Most DSO acquisitions take 12+ months to fully integrate—but the target is 90 days. The gap? Integration playbooks focus on PM system migration before establishing standardized intake processes. This playbook flips that sequence, giving you a week-by-week framework for standardizing patient intake that works regardless of which PM system the acquired practice uses.

Whether you’re a DSO COO hitting integration timelines, a PE operating partner overseeing a dental portfolio, or a regional director managing day-to-day execution, this guide provides the tactical framework you need.

Table of Contents

Why DSO Intake Integration Fails

Before diving into the solution, let’s understand why most DSO integrations miss their targets.

Mistake #1: Technology-First Thinking

The default approach: migrate everyone to the same PM system first, then standardize processes. This fails because:

Mistake #2: Underestimating the Human Element

Acquired practices have established cultures. The office manager has “always done it this way.” Staff view corporate standardization as criticism of their competence. Without change management, even perfect processes fail.

Mistake #3: No Clear Accountability

Who owns intake integration? Operations? IT? The practice manager? When ownership is unclear, integration stalls. Each team assumes someone else is handling it.

Mistake #4: Measuring Too Late

Most DSOs don’t have visibility into acquired practice performance until months post-close. By then, patients have churned and staff have disengaged.

The Workflow-First Integration Framework

The solution flips the traditional sequence:

ApproachSequenceTimeline
TraditionalPM System Migration → Process Design → Staff Training → Go Live12-18 months
Workflow-FirstProcess Standardization → Staff Training → Parallel Operations → PM Migration90 days

The key insight: you can standardize intake workflows independent of which PM system the practice uses. Dentrix, Eaglesoft, Open Dental—the phone still rings, patients still need appointments, and someone still needs to answer.

Standardize the human workflows first. Migrate systems around a proven process later.

Pre-Close: Intake Assessment (Weeks -4 to 0)

Integration starts before the deal closes. Use due diligence to assess intake operations.

Intake Assessment Checklist

Call Handling

Scheduling

New Patient Process

Staff & Knowledge

Technology

Red Flags to Watch For

These don’t disqualify an acquisition—but they indicate higher integration lift.

Week 1-2: Process Mapping and Gap Analysis

Day 1 readiness means understanding exactly how the practice operates today.

Process Mapping Steps

1. Shadow the Front Desk Spend 2-4 hours observing. Don’t try to change anything yet—just document:

2. Interview Key Staff Meet individually with:

Ask: “Walk me through what happens when a new patient calls.”

3. Document Current State Create a simple flowchart showing:

Don’t judge yet. Just document.

4. Gap Analysis Compare current state to your DSO standard (or create one if you don’t have it):

ProcessCurrent StateDSO StandardGap
Phone greetingVaries by staffScriptedHIGH
New patient info collectionPaper formsDigital intakeMEDIUM
Insurance verificationDay of visitPre-visitHIGH
Appointment confirmationManual callsAutomated textMEDIUM

Deliverable: Current State Assessment

By end of Week 2, you should have:

Week 3-4: Standardization Design

Now design the target workflows. The goal: create processes that work regardless of PM system.

Core Intake Workflows to Standardize

1. Inbound Call Handling

2. New Patient Registration

3. Appointment Scheduling

4. Confirmation and Reminders

Standard Operating Procedures (SOPs)

Create written SOPs for each workflow. Include:

Example: New Patient Call SOP

Purpose: Ensure consistent, professional handling of new patient inquiries that maximizes conversion to scheduled appointments.

Steps:

  1. Answer within 3 rings using standard greeting
  2. Collect caller name and callback number first
  3. Ask “Is this for yourself or someone else?”
  4. Determine appointment type needed
  5. Offer next available appointment within 7 days
  6. Collect required registration information
  7. Confirm appointment details and provide arrival instructions
  8. Send confirmation text/email within 5 minutes

Script: “Thank you for calling [Practice Name], this is [Name], how may I help you today?”

Phone Scripts Library

Create scripts for common scenarios:

Week 5-6: Staff Training and Rollout

This is where most integrations fail. Perfect processes mean nothing if staff don’t adopt them.

Change Management Principles

1. Explain the “Why” Staff resist change when they don’t understand the reason. Frame standardization as:

NOT: “Corporate says we have to do it this way.”

2. Involve Staff in Refinement Share draft SOPs and ask for feedback:

Staff who contribute to the design are more likely to adopt it.

3. Train, Don’t Tell Sending an email with new SOPs doesn’t work. Plan actual training:

4. Acknowledge What’s Working Don’t position everything as broken. Identify and celebrate what the practice does well:

Training Curriculum (2-Week Program)

Week 5: Knowledge Transfer

Week 6: Hands-On Practice

Resistance Handling

When staff push back (and they will):

“We’ve always done it this way.” Response: “I understand, and that approach has clearly worked. We’re building on what works while adding some consistency that helps when we have new team members or you’re out sick.”

“This takes longer.” Response: “It might feel that way at first. Most teams find it actually saves time once it’s routine because there’s less guessing and fewer do-overs.”

“Our patients won’t like this.” Response: “Let’s try it for two weeks and measure patient feedback. If patients genuinely prefer the old way, we’ll adapt.”

Week 7-8: Parallel Operations and Monitoring

Don’t flip a switch. Run parallel operations to ensure smooth transition.

Parallel Period Protocol

Daily Monitoring During Transition

Track these metrics daily:

Create a simple daily dashboard:

MetricTargetMonTueWedThuFri
Answer Rate90%+
Hold Time<60s
NP Conversion70%+

Issue Resolution

When problems arise (and they will):

  1. Document the issue - What happened, when, who was involved
  2. Identify root cause - Process gap? Training gap? Tool limitation?
  3. Implement fix - Update SOP, provide additional training, or adjust process
  4. Communicate change - Let all staff know about the adjustment

Week 9-12: Optimization and Documentation

The final phase: refine based on data and lock in the gains.

Performance Review

At Week 9, conduct a formal review:

Process Refinement

Based on the review, make targeted adjustments:

Documentation Finalization

Create the permanent documentation package:

Knowledge Transfer

Ensure the practice can maintain standards independently:

PM System Considerations

While this playbook is PM-agnostic, here are specific considerations for common systems.

Dentrix

Strengths: Most common DSO system, robust scheduling Intake Considerations:

Integration Tip: Standardize Appointment Book configuration across practices before standardizing workflows.

Eaglesoft

Strengths: Patterson support, strong clinical integration Intake Considerations:

Integration Tip: Document which IntelliCare features are active at each practice before standardization.

Open Dental

Strengths: Customizable, growing DSO adoption, lower cost Intake Considerations:

Integration Tip: Leverage Open Dental’s customization to match your standardized workflows exactly.

Multi-PM Environments

If your DSO has multiple PM systems (common during acquisition growth):

KPIs to Track During Integration

Measure these throughout the 90-day integration:

Operational KPIs

MetricDefinitionTargetMeasurement
Call Answer Rate% of calls answered live90%+Phone system reports
Avg Speed to AnswerSeconds to answer<20 secondsPhone system reports
Hold TimeAverage hold duration<60 secondsPhone system reports
Abandonment Rate% of callers who hang up<5%Phone system reports

Conversion KPIs

MetricDefinitionTargetMeasurement
NP Conversion RateNew patient inquiries → scheduled70%+Manual tracking or CRM
Time to AppointmentDays from call to appointment<7 daysPM system reports
Schedule Fill Rate% of available slots filled85%+PM system reports

Patient Experience KPIs

MetricDefinitionTargetMeasurement
Patient SatisfactionPost-visit survey scores4.5+/5Survey tool
Online ReviewsGoogle/Yelp rating trendStable or improvingReview monitoring
Complaint RatePatient complaints per 100 visits<2Manual tracking

Staff KPIs

MetricDefinitionTargetMeasurement
Process Adherence% of calls following SOP90%+Call monitoring
Training CompletionStaff certified on new processes100%Training records
Turnover RateFront desk turnover<20% annuallyHR records

Managing Staff Resistance

Change is hard. Here’s how to navigate the human side of integration.

The Resistance Curve

Expect this pattern:

  1. Initial Enthusiasm (Week 1): “New owners, fresh start!”
  2. Reality Check (Week 2-3): “Wait, things are actually changing.”
  3. Resistance Peak (Week 4-5): “This is too hard/different/unnecessary.”
  4. Grudging Acceptance (Week 6-7): “Fine, I’ll try it.”
  5. Adoption (Week 8+): “Actually, this isn’t bad.”

Plan for the resistance peak. It’s normal, not a sign of failure.

Identifying Resistance Types

Vocal Resisters: Express concerns openly

Silent Resisters: Agree publicly, don’t adopt privately

Saboteurs: Actively undermine new processes

The Practice Manager Challenge

The Practice Manager often determines integration success or failure. They may:

Approach: Make the Practice Manager your partner, not your adversary.

Key Takeaways

Next Steps

Ready to implement this playbook in your next acquisition?

For DSO Operators

Download the Complete DSO Integration Toolkit - Includes all checklists, templates, and scripts referenced in this guide.

For PE Operating Partners

Schedule a Portfolio Assessment - We’ll evaluate intake operations across your dental investments and identify the highest-impact opportunities.

Our Never Miss an Appointment solution is specifically designed for multi-location healthcare groups, combining trained healthcare specialists with technology that integrates directly into your practice management systems—including Dentrix, Eaglesoft, and Open Dental.

Frequently Asked Questions

How long does DSO intake integration typically take?

Most DSO integrations take 12+ months using the traditional technology-first approach. Using the workflow-first framework in this playbook, you can achieve standardized intake operations in 90 days. PM system migration can then happen separately without disrupting patient-facing operations.

Can I standardize intake across different PM systems?

Yes. The workflow-first approach standardizes human processes independent of technology. Whether acquired practices use Dentrix, Eaglesoft, or Open Dental, the phone greeting, information collection, and scheduling workflows can be identical. This is the key insight that enables 90-day integration.

What’s the biggest mistake DSOs make during integration?

Technology-first thinking—attempting to migrate everyone to the same PM system before standardizing processes. This creates 6-12 months of chaos where you can’t measure performance, staff resist simultaneous system and process changes, and patient experience suffers.

How do I handle staff resistance to new processes?

Staff resistance peaks around weeks 4-5 of integration—this is normal. Key strategies: explain the “why” behind changes, involve staff in process refinement, train (don’t just tell), and acknowledge what’s already working. Make the Practice Manager your partner by giving them ownership of implementation success.

What KPIs should I track during integration?

Track operational KPIs (answer rate 90%+, hold time <60s, abandonment <5%), conversion KPIs (new patient conversion 70%+, time-to-appointment <7 days), and experience KPIs (patient satisfaction 4.5+/5, complaint rate <2 per 100 visits). Measure from Day 1.

How does intake optimization affect DSO valuation?

For PE-backed DSOs, recovered revenue from improved intake flows directly to EBITDA at 20-30% flow-through. At typical 6-8x multiples, a $500K annual revenue recovery can add $750K-$1.2M to enterprise value. See our EBITDA Impact Calculator for specific modeling.

Last Updated: January 2026

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