SGA Internal · Six Shooters + Karen + Myles · May 5, 2026

Production Numbers Getting on the same page.

Four numbers. One vocabulary. Aligned by the end of this meeting.

SGA Dental Partners · Scott Guest
Working Session · 9:30 AM
01 · The Problem
Same word. Different meaning.

Two companies. Two budgets. Two definitions of the same word.

SGA West (Gen4)
Budgets on
Production
What the office walked patients out at.
Visible in the DPMS every day.
vs.
SGA East
Budgets on
Net Production
Production after contractual adjustments.
Calculated in PowerBI, not visible at the office.
Different words. Same network.
Until we share vocabulary, every cross-entity rollup is built on numbers that look the same but aren't.
SGA · Production Terminology
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02 · The Four-Number Hierarchy
The waterfall · UCR ceiling down to revenue

Four numbers, stacked.

The gap between each one is what we usually argue about. Both gaps have a name.

UCR ProductionUCR Ceiling
UCR FEE × PROCEDURE VOLUME
100%Theoretical Max
Posting behavior
↓ if office posts at insurance fee
ProductionAs Posted at WalkoutSGA West Budget
CHARGES ON THE PATIENT LEDGER
~88%DPMS Visible
Less contractual adjustments
↓ insurance write-offs finalize
Net ProductionAfter AdjustmentsSGA East Budget
PRODUCTION − CONTRACTUAL ADJUSTMENTS
~76%PowerBI Calc
Less bad debt
↓ uncollectible balances
RevenueCash Recognized
WHAT THE BUSINESS ACTUALLY EARNS
~72%Finance / GL
SGA West budgets here
Production
DPMS-visible. Mix of UCR and insurance fees by office.
SGA East budgets here
Net Production
After adjustments. Closer to revenue. Not visible at office.
The two gaps
Production → Net = contractual adjustments
Net → Revenue = bad debt
SGA · Production Terminology
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03 · Terminology Crosswalk
A shared vocabulary · same word, same meaning, network-wide

If we can't agree on the words, we can't agree on the numbers.

Concept SGA West Calls It SGA East Calls It Proposed Unified Term
UCR-based ceiling — Doesn't Exist Gross Production Calculated UCR Production
Charges as posted at walkout Production Mixed No standalone term Production
After contractual adjustments No equivalent No equiv. Net / Adjusted Production Net Production
After bad debt — what the GL sees Revenue Revenue Revenue
Future / scheduled production Mix by office Variable Mix by office Variable Scheduled Production
SGA · Production Terminology
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04 · The Recommendation
What we should show, everywhere

Show all four numbers. Honor both budgets through 2026.

Step 01 · Calculated
UCR Production
UCR Fee × Procedure Volume
Used ForDiagnostic ratios. Adjustment %. Payer-mix analysis.
Step 02 · As Posted
Production
Charges Posted on Ledger
SGA West Budget
What offices see in the DPMS daily.
Step 03 · After Adjustments
Net Production
Production − Contractual Adjustments
SGA East Budget
Closest to revenue. Settles over time.
Step 04 · Cash
Revenue
Net Production − Bad Debt
Used ForEBITDA. Investor reports. CFO numbers.
Through 2026
Each entity keeps its native budget. West = Production. East = Net Production. No mid-year goalpost moves.
Starting 2027
One unified budget basis network-wide. The Production-vs-Net decision happens in a Q3 working session.
SGA · Production Terminology
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05 · The Office-Level Truth
Why neither number is fully accurate

The real problem is how offices post — not which number we pick.

Office Type A · West-style
Posts at UCR fees
Patient walks out at the full UCR fee on every procedure.
Their "Production" looks gross-ish — closer to the UCR ceiling. Adjustments come later.
NETWORK "Production" a blend of both
Office Type B · East-style
Posts at insurance fee schedule
Patient walks out at the contracted insurance fee, not UCR.
Their "Production" looks net-ish — already discounted at posting time.
The takeaway
Both office types exist in both companies. The metric we choose can't fix the inconsistency — only standardizing how offices post can.
SGA · Production Terminology
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06 · Accuracy Over Time
Different accuracy curves · same time horizon

West is consistent. East is most accurate looking backward.

SGA West · ProductionSame accuracy across all time periods.
Months Ago → Weeks Ago
~ Same Accuracy
Posted as charged. No adjustment process to wait on.
Last Week → Yesterday
~ Same Accuracy
Same approximation as last quarter.
Today → Future
~ Same Accuracy
Future scheduled is identical methodology.
Predictably inaccurate in the same way across all time periods — which means revenue conversion ratios stay stable.
SGA East · Net ProductionAccuracy varies depending on time horizon.
Months Ago → Weeks Ago
✓ Most Accurate
Adjustments are finalized.
Last Week → Yesterday
~ Less Accurate
Adjustments still landing.
Today → Future
⚠ Least Accurate
Mix of UCR and insurance-fee posting by office.
Law of large numbers: aggregated up to office → region → entity, adjustments balance the noise into a reliable run rate.
SGA · Production Terminology
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07 · Decisions We Made
Aligned in this meeting · status today

Six decisions. Status as of today.

01
Adopt the four-tier vocabulary: UCR Production → Production → Net Production → Revenue.
✓ AlignedNetwork-wide vocabulary settled.
02
West keeps Production budget. East keeps Net Production budget. No mid-year moves through 2026.
✓ AlignedBoth entities run their native budget through year-end.
03
Build a new net-production budget in Power BI for executive / aggregate views.
⏳ In ProgressTracked as a separate project.
04
Replicate the West pacing dashboard for office managers — keep their familiar gross view.
⏳ In ProgressTracked as a separate project.
05
Target walkout net as 2027 future state — pick unified basis in Q3 working session.
🗓 ScheduledQ3 working session to confirm 2027 basis.
06
Scope office-level posting standardization workstream by 5/15.
● OpenRCM + Operations — metric choice doesn't fix posting behavior.
SGA · Production Terminology
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Appendix A · 08 · Adjustment Categories
Appendix A · Paul's framework, refined by Scott in the room

Four categories of adjustments. Three production. One collections.

Categories 1–3 reduce production. Category 4 reduces collections. Offices and dashboards see them the same way — that's the confusion.

01
Production Adjustment
No Fee Schedules
Fee-for-service / UCR-only posting. Office bills at UCR, then waits for insurance to pay. Adjustment lands weeks later.
Hits in waterfallUCR → Production gap
~50% of SGA West
02
Production Adjustment
Fee-Schedule Variance
Office HAS insurance fee tables loaded. Smaller residual production adjustments — mostly settled at walkout.
Hits in waterfallProduction → Net gap
The other ~50%
03
Production Adjustment
Practice-Level Courtesy
Doctor zeros out or reduces the UCR fee at the practice — courtesy, family, employee discounts. Per Scott: production, not collections.
Hits in waterfallProduction → Net gap
$450K/mo · $180K Katrina region
04
Collection Adjustment
Bad Debt / RCM Write-Offs
RCM-side write-offs, "outside the entity in waves." The big bucket. Drives the unpredictable end-of-month drops Paul described.
Hits in waterfallNet → Revenue gap
$13K–$18K month-end hits
Why this matters Three of four are production adjustments (1, 2, 3). Category 4 is collections. They all show up the same in dashboards — that's why offices think they hit budget, then the next-day adjustment hits and morale tanks.
SGA · Production Terminology
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Appendix B · 09 · Office Inventory
Appendix B · Gen4 / SGA West · 92 active offices · MAR26 BOD data

Where each office sits today: Net, Gross, or FFS.

38
Net
41%
Has fee schedules. Walkout net.
30
Gross
33%
Posts at UCR. Adjustments come later.
20
Fee-for-Service
22%
No insurance contracts. UCR posting.
4
Divestiture
4%
Active but on the way out.
Practice Group Total Net Gross FFS
Strategic Blue8060
New Horizons8700
Smile One5050
Stoner Perio5005
Accelerate5040
Evangelista5410
Bay Area Dental3003
Carabelli3012
Beaumont · Peak Family · Pony Express9900
All others (37 groups)41111310
⚠ Gating risk
~50 offices on Gross or FFS lack patient-level fee schedules. Switching them to net walkout requires a Medentix-style fee-schedule mgmt service — cost-per-practice TBD.
📊 Pattern
GP offices split Net (38) vs Gross (24). Specialty (perio, peds, cosmetic) skews FFS — 14 of 20 FFS offices are specialty.
Source
Gen4 MAR26 BOD · Collections tab, Fee Type column · 118 total / 92 PBI active. SGA East not in this file (mostly Net by methodology).
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Appendix C · 10 · Next Steps
Appendix C · Active workstreams · separate projects, in flight

Two parallel builds. We're on it.

Both decisions from this meeting are already moving as separate projects. The deck is just acknowledging — no action needed in this room.

⏳ Active Workstream
Power BI Net-Production Budget
Executive / aggregate view across all entities
Convert SGA West Gross-billing offices to a net basis using historical adjustment %. Existing pacing report stays untouched at the office-manager level. Net budget rolls up to RODs / VPs / above.
OwnersKaren + Scott · GoalExecutive net view live for 2026 reporting
⏳ Active Workstream
West Pacing Dashboard Replica
Office-manager view · keep what they know
Replicate the existing West pacing dashboard so OMs continue using their familiar gross view through 2026. No retraining, no goalpost moves at the office level.
OwnerScott · GoalOM-facing dashboard parity through year-end
What they enable together
Dual reporting through 2026 — offices stay on their familiar number, executives see the consolidated net. Q3 working session decides the unified 2027 basis. No mid-year goalpost moves.
SGA · Production Terminology
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Appendix D · 11 · Risks & Open Questions
Appendix D · What we still need to figure out

Carrying these forward.

RisksOperational realities that could derail standardization
01
Dentrix Enterprise can't surface estimated net walkout at scheduling — only at day-of-service.
02
50% of SGA West offices lack patient-level fee schedules — blocks net-walkout adoption without a Medentix-style service.
03
End-of-month adjustment hits ($13K–$18K) destroying office morale — offices think they hit bonus, then the adjustment lands the next day.
04
$450K/mo in courtesy discounts not actively managed · $180K in Katrina's region alone.
Open QuestionsNeed answers before 2027 decisions land
Q1
What's the cost-per-practice for a Medentix-style fee-schedule mgmt service? ~50 offices need it to convert to net walkout.
Q2
How do we estimate patient portions accurately in gross offices without fee schedules — without overcollecting and generating credits?
Q3
How do we compare year-over-year data after a 2027 methodology switch — without confusing investors and execs?
Next milestone Office-posting standardization scope due 5/15 · Q3 working session to pick 2027 unified basis.
SGA · Production Terminology
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