Industry sector:

Osteopath: Cash sales


'Cash sales' means all income from your main business activity which is received at the conclusion of a patient's treatment, whether this is spread over one or several appointments. Your Cash sales income will come from patients paying your fees out of their own pockets and from patients covered by health insurance who will pay you and then claim the cost from the insurance company after the treatment has been completed. If such a patient needs a course of treatment involving more than one appointment, you'll probably decide to charge them after each treatment rather than at the end of the course to improve your cash flow.

Income from patients that are covered by health insurance but who will pass you the claim forms at the end of the treatment for you to claim from the insurance company won't be Cash sales but will instead be 'Cash from debtors'. Similarly with NHS patients (if you're able to take them), you will be reimbursed by the Clinical Commissioning Group or Health Board and this will also be Cash from debtors.

You should also include any retail sales of equipment that you make in Cash sales.

While some of your patients will pay you in cash, remember that others will want to pay by card or by cheque.

To prepare your cash flow, you need to estimate how much income you will receive over the next twelve months. To do this you will need to work out how many patients you are likely to treat, how much you will charge them and when you will receive the money.

There are a number of things to consider when you make your estimates:

Nature of the clinic

Will you:

  • specialise in a certain area, such as working exclusively with sportspeople, children or even animals
  • already have a core of patients established previously while working in another clinic
  • work alongside other therapists, such as reflexologists, acupuncturists and so on to provide a broader service to your patients
  • close the clinic in the event of illness or holiday or will you engage a locum

Your fees

Things to consider include:

  • how will you set your fees for each treatment. Bear in mind that if you do any NHS work, your fees will be set against a locally decided rate or national tariff
  • who will pay you - the patient, the patient's health insurance company or, less commonly, the NHS
  • will there be any circumstances where you offer discounts from your normal fee rate

To help with your decisions, click on the checkpoints for guidance. Once you have worked out a Cash sales figure add it to the relevant field in your cash flow forecast.