Ask an endodontist how the practice is doing and you will usually hear a production number. Cases per day, production per month. Production is the number on the schedule, so it is the number everyone watches.
But production is a promise, not a payment. The KPI that decides whether the promise becomes money is your collections ratio: collections divided by net production. It answers one blunt question. Of the dentistry you already did, how much did you actually get paid for?
Endodontic practices live on referrals and insurance, and that combination creates collection risk a general practice does not feel the same way. One-visit relationships mean a missed payment does not resolve itself at the next hygiene visit, because there is no next visit. An insurance-heavy case mix means claims get filed, narrowed, delayed, and partially paid. And a high fee per case means one slipped payment is not a small leak.
To read your own number, pull collections and net production for the last 12 months and divide. A well-run specialty practice keeps this between 96 and 99 percent, with 98 percent or better as the target. Below that, the leak is usually aging insurance claims, patient portions never collected at time of service, or write-offs nobody reviews.
Watch the trend, not just the level. A ratio that drifts down two points a year is a slow leak that compounds. Nobody notices in any single month; everybody notices at year end, or a buyer notices during diligence.