Calculation governance

A calculator needs a contract—not only a visible formula.

Each consequential tool identifies its version, units, rounding, invalid-input behavior, example rule, controlling arithmetic, and review status. AI may explain outputs; these deterministic functions control them.

patient-centered-capacity-growth

Patient access, recall, referrals, and associate capacity

v1.0.0

Units: Aggregate patient or appointment counts, period hours, weekly associate hours, days, U.S. dollars, and separate evidence states
Rounding: Calculate with full precision; present counts, hours, dollars, and ratios with their denominators and periods visible
Invalid inputs: Negative or nonfinite numeric values are bounded at zero; ratios with no positive denominator are unavailable. Contradictory funnel, schedule, recall, and referral counts remain visible as open controls; supported imports require the complete declared schema.
Examples: One replaceable fictional aggregate case; no patient records, employee records, credentials, clinical directives, or payer agreements
Controlling formula: Each access and recall rate retains its own event denominator. Sustainable, scheduled, completed, cancelled, refilled, and overtime hours remain separate. Expected ending referrals equal opening plus placed less completed and otherwise closed referrals, with a reconciliation variance. Supported associate hours are limited by planned hours, demand, assistant/room support, and payer-effective hours. Mentorship reduces the owner’s residual clinical hours; guarantee cash exposure equals daily guarantee times days per week times guarantee weeks.
Reviewer status: Deterministic aggregate contract and regression tests recorded; office-specific clinical, operations, employment, payer, and accounting review still required. No staffing optimum, employment recommendation, or combined score is produced.

practice-flow-staffing-schedule-access

Practice Flow staffing, rooms, access, schedule, and demand-test planner

v1.2.0

Units: Aggregate visits per week, active minutes, chair-minutes, instrument-set turns, people present, usable rooms, service-specific days, four-week hours, and visible ratios
Rounding: Calculate with full precision; display whole percentages and one-decimal counts, minutes, hours, days, and ratios
Invalid inputs: Browser values are bounded at zero, rates at 0–100%, and local imports to the exact seven-appointment, four-service, office, room, and schedule schema; contradictory room, staffing, access, or refill entries remain visible
Examples: One fictional aggregate general-practice scenario is visibly labeled, replaceable, and restorable; patient appointments, charts, images, employee files, credentials, contracts, and identifiable payer data are prohibited
Controlling formula: Each resource load equals entered task minutes or set demand divided by the corresponding available minutes or set-turn capacity. Doctor, assistant, hygiene, room, imaging, reprocessing, instruments, and front-office loads remain separate. Access pressure, future fill, completed utilization, refill, backlog coverage, service opening upper bounds, and the daily doctor-active template remain separate. A service demand test is held when a required shared resource is binding or unavailable, appointment definitions are incomplete, or inputs contradict one another. Opening hours are not additive across services and do not allocate appointments.
Reviewer status: Deterministic aggregate planning contract implemented; current state scope, clinical, infection-prevention, employment, OSHA, privacy/security, accounting, facility, equipment, and team competency review still required

Complete metric contract

Decision purpose: Identify the first operating constraint to verify before changing staffing, rooms, appointment blocks, training, or service-specific marketing.
Numerator: Entered task minutes, room minutes, instrument-set demand, third-next days, scheduled hours, completed hours, refilled hours, backlog hours, or potential test hours depending on the displayed measure.
Denominator: Minutes actually present for the matching resource, usable room minutes, quick instrument-set turn capacity, office-set access target, four-week available service hours, cancelled hours, or weekly service capacity.
Event date: A typical week for resource loads, the entered next or prior four weeks for access, and an undated non-patient daily template for scheduling.
Measurement window: One typical week plus separate service-specific four-week access windows; the user must keep periods consistent.
Inclusions: Entered provider, team, room, imaging, active reprocessing, instrument, appointment, access, cancellation, refill, backlog, inquiry, obligation, urgent-capacity, and schedule-preference assumptions.
Exclusions: Patient-level decisions, state duty authorization, staffing ratios, clinical time standards, employee scoring, production quotas, direct booking, diagnosis, and permanent marketing recommendations.
Failure modes: Treating headcount as availability, plumbed rooms as usable, assistant minutes twice, one cancellation as normal access, scheduled time as completed use, broad marketing as service-specific demand, cycle time as hands-on reprocessing work, or an aggregate instrument set as a procedure-level audit.

payer-credentialing-cash-continuity

Payer, credentialing, and cash-continuity control

v1.0.0

Units: Aggregate U.S. dollars per week or month, relative weeks 1–52, service-to-bank days, percentages, coded relationship fields, and evidence states
Rounding: Calculate with full precision; display whole dollars, days, weeks, counts, and one-decimal percentages
Invalid inputs: Numeric inputs are bounded at zero, rates at 0–100%, relative weeks at 0–52, and imports to the exact three-payer, eight-step-per-payer, four-scenario, five-event, and seven-gate schema
Examples: One fictional coded transition is visibly labeled, replaceable, and restorable; patient information, exact dates, credentials, actual payer names, contracts, fee schedules, EOBs, and portal contents are prohibited in the browser workbench
Controlling formula: Weekly expected bank cash = aggregate weekly expected allowed amount × entered steady-state collection rate. The 26-week transition separately models patient-access cash at risk, interim bank cash, later recoverable cash, unresolved pending-service exposure, first standard bank week, cumulative cash-timing gap, and practice reserve margin. Identification, credentialing, contracting, enrollment, directory, claim, EFT/ERA, and first-paid-claim evidence remain separate.
Reviewer status: Deterministic transition contract implemented; payer-enrollment, dental benefits, billing, dental CPA, contract counsel, privacy/security, lender, owner, and patient-communication review still required

Complete metric contract

Decision purpose: Protect patient access and practice liquidity while a payer relationship changes without calling every delayed dollar permanent lost revenue.
Numerator: Aggregate expected bank cash in U.S. dollars for each payer and week.
Denominator: Expected allowed dollars only for the entered steady-state collection rate; patient counts and claim counts do not enter the cash formula.
Event date: Relative transition week, broad service period, and broad cash period; exact patient or claim dates are excluded.
Measurement window: Twenty-six weekly periods from planned service start, with effective and recovery weeks allowed through week 52.
Inclusions: Entered aggregate allowed amount, collection rate, care continuity while pending, interim cash, reviewed later-recovery assumption, effective week, service-to-bank lag, and transition reserve.
Exclusions: Patient-level data, a fee schedule, contract text, an automatic loss conclusion, household reserve, payer recommendation, and collective competitor action.
Failure modes: Treating NPI or credentialing as payment approval, using seller participation for a buyer, unsupported retroactive recovery, mixed service and cash periods, double-counted reserve, and omitted network or product path.

succession-offer-and-stewardship-control

Succession, DSO offer, and patient-stewardship control

v2.0.0

Units: One to twenty annual periods in nominal U.S. dollars, percentages, present values, and coded evidence, authority, stewardship, obligation, and gate states
Rounding: Calculate with full precision; display whole dollars and whole percentages
Invalid inputs: Browser and imported values are bounded at zero, probabilities and tax rates at 0–100%, the horizon at 1–20 years, and imports to the exact seven-option, four-component, ten-control, ten-stewardship, eight-obligation, and ten-gate schema
Examples: One fictional coded seller comparison is visibly labeled, replaceable, and restorable; agreements, offers, patient records, employee records, adviser communications, credentials, and direct identifiers are prohibited
Controlling formula: Ownership value PV = net cash at close + expected after-tax PV of seller note, holdback, earnout, and rollover equity + post-close ownership cash PV + terminal net-proceeds PV after separately entered disposition cost − transition, operating-friction, and expected guarantee-loss PV; earned clinical compensation remains separate and rollover-equity face value is never cash at close
Reviewer status: Deterministic comparison contract implemented; independent transaction, tax, valuation, financial-planning, employment, real-estate, patient-transition, and seller review still required

Complete metric contract

Decision purpose: Compare credible seller paths over one horizon without treating contingent value or paid clinical work as closing cash.
Numerator: Expected after-tax ownership proceeds and cash flows, by component.
Denominator: None; this is a present-value bridge, not a ratio.
Event date: Closing, specified annual receipt dates, and the entered terminal year.
Measurement window: One common 1–20 year horizon.
Inclusions: Closing cash, note, holdback, earnout, rollover, ownership cash, net terminal proceeds, transition friction, and guarantee exposure.
Exclusions: Clinical compensation from ownership proceeds; headline value from realized cash.
Failure modes: Unsupported probabilities, mismatched horizons, omitted disposition costs, and face-value treatment of restricted or contingent instruments.

patient-centered-revenue-cycle-control

Patient-centered revenue-cycle control

v2.0.0

Units: Aggregate U.S. dollars, period days, administrative hours, ratios, and coded evidence states
Rounding: Calculate with full precision; display whole dollars, one-decimal minutes, and one-decimal percentages
Invalid inputs: Browser and imported numeric inputs are bounded at zero and practice-scale maxima; imports require the exact mandate, cash, five-exception, three-payer, and eight-gate schema
Examples: One fictional aggregate operating period is visibly labeled, replaceable, and restorable; patient rows, employee records, credentials, private fee schedules, EOBs, and contract text are prohibited
Controlling formula: Net production = gross production − contractual adjustments − other adjustments/write-offs. Receivable-bridge expected receipts = net production + opening receivables − closing receivables. Receipt channels, service-period attribution, refunds, deposits in transit, bank-cleared cash, operating payments, tax, capital, owner clinical compensation, distributions, and reserve transfers reconcile in separate bridges.
Reviewer status: Deterministic reconciliation contract implemented; dental CPA, owner dentist, practice manager, qualified payer or coding reviewer, counsel, security reviewer, and payment provider review still required

Complete metric contract

Decision purpose: Explain where cash moved or failed to move from care to receivables, receipts, bank clearing, and operating cash.
Numerator: U.S. dollars for each bridge; claim events remain a separate count.
Denominator: Only payer ratios use expected allowed dollars or collected dollars; claim count never enters dollar arithmetic.
Event date: Service/posting, claim submission, adjudication, receipt, bank-clear, and period-end dates remain distinct.
Measurement window: One declared aggregate period with opening and closing balance-sheet values.
Inclusions: Current/prior service receipts, channel receipts, refunds, deposits in transit, outside funding, taxes, capital, reserves, and distributions.
Exclusions: Patient rows, claim processing, accrual-accounting conclusions, and treating prior-period receipts as current-period production.
Failure modes: Mixed periods, count/dollar mixing, omitted receivable or deposit balances, and reporting owner funding as collections.

patient-centered-startup-control

Startup and buildout control system

v1.0.0

Units: U.S. dollars, calendar days, rooms, people, weekly clinical days, working-capital months, and coded evidence states
Rounding: Calculate with full precision; display whole dollars and days and one-decimal working-capital months
Invalid inputs: Browser and imported numeric inputs are bounded at zero and project-scale maxima; imports require the exact five-budget, three-bid, eight-gate, twelve-dependency, and four-change schema
Examples: One fictional aggregate startup is visibly labeled, replaceable, and restorable; private quotes, contracts, patient records, employee records, credentials, and direct identifiers are prohibited
Controlling formula: Opening working capital = committed project sources − five-budget base − max(planned contingency, approved direct and downstream change cost); the pending case also reserves draft and pending change exposure; evidence, bid, dependency, practice-reserve, and household-reserve controls remain non-averaged
Reviewer status: Deterministic capital contract implemented; local architect, engineers, authorities, construction and real-estate counsel, independent dental CPA, lender, contractor, equipment, IT/security, credentialing, owner, and household review still required

patient-centered-acquisition-transfer

Five-bridge acquisition transfer

v2.0.0

Units: Annual U.S. dollars, separately dated source periods, liquidity months, and debt-service multiples
Rounding: Calculate the visible non-overlapping dollar bridge with full precision; display whole dollars, one-decimal liquidity months, and two-decimal debt coverage
Invalid inputs: Browser inputs are bounded at zero, cost percentages at 0–100%, source periods at 0–240 months, and imports to the exact five-bridge, timing, capital, and six-gate schema
Examples: One fictional aggregate target is visibly labeled, replaceable, and restorable; patient- and employee-level inputs are prohibited
Controlling formula: Buyer-repeatable collections = seller collections + the five separately disclosed non-overlapping dollar adjustments for seller-only activity, clinical mix, patient/referral transfer, payer/fee transfer, and collection loss. First-year receipts then apply a separate cash-timing bridge. Practice sources and uses, operating reserve, household reserve, clinical compensation, and debt remain separate.
Reviewer status: Deterministic contract implemented; independent dental CPA or valuation professional, transaction attorney, clinical reviewer, payer reviewer, lender, buyer, and household review still required

Complete metric contract

Decision purpose: Estimate collections a buyer can reproduce without multiplying correlated retention guesses or double-counting losses.
Numerator: Annual U.S.-dollar increase or decrease for each transfer bridge.
Denominator: None in the bridge; cost percentages apply only to buyer-repeatable collections.
Event date: Each bridge states its source period; first-year receipt timing is separate from steady state.
Measurement window: One normalized annual steady-state period plus one first-year cash view.
Inclusions: Five non-overlapping transfer adjustments, restored expenses, clinical compensation, recurring capital reserve, debt, and separate practice capital uses.
Exclusions: Household reserve from practice funding; prior-period receipts from steady-state transferability; clinical labor from ownership return.
Failure modes: Multiplying correlated percentages, mixing cash timing with steady state, and netting capital needs into operating value.

purchasing-and-vendor-control

Purchasing and vendor comparison

v2.0.0

Units: Annual U.S. dollars, packages or service units, usable units, percentages, hours, and one common 1–10 year comparison horizon
Rounding: Calculate with full precision; display whole dollars and two-decimal unit costs
Invalid inputs: Inputs are bounded at zero, rates at 0–100%, and imports to the exact three-offer, sourcing, GPO-review, and governance schema
Examples: One fictional coded comparison is visibly labeled; vendor identity, confidential quotes, contracts, patient data, credentials, payer fees, and competitor strategy are prohibited
Controlling formula: Documented landed cost = item spend + freight + tax + documented processing/rush fees − rebates actually received. Labor, storage, waste, returns, downtime, recurring service, installation, and exit remain separately labeled scenario costs.
Reviewer status: Deterministic comparison contract implemented; qualified clinical, procurement, accounting, legal, security, and product-specific review still required

Complete metric contract

Decision purpose: Compare the same product or service scope without presenting uncertain operating effects as invoice facts.
Numerator: Documented annual landed dollars or modeled annual total dollars.
Denominator: Modeled usable units under one disclosed definition.
Event date: Quote validity period and annual comparison period.
Measurement window: One annual view and one common 1–10 year horizon.
Inclusions: Invoice economics in the documented bridge; labor, storage, waste, downtime, recurring, installation, and exit in the scenario bridge.
Exclusions: Promised but unreceived rebates from both bridges and paid placement from evidence conclusions.
Failure modes: Different configurations, unsupported usable-unit rates, expired quotes, uncertain costs mislabeled as landed cost, and omitted exit terms.

ownership-path-comparison

Six-path ownership comparison

v1.0.0

Units: Ten annual periods in nominal U.S. dollars, hours, percentages, and year-end debt balances
Rounding: Calculate with full precision; display whole dollars and hours
Invalid inputs: User controls bound rates to 0–100%, growth to −95–100%, debt terms to 0–40 years, and local imports to the exact six-path schema
Examples: One fictional six-path example is visibly labeled, replaceable, and restorable
Controlling formula: Present economic value = discounted after-tax cash + benefits − imputed unpaid management labor + discounted net terminal proceeds − owner cash committed; monthly debt amortization, household reserve, guarantees, owner hours, clinical fit, control, evidence, and exit remain separate
Reviewer status: Deterministic contract implemented; independent dental CPA, tax adviser, lender, attorney, owner, and household review still required

viability-gap

Independent-practice viability gap

v3.0.0

Units: Annual U.S. dollars, hours, percentages, and year-end balances
Rounding: Calculate with full precision; display whole dollars
Invalid inputs: Browser inputs are bounded at zero; liquidity haircut is bounded to 0–100%
Examples: Fictional values are visibly labeled and can be cleared
Controlling formula: Undiscounted nominal owner value = cash + benefits + retirement + change in realizable equity − owner capital − unpaid management-time cost; crossover requires every remaining cumulative year to stay nonnegative
Reviewer status: Deterministic contract implemented; independent dental CPA/valuation sign-off still required

first-48-months

First 48 Months runway

v2.0.0

Units: Monthly U.S. dollars, days, percentages, and month numbers 1–48
Rounding: Calculate with full precision; display whole dollars
Invalid inputs: Inputs are bounded at zero; percentages are bounded to 0–100%; capital events outside months 1–48 are ignored
Examples: Fictional startup-like values are visibly labeled and can be cleared
Controlling formula: Practice and household cash roll forward separately; household cash receives only the planned owner draw that available modeled practice cash can fund, and the remainder is reported as unfunded
Reviewer status: Deterministic contract implemented; independent dental CPA/lender sign-off still required

delay-cost

Delay Cost Clock

v1.1.0

Units: U.S. dollars, calendar days, monthly rates, and percentages
Rounding: Uses 30.4375 days per average month; calculate with full precision; display whole dollars
Invalid inputs: Inputs are bounded at zero; recoverable contribution is bounded to 0–100%
Examples: Fictional construction-delay values are visibly labeled and can be cleared
Controlling formula: Economic delay cost = recurring cash burn + one-time cash burn + unrecovered operating contribution
Reviewer status: Deterministic contract implemented; project-specific CPA, lender, contractor, and counsel review required

decision-lab

Eight Decision Lab calculators

v3.2.0

Units: Each function defines dollars, counts, clinical days, hours, ratios, or percentages explicitly in its labels
Rounding: Calculate with full precision; presentation rounding varies by output unit
Invalid inputs: Missing Medicaid comparators and undefined hygiene/team denominators remain unavailable. Legacy capacity and debt safety ratios return zero for nonpositive denominators. Retention, collection, reappointment, attendance-loss, and paid-claim percentages are bounded at 0–100%; fee imports reject missing columns or numeric values.
Examples: Fictional examples are held separately from clear-input states
Controlling formula: Entry evidence dimensions and safety checks remain separate with no composite score; pre-sale buyer-repeatable cash subtracts nonclinical operating cost, market clinical compensation for every provider, replacement management, and recurring capital reserve before debt sizing; team continuity remains in natural counts, percentages, hours, and days.
Reviewer status: Pure calculation modules implemented; independent domain review remains required

Version rule

Old outputs must identify the formula that produced them.

Patch

Presentation or non-output behavior changes. Arithmetic remains identical.

Minor

New optional output or backward-compatible input support. Existing approved fixtures remain reproducible.

Major

Controlling arithmetic, units, interpretation, or required inputs change. Saved bundles must be recomputed and the correction impact stated.

Human sign-off

Implementation does not equal independent validation. The reviewer status stays visible until the required professional completes it.