How to choose dental billing software for a DSO
Dental billing software for a DSO has to do three things a single-office tool does not: read and post to every practice management system the group runs, reconcile every location to the bank and the books, and put the whole group on one set of numbers. Here are the eight things to evaluate, and the questions to ask every vendor.
Book a demoBy Dr. Mark Haddad, endodontist and DSO co-founderPublished Updated 9 min read
Key takeaways
- A DSO buys billing software for the group, not for one office: it has to read every practice management system the group runs and give one set of numbers across all of them.
- Insurance posting is the largest block of billing work. Ask how payments arrive (ERA, paper EOB, portal, virtual card), what share match with no human review, and what happens to the rest.
- Posting is not finished until the money is reconciled: practice system, bank deposit and books, per location.
- Judge rollout by how locations come on, not by a demo: no migration, no new PMS, and a stated time to go live.
- Ask for measured results from customers, in their own records, with the method. Estimates should be labeled as estimates.
What the software has to do for a group
Billing in a group is the same work as in one office, multiplied and mixed: insurance payments to read and post, patient balances to collect, deposits to match, and books to close, across locations that often run different practice management systems. The software a group buys has to take that work off each desk and show the group the result on one definition.
That is why the evaluation starts with systems and data, not features. A tool that cannot read a location’s system cannot do its billing, and a tool whose numbers disagree with the books creates work instead of removing it.
The eight things to evaluate
Every practice management system the group runs
Acquired practices arrive on whatever system they already used. Billing software for a group has to read and post to all of them, general and specialty, and map them onto one model so a location on Dentrix and a location on Open Dental report the same way.
Ask for the list of supported systems and how a system not on the list gets added. Ask whether the vendor posts into each system or only reads from it: reading gives you reports, posting takes the work off the desk.
Insurance payments from every door
Payers explain claims by ERA or paper EOB and pay by EFT, check or virtual card. Software that only handles electronic remittances leaves the paper, the portals and the cards on someone’s desk.
Ask what share of insurance payments match their EOB with no human review, and what happens to the rest: the right answer is that exceptions are flagged with the reason, never posted wrong.
Ask how short pays and denials are surfaced, with the reason code and the days left to appeal.
Reconciliation across practice system, bank and books
At group scale, the hard question is not whether a payment was posted but whether the posting, the bank deposit and the accounting entry agree, at every location, every day.
Ask whether the software reconciles to the bank and to QuickBooks, Xero or your accounting system, by location, and how differences are named and assigned.
Patient balances that post themselves
Patient billing should reach patients by text, email and mail, take payment by card, plan or text-to-pay, and post every payment back to the practice system with no keying.
Ask what share of patient payments post with no human touch, and how the rules (timing, plans, card on file) are set per location within a group standard.
One set of numbers, and work routed to the right person
A group needs production, collections, what is owed and costs across every location on one definition, plus a ranked list of the work that gets money in, routed to the billing team, office manager or front desk who owns it.
Ask whether the reporting reads the same data the automation uses, so the numbers and the work never disagree.
A rollout measured in days, location by location
Nothing to migrate, no new PMS, and a stated time to go live. Each acquisition should join the same model and become comparable from its first day.
Ask how long a location takes to go live, what the group has to provide, and whether locations on different systems can come on together.
Controls a compliance team will sign off
HIPAA with a Business Associate Agreement, encryption in transit and at rest, US hosting, access by role and location, and a log of every access and every change the software makes in your systems.
Ask whether every change in the practice system can be seen and reversed, and what goes to a person instead of being posted.
Proof measured in customers’ own records
Ask for named customers, measured in their own practice system and payment records against a comparable period before, with the method written down. Projections are useful, but they should be labeled as estimates.
Ask for results at a practice like yours: the same system, a similar size, the same mix of insurance and patient pay.
Questions to ask every vendor
Put the same questions to every vendor, in writing, and ask for the answers to be shown on your own data in the demo.
- Which of our practice management systems do you post into, not just read from?
- What share of insurance payments match their EOB with no human review? What happens to the rest?
- Do you handle paper EOBs, payer portals and virtual cards, or only ERAs?
- Do you reconcile each location to the bank deposit and to our accounting system?
- Do you submit or resubmit claims? If not, where does your work start?
- How long does a location take to go live, and can several go live together?
- Will you sign a BAA? Where is data hosted? Can we see and reverse every change you make?
- Which customers can we talk to, and how were their results measured?
Claims are a separate job
One platform or separate tools
Many groups run a posting tool, a patient billing tool and an analytics tool side by side. Each can do its job; the cost is in the seams between them.
| Job | Separate tools | One platform |
|---|---|---|
| Insurance posting | A posting tool per location, or by hand | Posted from every door, exceptions flagged |
| Patient billing | A statement or text-to-pay tool | Collected and posted back to the practice system |
| Reconciliation | A spreadsheet at month end | Practice system, bank and books, daily, by location |
| Reporting | A separate analytics tool with its own numbers | The same data the automation uses |
| New acquisitions | Each tool set up again | The location joins the same model |
| Vendors to manage | Three or more | One |
Where ScoutIQ fits
ScoutIQ is one platform for the three jobs: Insurance Billing Automation, Patient Billing Automation, and AI Analytics + Atlas Assistant. It works on top of 59 practice management systems, general and specialty, plus accounting, banking and payroll. 95% of insurance payments match with no human review, and the rest are flagged with the reason. It does not submit or resubmit claims. Practices and groups are live in 48 hours.
Measured in their own records, Gulf Coast Endodontics recovered $49,983 of old balances across four offices, Todaro Dental cut days in A/R 28%, and Polish Dentistry reached a 99% net collection rate. See the customer results and how each figure is defined on the data page.
ScoutIQ product
Insurance Billing Automation
Insurance Billing Automation
ERAs and EOBs read; EFT, check and card payments reconciled.
See Insurance Billing Automation