DSOs · Emerging Dental Groups · PE-Backed Platforms
Grow production and margin in the offices you already support, and in every one you add.
Dental platforms are built by adding offices. Their value is decided by how each office performs: hygiene schedules that fill, diagnosed treatment that gets scheduled, claims that pay the first time, and a support center whose cost grows slower than the office count. We work with DSO and dental group leadership teams and their sponsors to find where production, collections and cost-to-serve are leaking, redesign the work across offices and the support center, and build the automation and AI that keep the redesigned workflows running. Every result is measured against your own baseline.
Health & Wellness · Care Platforms
The landscape
Consolidation built the platforms; office-level performance now sets what they are worth.
Dental support organizations are now a structural part of the profession: the ADA Health Policy Institute reports that 16% of US dentists were DSO-affiliated in 2024. Platforms grew by affiliating practices and opening de novos, and that remains the growth model. What it does not do on its own is lift performance in the offices a platform already supports. Production per provider, schedule fill, net collections and support-center cost per office are where the next stage of value creation sits, and they are the numbers a buyer's diligence team will rebuild office by office.
The constraints are operational. In the ADA Health Policy Institute's Q4 2025 panel, the challenges DSO-affiliated dentists cited most often for 2026 were staffing (59.3%), insurance (55.6%) and maintaining a full schedule (35.2%). Among dentists who had recently recruited staff, 88.3% rated hiring hygienists very or extremely challenging, and across all US dentists, not only those in DSOs, one in three said they were not busy enough. Hygiene capacity can be short while doctor schedules have open time, which makes patient access, recall and scheduling a capacity problem as much as a marketing one.
Insurance administration is the other margin line. The CAQH Index found US dental spending on eligibility and benefit verification rose 15% to $2.1 billion in 2023, and estimated $580 million in savings from moving portal and manual checks to automated electronic ones. ADA News reports that offices often do not get enough dental detail from the automated transaction, so teams fall back on payer portals. For a multi-office group, that is a support-center cost and a patient-experience problem at checkout. It is also where automation and AI earn their place: inside verification, claims, posting and denial work that has been redesigned first, with people handling the exceptions.
The market problem, in published numbers
16%
of US dentists were affiliated with a dental support organization (DSO) in 2024
ADA Health Policy Institute, Dental Practice Research (2024)
59.3%
of DSO-affiliated dentists cited staffing as one of their top 3 practice challenges for 2026, ahead of insurance (55.6%) and maintaining a full schedule (35.2%)
88.3%
of dentists who recently recruited practice staff rated recruiting dental hygienists "very" or "extremely" challenging in Q4 2025 (94.9% in Q4 2023, 90.1% in Q4 2024)
1 in 3
US dentists across all practice types, not only DSO-affiliated, reported they were not busy enough and could have treated more patients in Q4 2025
$2.1B
spent by the US dental industry on eligibility and benefit verification in 2023, up 15%; the CAQH Index put the savings from moving portal and manual checks to automated electronic checks at $580 million
Figures are third-party market benchmarks from the cited sources, not Ometz Partners client results. We share them so you can size the problem before we ever talk.
Where performance is lost
Same-office growth flattens
Affiliated and de novo offices add revenue, but production per office stalls when new-patient conversion, recall and treatment follow-up depend on each office manager's bandwidth.
Hygiene capacity sets the ceiling
Hygienists are the hardest role in the office to recruit, and every open hygiene column slows recall, periodontal maintenance and the restorative work that follows.
Insurance administration absorbs margin
Verification, claims, denials and posting consume support-center and front-desk hours, and the workload grows with every payer contract and every new office.
Integration debt from affiliations
Several practice management systems, phone platforms and fee schedules make offices hard to compare and central workflows hard to run.
The DSOs & Dental Groups program
Programs built around how your business runs.
ACCESS
Patient Access & Treatment Acceptance
More production from the demand and the patient base you already have: every new-patient request answered and booked, recall and unscheduled treatment worked as a system, and schedules filled to template in every office, with the support center and office teams working from one queue.
What we measure
- New-patient request-to-appointment conversion by office
- Hygiene reappointment rate
- Unscheduled treatment converted to scheduled
- Schedule utilization by provider against template
01
New-patient conversion
Calls, web forms and online booking routed into one intake flow. Voice and text agents handle overflow and after-hours requests, book into the PMS and pass exceptions to the support center with full context.
02
Recall and treatment follow-up
Prioritized outreach on overdue hygiene, periodontal maintenance and unscheduled treatment, sequenced by value and remaining annual benefits. The office team keeps the clinical conversation; the system makes sure it happens.
03
Schedule fill and confirmations
Confirmations and short-notice fill from waitlists and recall lists, with template utilization tracked by provider and office every day.
MARGIN
Dental Revenue Cycle Performance
A lower cost to collect and faster cash: eligibility and benefits confirmed before the patient sits down, clean claims out the door, and denials and posting worked from prioritized queues in the support center.
What we measure
- Net collection rate
- First-pass claim acceptance rate
- Days in AR and aged AR share
- Verification cost per appointment
01
Verification at scale
Eligibility and benefit breakdowns gathered ahead of the schedule through clearinghouse and payer connections, exceptions routed to a central team, and patient estimates ready before the visit.
02
Claim readiness and denial queues
Pre-submission checks for attachments, narratives and payer rules, and denials grouped by cause and payer so fixes happen upstream. Coding judgment stays with the dentist and your coding team.
03
Posting and follow-up
ERA and EOB posting, payer follow-up and patient balance outreach sequenced by value, with every action logged for audit.
VALUE CAPTURE
Affiliation & De Novo Integration
Newly affiliated offices and de novos reach platform standards faster: PMS and phones converted, providers credentialed, fee schedules loaded, teams retained, and performance measured against the pre-close baseline.
What we measure
- Time from close to platform PMS and phones
- Claims held for credentialing
- Same-office production against pre-close baseline
- De novo ramp against business case
01
Integration playbook and tracker
A standard sequence for each affiliation, covering data migration, phones, payer enrollment, fee schedules, branding and team onboarding, tracked in one view the sponsor can read.
02
Credentialing and payer transition
Provider and location credentialing tracked against held claims, so revenue is not parked while paperwork moves.
03
De novo ramp management
Pre-opening patient acquisition, scheduling templates and weekly ramp reporting against the business case, with early warnings when an office falls behind.
The diagnosis
What we look for in your offices.
A Performance Diagnostic measures these in your own systems first, so every later result is judged against the same baseline.
New-patient calls, web requests and online bookings: answered, booked and arrived, by office and by hour
Hygiene reappointment rate, and the size and age of the overdue recall and periodontal maintenance lists
Diagnosed-but-unscheduled treatment value by office and provider, and who works it
Schedule utilization by provider against template, with open hygiene and doctor time side by side
Verification and claim workload per appointment, first-pass claim acceptance, top denial reasons by payer, and AR aging
Support-center cost per supported office, and the tasks offices still do by hand
Time from affiliation close to platform PMS, phones, credentialing and fee schedules
De novo ramp against the business case: new-patient flow, provider schedule fill and collections
How an engagement runs
01
Performance Diagnostic, 2 to 4 weeks
Fixed fee. We baseline patient access, scheduling, revenue cycle and support-center cost office by office from your PMS, phone, clearinghouse and financial data. You receive three priced improvement plays, each with its EBITDA and cash estimate, and a 90-day plan your leadership team and sponsor can hold us to.
02
First 90 days: Prove it in a pilot region
The first play goes live in a pilot region or office cohort, for example the recall and unscheduled-treatment workflow, or verification and claim readiness in the support center, with weekly reporting against the baseline.
03
From the second quarter: Scale and standardize
Proven plays roll out across offices on one reporting layer. The affiliation and de novo playbook is written from what worked, so each new office reaches platform standards faster.
Our thinking for DSOs & Dental Groups
All insightsDSOs & Dental Groups FAQ
Inside it. We map which calls, verifications, claims and follow-ups land in the support center versus the offices, redesign that split, and automate the high-volume work. Your team keeps the exceptions, the office relationships and ownership of the results. Headcount decisions stay with you; the diagnostic shows where capacity is better spent.
No. Diagnosis, treatment planning and coding judgment stay with dentists and your clinical leadership, and we do not provide clinical or radiographic AI. Our work is the non-clinical operation around the chair: patient access, scheduling, revenue cycle, reporting and integration. Where state corporate-practice rules limit what a management company may control, we design workflows with your counsel so each decision sits with the right person.
Yes. Where our work touches protected health information, we sign a BAA and scope PHI handling during the diagnostic: what is accessed, where it is stored, which downstream vendors are involved, and what stays human-only. Patient-facing automation identifies itself and follows the consent and disclosure rules your compliance team sets.
It is normal after affiliations. Groups commonly run Dentrix, Eaglesoft, Open Dental, Denticon or CareStack, often more than one at once. We assess integration options for each (direct API, clearinghouse, middleware or structured exports) during the diagnostic and price only what is confirmed. Where a PMS consolidation is planned, we sequence the work around it.
Each play from the diagnostic carries an EBITDA, cash and timing estimate built from your own office-level baseline, in a format an operating partner can test. We report against that baseline monthly, so the plan and the results are read from the same numbers.
Next step
Start with a Performance Diagnostic.
The Performance Diagnostic runs for two to four weeks at a fixed fee and ends with a baseline, three priced improvement plays and a 90-day plan. The findings are yours whether or not we continue.