The revenue system.

Five pipelines, one direction of travel, one loop back. Every stage has an owner, a rot timer, and an automation. Nothing is moved by feeling.

The journey

flowchart LR
    PS[Paid social]:::src --> P1
    OR[Organic]:::src --> P1
    GO[Google]:::src --> P1
    RF[Referral]:::src --> P1
    WI[Walk-in]:::src --> P1
    PH[Phone]:::src --> P1

    P1["P1 · New Enquiry
enquiry to attended"]:::pipe
    P2["P2 · Consultation to Treatment
examined to treated"]:::pipe
    P3["P3 · Course and Program
multi-session delivery"]:::pipe
    P5["P5 · Membership and Retention
where lifetime value is made"]:::pipe
    P4["P4 · Reactivation
the database as an asset"]:::react

    P1 -- "consultation attended" --> P2
    P2 -- "treated and paid" --> P3
    P3 -- "course complete" --> P5
    P5 -- "lapsed or cancelled" --> P4
    P2 -. "21 days quiet" .-> P4
    P1 -. "no response" .-> P4
    P3 -. "discontinued" .-> P4
    P4 -- "returned patient" --> P2

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    classDef pipe fill:#14251F,stroke:#14251F,color:#F4F1EA
    classDef react fill:#F6EDE4,stroke:#9A4B22,color:#9A4B22,font-weight:600

A contact holds exactly one open opportunity at a time. The loop from P5 back through P4 is the one that pays for the rest of the build, and it is deliberately the last thing switched on.

New Enquiry

First contact to a consultation that was actually attended. Where the practice currently loses the most money, and where it is cheapest to stop.

01 New Enquiry SystemROT 15 MINW-01 · W-02 · W-16

02 Contacted, Awaiting Reply Front deskROT 24 HW-01 cadence

03 In Conversation Named ownerROT 48 HAll automation paused

04 Consultation Booked SystemPAID ONLYW-03 · W-04 · W-05

05 Did Not Attend CoordinatorROT 24 HW-06 recovery

06 Consultation Attended Won→ P2W-07 creates P2

P1 wins on attendance, not on booking. A booking that does not show is not a win, and a pipeline that counts it as one hides the practice's most expensive problem.

Consultation to Treatment

Examination to first treatment paid. This pipeline answers the question Alex has been asked twice this year and could not answer.

01 Consultation Attended SystemROT 2 HTask: issue plan

02 Plan Issued CoordinatorROT 48 HPlan value set here

03 Considering Branched nurtureROT 21 DAYSW-07 by objection

04 Treatment Booked System—W-08 pre-care

05 Deposit Paid System—Fee credit applied

06 Treated Won→ P3 / P5W-09 · W-11

The Considering branch

Chosen by the objection tag the coordinator sets before the patient leaves the room. No tag raises a task rather than guessing, because the wrong branch is worse than a delay.

Tag	The branch answers
obj-price	Sequencing the plan into stages, cheapest first step, the Maintenance Plan, finance as a footnote
obj-fear	How it is actually done, what happens if it goes wrong, reversal and management
obj-timing	Recovery calendars mapped to their stated date, honest lead times
obj-recovery	Day-by-day reality, what can be worked through and what cannot
obj-partner	Written to be forwarded and read by someone who was not in the room
obj-unsure	The plan in plainer language, and a no-charge fifteen-minute call

What this branch never does

It never applies a deadline, never discounts the plan, and never says spots are filling up.

The practice's whole position is that the price does not move. One urgency message contradicts the entire website, and patients notice the contradiction faster than they notice the offer.

The number that justifies the build

Consultation-to-treatment is measured at both 30 and 90 days. The 30-day figure is coordinator performance. The gap between 30 and 90 is exactly what this nurture recovers, in dollars.

Course and Program Delivery

Multi-session work. Exists so that nobody ever falls out of a paid course because a session was never rebooked.

01 Course Planned CoordinatorROT 7 DAYS

02 Session Booked System—W-08 pre-care

03 Session Complete, Next Unbooked Front deskROT 48 HEscalates to a call

04 Course Paused CoordinatorROT 30 DAYS

05 Course Complete Won→ P5

Stage 03 is the entire reason this pipeline exists. A patient who finishes session two and leaves without session three booked is the most common silent loss in a device practice.

Reactivation

The database as an asset. Everyone who goes quiet, in any direction, ends up here rather than nowhere.

01 Segmented System4 AXESTreatment · recency · value · reason

02 Campaign Running SystemROT 14 DAYSW-13, four touches

03 Re-engaged Front deskROT 72 H

04 Consultation Booked SystemPAID ONLY

05 Returned WonDATABASE REVENUE

06 Suppressed PermanentNO RE-IMPORT

No discount in the first two touches of any reactivation campaign. The opening is clinical relevance: your interval, your history, what has changed in what is appropriate for you. Leading with a discount trains exactly the behaviour the practice is trying to unlearn.

Membership and Retention

Where lifetime value is actually made. Recall intervals are set per treatment on the patient's own plan, never by a global default.

01 Maintenance Due SystemROT 7 DAYSW-12 recall

02 Membership Offered CoordinatorROT 14 DAYS

03 Active Member WonRECURRINGW-14 lifecycle

04 At Risk CoordinatorROT 7 DAYSCall, not email

05 Cancelled System→ P4 AT 60 DAYS

At Risk fires on a failed payment, no appointment in 120 days while paying, two consecutive cancellations, unused credit above $600, or an unsubscribe from clinical email. Reaching a member at 120 days is retention. Reaching them at cancellation is an argument.

The automations

Two rules govern all of them. Any inbound reply pauses every sequence immediately. No marketing SMS outside 8:00 am to 9:00 pm, timezone fixed to Mountain Standard Time.

Ref	Workflow	Trigger	Ship
W-01	Speed to lead	P1 opportunity created, any source	Phase 1
W-02	Missed call text back	Inbound call unanswered, any hour	Phase 1
W-16	Source attribution stamp	Contact created	Phase 1
W-20	Consent and compliance	Contact creation, preference change	Before go-live
W-03	Booking and payment	Consultation slot selected	Phase 2
W-04	Confirmation and preparation	Consultation booked and paid	Phase 2
W-05	Reminder and confirmation loop	72 hours before any appointment	Phase 2
W-06	No-show recovery	Appointment marked no-show	Phase 2
W-07	Post-consultation follow-up	Consultation attended	Phase 3
W-08	Pre-care	Treatment booked	Phase 4
W-09	Aftercare	Treatment completed	Phase 4
W-11	Clinical review booking	Treatment with a review interval	Phase 4
W-10	Review request	Review attended, patient settled	Phase 4
W-12	Maintenance recall	Per-treatment interval reached	Phase 4
W-14	Membership lifecycle	Membership state change	Phase 6
W-13	Reactivation campaigns	Entry into a P4 segment	Phase 5
W-15	Declined and unsuitable nurture	Lost, clinically declined	Phase 6
W-18	Referral request	30 days post-course, 90 days into membership	Phase 6
W-19	Rot escalation	Opportunity past its stage rot timer	Phase 6

The six numbers

Alex asked his agency how many leads became consultations. The answer took two weeks and turned out to be an estimate. These six exist so that never happens again.

01Speed to leadMedian seconds to first delivered response, by source and hour

02Enquiry to consultationSeparates a lead-quality problem from a follow-up problem

03Consultation attendanceSplit by lead time, so the cause is visible

04Consultation to treatmentAt 30 and 90 days. The gap is what nurture recovers

05Revenue by sourceReconciled monthly against the payment processor

06Database revenueIsolated from new acquisition. The number he has never seen

Publish the baseline in week one, before anything is built. It will be uncomfortable and worse than expected, and it is the only thing that makes month six provable.