Dental practice accounting that shows production, collection, and every adjustment in between.

Dental practices generate revenue through production (charges at full fee schedule) but collect only a portion of it after insurance adjustments, PPO contract write-offs, patient discounts, and uncollectible accounts. The gap between production and collection — typically 8–15% of production — is real money that must be measured, not buried in “discounts.” Lab fees for outsourced crown, denture, and surgical guide work are a genuine cost of services, not overhead. Associate-doctor compensation runs on production-based, collection-based, or hybrid formulas that must be calculated accurately and classified correctly (often the difference between W-2 employment and 1099 contractor treatment with real tax implications). Multi-location DSOs need chair-level and operatory-level economics. None of this fits into a generic service-business chart of accounts — running a dental practice on generic bookkeeping means flying blind on the metrics that actually determine practice profitability.

Production is the total dollar value of dentistry performed at full fee schedule — what the practice would have billed if every patient paid full price with no insurance. Collection is what was actually received after insurance adjustments, PPO contracted write-offs, patient discounts, and bad debt. The Collection Ratio (collections divided by production) is one of the most important dental practice KPIs: a healthy ratio is 90% or higher; 85–90% is acceptable; below 85% signals operational issues with insurance verification, treatment planning, financial coordination, or accounts receivable management. We configure the books so production, adjustments, write-offs, and collections are tracked separately by month, by provider, and by procedure category — making Collection Ratio a measured number reviewed monthly, not an annual surprise.

Insurance adjustments come in several forms that need different accounting treatment. PPO contractual write-offs (the difference between full fee and the negotiated PPO fee schedule) are immediate adjustments at the time of treatment — these reduce production to expected collection. Insurance claim payment differences (when the insurer pays less than expected) are adjustments at the time of payment. Patient courtesy discounts, professional courtesy adjustments, and senior discounts are tracked separately for management visibility. Bad debt write-offs (uncollectible patient balances) flow through allowance accounts. Each category gets its own account in the chart of accounts so the monthly P&L shows the practice exactly where the production-collection gap is coming from — PPO discounts vs insurance payment differences vs patient discounts vs bad debt. Lumping them together is the most common bookkeeping mistake we see in dental files.

Yes. Associate compensation in dental practices runs on several models: production-based (associate paid a percentage of their personal production, typically 25–35%), collection-based (paid a percentage of what their production actually collected, typically 30–40%), salary-plus-production (base salary plus production bonus above a threshold), daily-rate (typical for part-time or per-diem coverage), and hybrid arrangements. Calculation accuracy requires pulling production and collection data by provider from the practice management system (Dentrix, Eaglesoft, Open Dental) and applying the contractual formula correctly — including lab fee deductions, supply cost allocations, and any specific arrangements about who pays for what. Classification matters enormously: associates classified as 1099 independent contractors who functionally operate as employees create real legal and tax exposure. We configure the compensation calculation and classification in coordination with the practice’s CPA or attorney on the legal characterization.

Lab fees for outsourced crown, denture, implant, and surgical guide work are a real cost of services and should appear as a separate COGS line, not buried in supplies or general overhead. Lab fees as a percentage of production is a key dental practice benchmark — typically 7–10% of total production for general practices, higher for restorative-heavy or implant-focused practices. Dental supplies (consumables — gloves, anesthetic, restorative materials, impression materials) are similarly a real cost of services and benchmark around 5–7% of production. We configure the chart of accounts so lab fees and supplies are visible as separate line items, calculate them as a percentage of production monthly, and surface when they drift outside healthy ranges — typically a sign of price changes, inventory shrinkage, or treatment-mix shift.

Yes. Multi-location dental practices and DSOs need three things generic bookkeeping doesn’t provide: location-level P&L for each office (revenue, lab/supply COGS, provider compensation, location-specific overhead, contribution to overhead and profit), consolidated DSO-level reporting with intercompany elimination for management services agreements and inter-location transactions, and provider-level reporting that crosses locations for associates who work at multiple offices. We configure the chart of accounts with Class or Location tracking for every office, maintain the management entity vs operating entity structure cleanly (common in DSO setups for state corporate-practice-of-dentistry compliance), and produce both location-level and consolidated reporting monthly. For DSOs growing through acquisition, due-diligence support and post-acquisition integration are scoped separately as project engagements.

Dental practice management systems handle the patient-facing side (scheduling, charting, billing, insurance claims). The integration between practice management and QuickBooks requires reconciliation rather than direct sync — practice management is the source of truth for production, collection, and adjustment data; QuickBooks is the source of truth for the financial general ledger. We work with all major dental practice management systems: Dentrix and Dentrix Ascend, Eaglesoft, Open Dental, Carestream PracticeWorks, Curve Dental, Dovetail, and Denticon (commonly used by DSOs). The reconciliation process: monthly production, adjustment, and collection reports pulled from practice management; posted to QuickBooks as summary journal entries by provider, location, and procedure category; reconciled to bank deposits and merchant settlements. The result: one ledger that ties to practice management daily and supports the full set of dental practice KPIs.