In 2022, thesix dental offices of a West Coast metropolitan-area DSO were performing well. The business had recently grown from four to six locations. Business was good, and customers were happy. But the company’s COO and the rest of its leadership team noticed some growth-related challenges as they scaled up.

At the core of many of those challenges was their use of multiple practice management software (PMS) packages throughout their offices. However, their transition to tab32's cloud-based PMS and integrated solutions marked a significant turning point, allowing them to overcome these challenges and become a more unified and effective organization. This case study explores the practical difficulties encountered by this DSO during its expansion and reveals how the dedicated team at tab32, along with their comprehensive cloud-based services and a data merger from four separate PMS’s across their six locations,played a crucial role in facilitating its success.

Problems only revealed at scale


Over the years, as this dental service organization (DSO) added solo practitioners into their business, they had opted to leave each running its existing PMS for consistency’s sake. They had four offices working together for over 15 years. Three of those offices shared an on-premises hosted application that served them well on a small scale. The fourth office was on a separate PMS, but copying PPO and Medicaid information was not too big of a challenge over the years.

But then the DSO added two more offices. This was positive growth, but each new office had its own PMS. The COO sounded a little exasperated, recounting it: “So we were running on four different software packages, which means four different client databases and sets of insurance records. Basically, we were trying to systematize things in four different systems.”

Having six decentralized offices on different PMSs made juggling schedules difficult. “Our oral surgeon travels to each location, and so he wants to see his schedule.” Under the old setup, the COO needed to remote desktop into different offices to pull the surgeon's schedules. “He's not in each location every day. I needed to look at the next two days ahead for him.”

“As far as keeping standard operating procedures, it was incredibly hard.”

Siloed offices created unnecessary work

“We were on good systems, but we were on four different good systems.” For the COO, this created a lot of extra work. “As far as keeping standard operating procedures, it was incredibly hard.” Some systems were similar, and he could replicate their business practices in the new software. However, the working environment became too complicated once they brought the final two offices into the network with their own PMSs.

“We had some hard questions to answer,” the COO said. “We're onboarding a new office and team, and we kept asking about basic tasks, ‘How do we do it?’ Well, we can't do it that way because their system doesn't run that report or print that treatment plan the same way. Or the ledgers are different.”

The different accounting systems, in particular, were a challenge for the COO. Some of his offices followed line-item accounting. While others tracked expenses in and out in one common account. This created a great deal of work to reconcile, and it also created secondary reporting problems. “The reports ran different ways, so we had certain KPIs that we're trying to track, and the different PMSs spit out different numbers and had different ways of sending insurance claims.” The different systems also had different clearing houses, so reconciling which insurance claims came from where was a headache.

Fee schedules were the breaking point

One issue in particular became too time-consuming to ignore. “A big challenge for us was insurance fee schedules. Once a year, insurers update their fees. So I had to update that six times,” across all their different on-premises PMSs, the COO explained.

“The HMOs are the most challenging because we get new schedules every day or every week, and we have to input the whole fee schedule because plan one has a different fee schedule than plan two.”

The leadership team decided they needed to make a change. They needed a reliable, centralized PMS.

“The team from Tab was awesome. They were very structured.”

Taking action
with tab32


The DSO’s COO identified tab32 as an ideal centralized PMS early on. “Migrating to a single PMS was something that we had always talked about. And so we thought making the move to the cloud and just getting all [of our practices] onto the same platform would be beneficial. That way, our regional managers know how to pass along information and train,” the COO said. Now, they felt they needed to take action at the scale they had grown to.

The DSO’s team and the tab32 team undertook a thorough assessment of their operations. “The team from Tab was awesome. They were very structured when we had our meetings daily or weekly. With tab32’s Director of Implementations getting things set up, everything was laid out nicely. She could say, ‘This is what you're going to need to know,’ and walk us through the steps very clearly.”

Efficient deployment

When it comes to deployment, some dental practices or DSOs prefer a slow, steady approach, piloting and finalizing one office before moving on to the next. This DSO had different needs. They wanted to fully migrate all of their offices as quickly as possible and so they opted for a single organization-wide migration. Fortunately, tab32’s deployment process was adaptable and could be adjusted to fit their business needs.

“We knocked them all out on the same day,” the COO said happily. “Tab might’ve thought we were crazy, but to us it was more just a ‘rip the bandage off’ situation at that point. Our teams were ready for it. They were up for the challenge.”

The COO’s goal was to reduce six sets of records to one as efficiently as possible, especially since they dealt with so many managed care plans that received so many regular updates. The sooner they could consolidate to one PMS in the cloud, the sooner they’d reclaim all their work hours manually updating codes.

The DSO wanted to take the same approach to training, too: get everyone up and running as fast as possible. “When we got to the end [of the migration], we said, ‘You know what? Let's just train them all together.’ Let's rip the band-aid off again and make it happen.”

So tab32's training team assembled a library of training videos for their staff. “Our offices aren't all right next to each other, so having the training beforehand was huge. Getting our teams together and having your trainers come out and walk them through it in person helped a lot for sure. Day one will be a shock no matter what, but it helped. Having them there and then having them in the office when I went live to help walk people through as well was important.”

The COO’s trainers found that library helpful both during the migration and after the fact. They also appreciated the in-app walkthroughs embedded throughout the tab32 PMS. These allow users to search how to specific tasks right in context. “We just hired someone new a couple of days ago,” the COO said. “I went back, and we pulled out the training videos and said, ‘Go look at these.’ Having those available is immensely helpful.”

Overcoming obstacles

Major projects—like cloud software migrations—are complex, with many moving parts. Things will never go perfectly smooth. Instead of eliminating every possible point of failure, it is best to remain adaptable and prepare contingencies. The COO agreed. “You migrate one office, it's not fun. I've done that, and I've migrated multiple times. It's never an easy lift. We are realistic in knowing it wasn't going to be perfect. But the team from Tab was very organized. They were able to roll with all the little surprise issues.”

“The efficiency gains are huge, especially for our central management team,”


Major efficiency gains through centralization


Migrating to tab32's unified cloud environment had an immediate and profound effect.

“The efficiency gains are huge, especially for our central management team,” the COO said. “And our providers really enjoy being able to look at their schedule, see their numbers, and complete their notes from anywhere. Even from home if they have to. tab32 gives them more flexibility.”

Centralization was paying off in other ways, too. In particular, the COO was also impressed with the new wealth of data generated through the tab32 Open Data Warehouse. “Being able to get on and see all the data, look at it in real time, helps track our KPIs. And running queries in PowerBI is huge for us.” the COO laughed, recalling first seeing just how much new information they had available. “It's a lot of data, which is awesome, and a lot of access.”

Ongoing support from tab32 is a big benefit

The DSO also appreciated the ongoing business partnership with tab32. “Another big thing for us is having ongoing communication, having the Client Success Manager available and knowing that, if we ask for something new, it can happen. Whereas with their old PMS, it wouldn't happen until they updated the whole thing in maybe a year, two years, or whenever.”

With tab32’s faster development cycle, new features “could be released next week and happen next month. Getting things changed promptly, whether it's a system update or things like that, for me, it's nice to know that it can happen.”

Looking forward to an ongoing collaborative journey

By forging a partnership with tab32 and transitioning to an enterprise cloud-based PMS, this rising DSO overcame numerous operational challenges created using six different on-premises PMS deployments. Their migration not only streamlined their processes and enhanced patient satisfaction, it created new adaptability to evolving business demands and set the stage for future expansion.

Their journey so far shows how dental practices can utilize cloud technologies, including tab32's practice management solutions, to navigate challenges associated with expansion and improve the delivery of dental care. The success wasn’t solely due to the technology, either. “There's a human around we can actually talk to and bring our questions to,” the COO said. “We're good to go.”


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