The most expensive patients you lose are the ones somebody handed you.

Four numbers, multiplied

Factor	Where it comes from
Referrals per week	Your answer — midpoint of the range you pick
× estimated vanish rate	Conservative lookup keyed to your Intake Score — weaker intake, more sent patients never contacted
× schedule rate when reached	HIGH by design (60–80% per vertical) — a referred patient already said yes to care; reached promptly, most schedule
× value of one completed referral	Your answer

An imaging center receiving 28 referrals a week, scoring in the "Leaking" band (25% estimated vanish rate), with an 80% schedule-when-reached rate and a $1,500 average case: 28 × 4.3 × 25% × 80% × $1,500 ≈ $36,000 a month in patients who were already sent to you. No marketing spend recovers cheaper revenue than this, because the acquisition was free and the intent was pre-built.

Estimates from your own answers using stated assumptions — labeled that way in every report. The first fix baselines the intake flow that produces your real rate — then repairs its weakest link.

The second ledger: referrer trust

The vanished patient also debits an account no report shows: the sending office's confidence. Referrers experience your intake as what-happened-to-my-patient, and they reroute quietly — no complaint, no meeting, just fewer faxes over the following quarters. That decay reads as "referrals are slowing" and gets treated as a marketing problem, when it started as an intake problem. Fixing intake is referral marketing, at zero spend.