Internal Comms & Meetings

How to run a monthly business review as Independent Clinic Owner-Operators

Internal Comms & MeetingsFor Independent Clinic Owner-Operators3 apps10 steps~20 min to set up

Once a month you need to answer the question: how did the clinic actually do? You pull appointment counts from your EHR, chase deposit totals from your bank, text the billing person for denial numbers, and try to remember what happened to that insurance contract negotiation. By the time you've assembled it all in a Google Doc, it's three hours later, the numbers don't reconcile, and the 'review' is really just you staring at a spreadsheet trying to remember why August collections were down. You don't have a CFO or an office manager with a reporting background. You have a front desk, a billing person, and 45 minutes before your first patient.

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Internal Comms & MeetingsFor Independent Clinic Owner-Operators3 apps10 steps~20 min to set up

Outcome

What you'll set up

A monthly clinic performance dashboard that pulls real cash figures from your bank and payment processor automatically — no manual number-gathering before the meeting

A structured MBR doc generated from your own data each month, covering collections, payer mix, no-show rate context, and top operational flags, ready to review in 20 minutes instead of building from scratch

A running archive of monthly summaries with action items extracted so you can actually follow up on what you said you'd fix last month

The Starch recipe

Apps, data, and prompts

The combination of Starch apps, the data sources they pull from, and the prompts you use to drive them.

Apps used

Runway Analysis Investor Reporting Meeting Notes

Data sources & config

Starch syncs your Plaid bank feed data on a schedule (transactions, balances, categorized expenses) and your Stripe data on a schedule (charges, payouts) — both refresh automatically so your numbers are current before the meeting starts. Meeting Notes captures the MBR conversation in real time with no additional integration required.

Prompts to copy

Pull my Plaid bank transactions and Stripe deposits for the last 30 days, break down collections by week, flag any week where deposits dropped more than 15% from the prior week, and show me my current cash balance and projected runway at this burn rate

Draft my monthly clinic business review using this month's Plaid and Stripe data. Include: total collections, net cash burn, top expense categories, notable one-time costs, and three operational observations I should discuss with my billing person. Match the tone of last month's summary.

Transcribe today's monthly business review meeting, pull out every action item with an owner and due date, and save a summary I can search later when I need to remember what we decided about the United credentialing issue

Run these in Starch → or paste them into your favorite agent

Walkthrough

Step-by-step

1 Connect Plaid from Starch's scheduled-sync providers — Starch syncs your practice bank account transactions and balances automatically so collections data is waiting for you, not something you have to pull.

2 Connect Stripe from Starch's scheduled-sync providers if you collect copays or self-pay balances through Stripe — charges and payouts sync on a schedule alongside Plaid.

3 Open the Runway Analysis starter app. Tell Starch: 'Show me net cash collections for this month vs. last month, broken down by week, with a flag on any week that dropped more than 15%.' This gives you the top-line collections picture without touching a spreadsheet.

4 Ask Starch to categorize your top 10 expense lines from Plaid transactions this month — payroll, supplies, rent, malpractice, lab fees, software. Takes 30 seconds and catches the irregular costs (that new autoclave maintenance contract, the one-time credentialing fee) that skew your normal burn.

5 Before the MBR meeting, open Investor Reporting and prompt it to draft a monthly clinic summary: total collections, net burn, payer-mix observations from transaction labels, and any cash anomalies. This becomes your agenda — not a blank doc.

6 Add the two or three things the numbers don't capture: your denial rate update from the billing person, the no-show trend you noticed, the provider who has 6 open slots next Tuesday. These go in as narrative context before the meeting.

7 Start the MBR meeting with Meeting Notes running. It transcribes the conversation in real time so you're not writing anything down while you're also trying to think.

8 After the meeting, Meeting Notes generates a summary with key decisions and extracted action items — 'Follow up on the Aetna resubmission by the 15th,' 'Check whether the Thursday afternoon block should be opened to new patients.' Each item has an owner.

9 File the summary in your searchable meeting archive. Next month, before the next MBR, search 'Aetna' or 'Thursday block' and see exactly what you decided and whether it happened.

10 Once the format feels right, tell Starch to run the Plaid and Stripe data pull automatically on the last business day of each month and drop a draft MBR doc into your inbox — so the numbers are ready before you sit down, every time.

See this running on Starch

Connect your tools, describe what you want, and the agent builds it. Closed beta is free.

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Worked example

March 2026 Monthly Business Review — three-provider general practice

Sample numbers from a real run

Total collections (Stripe + Plaid deposits)	87,400
Payroll (3 providers + 2 front desk)	51,200
Rent + utilities	8,100
Malpractice insurance	2,400
Lab fees + supplies	6,300
Software and EHR subscription	1,850
One-time: autoclave service contract	1,400
Net cash position (end of March)	16,150

Starch pulled Plaid transactions and Stripe payouts the morning of the review. Collections came in at $87,400 — down $4,200 from February, which showed up as a single weak week in the third week of March (spring break, four patients rescheduled, two no-showed). The Runway Analysis app flagged that week automatically. Expense breakdown showed the autoclave service contract as a $1,400 one-time item that explained why March burn looked higher than usual — without that flag, the billing person would have spent 20 minutes trying to reconcile it. The Investor Reporting draft pulled all of this into a two-page summary: collections trend, top expenses, net burn of $71,250 for the month, and a note that the lab fee line has grown 18% over three months (worth investigating with the ordering providers). The MBR itself ran 35 minutes. Meeting Notes captured the decision to open Thursday afternoons to new patients and extracted the action item to call the United rep about the credentialing delay before April 10th. The whole prep-to-archive cycle took under an hour.

Measurement

How you'll know it's working

Monthly net collections (total deposits minus refunds and chargebacks)

Net cash burn vs. prior month (to catch expense creep before it compounds)

No-show and late-cancellation rate by provider (front-desk gut feel isn't enough)

Denial rate and average days-to-resubmission (sitting 45+ days is a collections leak)

Open appointment capacity next 2 weeks across all three providers

Comparison

What this replaces

The other ways teams handle this today, and how the Starch version compares.

EHR built-in reports (Jane, SimplePractice, Kareo)

Good for appointment and clinical billing data, but doesn't include your operating expenses, bank balances, or cash burn — you still have to stitch those in manually.

QuickBooks + manual spreadsheet MBR

QuickBooks captures the expense side accurately but generating a readable monthly summary still requires someone to pull it, format it, and write the narrative — which is the hour you're trying to get back.

Google Docs MBR template filled manually each month

Free and flexible, but the data doesn't populate itself — you're still the one gathering numbers from three different places before you can start the actual review.

Hiring a fractional CFO or office manager

Right answer if you're growing past 8-10 providers, but at $2,000–$4,000/month for fractional help, it's expensive infrastructure for a clinic where the owner is still the most senior clinician.

On Starch RECOMMENDED

One platform — runway analysis, investor reporting, meeting notes all running on connected data. Setup in plain English; numbers stay current via scheduled syncs and live agent queries.

Try it on Starch →

FAQ

Frequently asked questions

My EHR already has a monthly summary report. Why do I need this?

Your EHR report covers clinical billing — charges, payments applied, adjustments. It doesn't know about your rent, payroll, malpractice insurance, or what's actually in your bank account. The MBR Starch builds combines your real cash position from Plaid with your revenue data from Stripe, so you're looking at actual operating health, not just billing throughput.

I don't use Stripe — I collect payments through my EHR or a different processor. Can Starch still do this?

Yes. If your processor deposits to a bank account that Plaid can reach, Starch captures the deposit transactions from Plaid. You'll see the cash hitting your account even if Starch can't break down the per-patient detail from inside the EHR. For EHR-specific reports (appointments, no-shows, denial rates), you'd pull those separately and add them as narrative context in the MBR draft.

Is Starch SOC 2 certified? I'm cautious about connecting bank data for a healthcare business.

Starch is not SOC 2 Type II certified today — that's worth knowing upfront. Plaid is the established financial data connector most banks already trust, and it's read-only access to transaction and balance data only. No PHI flows through the MBR workflow — clinical records stay in your EHR. Whether that meets your bar is a real question; it's something we'd rather you know now than find out later.

Can Starch pull my QuickBooks data instead of Plaid if that's where my books live?

Yes — Starch connects directly to QuickBooks and syncs invoices, bills, vendor payments, and journal entries on a schedule. One thing to know: QuickBooks report views like P&L and Transaction List are temporarily unavailable pending a fix, but entity-level data (bills, invoices, payments) syncs normally. For a monthly cash review that's usually enough to work with.

How does Meeting Notes work if we do the MBR over the phone or in the same room?

Meeting Notes works best when there's a call it can join (Zoom, Google Meet, or similar). For in-person or phone reviews, you can record the conversation on your phone and upload the audio, or type a brief summary of what was discussed and let Starch extract decisions and action items from that text. It's a bit more manual but still gets you the searchable archive and extracted follow-ups.

Can I set this up to run automatically every month without me triggering it?

Yes. Once the data connections are live and you've confirmed the MBR draft format looks right, you can tell Starch: 'On the last business day of every month, pull this month's Plaid and Stripe data, generate the MBR draft using the same format as last month, and email it to me.' It runs on schedule from there. You still do the actual review — Starch just makes sure the numbers are assembled before you sit down.