Coming soon: Our episodes with the CEO of a large independent practice and with an IPA leader The end of September is the moment to start planning your first quarter ofredactedWhat you collect in January through March is mostly decided by what you do now. Dr. Heather Signorelli covers the five areas every owner, CEO, COO, or practice manager should review before the year closes. Your net collection rate. Gross collection rate compares what you collect to what you charge. Net collection rate removes contractual adjustments, so it shows what your team is writing off that it should be chasing: timely filing, bad debt, patient balances. Heather notes most practices sit in the mid to high 90s. Know your number and why it is where it is. A growth plan forredactedSet revenue goals in the first week of October. Use this year's average reimbursement per visit (claims through June should be paid by now) to work out the patient volume you need, whether you need to hire, and whether services you refer out, like PT, subspecialty care, or lab work, have a business case to come in-house. Payer contracts. When did you last negotiate? Are any credentialing denials still open? Starting in October gives new rates the best chance of loading early. IPA options. An independent physician association can strengthen your contracting position, but there are good and bad ones. Look at who they serve, how fast claims get paid, quality metrics, and shared savings before you join. A coding audit. If it has been years, get one. Check levels, modifiers, and incident-to billing, and make sure your documentation supports the codes. OB practices in particular need to be ready for the 2027 code changes. Three actions this week: • Pull your net collection rate and ask your billing team what is behind every non-contractual write-off • Put a two-hour 2027 planning session with your leadership team on the calendar for the first week of October • List every payer contract with the date it was last negotiated