Telehealth startup cost worksheet

Use this worksheet to organize a clinic's own quotes and assumptions. It does not quote Telehealth US fees, represent customer results, or predict earnings. Print this page or copy these tables into your planning document. Complete them with your own quotes and records. Do not include patient information.

1. Define what you are budgeting

Clinic or project: [enter]. Prepared by: [enter]. As-of date: [enter]. Currency: USD. Planning horizon: [enter months]. Programs and patient locations: [enter]. Payment model: [enter]. Current systems and team: [enter].

Choose one economic unit for the monthly model, such as one active paying patient per month. Do not mix a per-visit price with a per-patient cost. For patients using several programs, reconcile patient counts and service usage separately before calculating averages. Separate clinical/provider entities and management-company cash flows where applicable; do not assume all patient collections belong to the entity whose budget you are preparing.

For every input, record: amount, billing unit, frequency, responsible payer, quote or record, date, status and exclusions. Use quoted, historical actual, planning assumption, unknown, or not applicable with reason. A blank or unknown cost is not zero.

2. One-time setup and launch worksheet

Enter each expense once. Split a combined setup-and-subscription quote into its actual components. A deposit or prepaid service must be reconciled to later invoices so it is not counted twice.

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Total setup cash: sum the relevant cash payments. Keep refunds, credits and financing separate. An accountant should determine the accounting and tax treatment; this worksheet is not a deduction schedule.

3. Recurring fixed and usage costs

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Annual payments can be divided by 12 for a normalized monthly comparison; quarterly payments by 3. Record the actual due month in the cash schedule. Do not treat normalization as the bank payment schedule.

A minimum commitment may work differently from a base fee plus usage. For a minimum that is credited against usage, use the greater of the minimum and the usage amount. For a base fee plus usage, add both. Use the actual agreement. Tiered pricing and extra staff at higher volume need separate scenarios.

4. Compare three sets of assumptions

Label scenarios lower-volume stress, reference assumptions, and higher-volume capacity. A reference scenario is not “most likely” unless evidence supports that description. Higher volume can increase staffing and operating costs.

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Use net amounts after the adjustments included in your assumptions. If processor fees are assessed on a different base, such as gross charges before refunds, compute the actual expected fee separately. Do not silently assume that a simple percentage of net receipts matches the contract.

For compatibility with the current six-input calculator, use:

• Modeled monthly receipts = N × P.

• Variable care cost = N × V.

• Modeled payment fees = N × P × r / 100.

• Fixed monthly operating costs F = M + O.

• Monthly operating result = N × P − N × V − N × P × r / 100 − F.

• Contribution per patient C = P − V − P × r / 100.

• For positive contribution and positive fixed costs: operating break-even patients = ceiling(F ÷ C).

If contribution is zero or negative and fixed costs are positive, additional volume cannot reach break-even under those assumptions. If fixed costs are zero, zero patients produces zero operating result, but this does not mean positive-volume activity is profitable when contribution is negative.

The break-even threshold assumes the same unit economics and fixed costs at that patient count. If the threshold crosses a staffing or pricing tier, recalculate within the relevant tier. This is operating break-even, not recovery of setup cash.

Keep taxes, financing costs, debt principal, owner distributions and setup investment visible in the appropriate separate schedules. Do not call this simplified result net income or cash in the bank.

5. Build a cash schedule

Use actual expected receipt and payment dates. A billed amount is not a bank receipt. Keep unpaid balances and timing assumptions separate from collected cash.

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Closing cash = opening available cash + funding received + cash receipts − all cash payments. Reconcile every payment to exactly one line. Record restricted funds or settlement reserves separately from available cash.

For a constant desired minimum balance, a simple one-time funding-gap calculation is max(0, desired minimum − lowest modeled cash balance), with setup already included and existing committed funds already reflected. This assumes the additional money arrives before the shortfall. It is not a recommendation to borrow or invest that amount and excludes any cost of obtaining funding unless modeled.

6. Questions to resolve before relying on the budget

• Which items are included in another fee, and which are optional?

• What starts billing: signature, configuration, onboarding, availability or actual usage?

• Which minimum commitments, additional charges and capacity limits apply?

• Who receives customer payments and who pays each supplier?

• What assumptions support patient demand and retention?

• Which receipts can be delayed, refunded or withheld?

• What additional staff or systems are needed at the higher-volume case?

• Which figures remain unknown, and how much could they change the result?

Discuss your plan using the existing calculator, vendor checklist and a scoped service-plan inquiry. Obtain current quotes; do not substitute historical prices from another engagement.

Source: SBA business planning guidance supports organizing startup and recurring expenses. These clinic-planning tables are original Telehealth US material. This general planning aid does not establish fees, service availability or expected financial results. Review your completed budget with qualified advisers.