancy, marketing spend, owner compensation and associate cost do not, and that is a property of those metrics rather than a gap in the research, because they are set by location, market and how you elected to pay yourself. Read the first group against range and the second against your own trend." }, "name" : "Which numbers have real benchmarks and which do not?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Fewer people than most owners assume. You, and whoever owns the numbers most likely to need a decision, which is usually the office manager for collections and accounts receivable. Your bookkeeper owns the close date and the accuracy of the statements and does not need to attend every month. The test for inviting someone is whether an action item could land on them by name." }, "name" : "Who should be in the review?" } ] } ```