Meridian Dental Partners / Overview
Location
All Sites (3)
Period T90 · Feb 16 → May 16, 2026
Date
T7 T30 T90 T6mo T12mo YTD Custom…
Location
All Sites (3) Plano Frisco Southlake
Live · synced 2m ago
Global: Date · T90× Location · All Sites× Reset all Pillar-specific filters appear inside each pillar page →
OVERVIEW · GROUP LEVEL · TRAILING 90 DAYS

The state of Meridian Dental Partners, end of Q2 2026.

Practice valuation, core economics, pillar health, and the actions that matter this quarter — all on one screen. Drill into any pillar from the left rail, or open the full Connected Practice Report.

ENTERPRISE VALUATION · TRIANGULATED

Meridian Dental Partners valuation, May 2026

$25M$32M

Dual-method triangulated range across EBITDA-multiple and forward-revenue-multiple. Mid-point $28.4M reflects current run-rate adjusted for 90-day recoverable revenue execution.

Method 01 · EBITDA Multiple
EV = EBITDA T12 × multiple
$28.0M
$3.5M EBITDA × 8.0x (premium multispecialty group, multi-site)
+24% YoY
Method 02 · Revenue Multiple
EV = Forward Revenue × multiple
$28.4M
$13.5M FY26 forward × 2.1x (private multispecialty DSO comparable)
+18% YoY
CONSULT REPORT · 12-SECTION DEEP-DIVE

Read the full Connected Practice Report →

Five cross-pillar stories. $1.05M of recoverable revenue stacked by source. 90-day plan with named action cards. The full investor-grade narrative.

Open report ↗

Core economics · T90

Cash collected
$3.35M
+12.1% YoY
Procedures completed
6,650
+312 vs prior 90d
Avg production / visit
$504
+4.8% YoY
Operatory util
75.4%
Range 51–91%
Margin / chair-hour
$329
Southlake: −$28
Recoverable revenue (T90)
$1.05M
8 sources · stacked in Consult
★ Top-margin specialty
56%
Oral Surgery / Implants · drill in →
EBITDA margin
26.2%
+1.4 pts YoY
Case acceptance rate
62.6%
Plano 71% · Southlake 41%
High-value case share
9.1%
31% of total gross margin
Recare compliance
71.2%
Southlake at 38% drags average
Complication rate · T12
0.9%
Below 1.5–2.2% benchmark

Pillar health · click any pillar to drill in

Operations
72/100
Plano util 91% · Frisco 78% · Southlake 51% drags average. Missed callbacks Southlake-dominant.
Finance
81/100
Cash +12% YoY. Avg case value $6,420 +4.8%. $127K unbilled restorations easy recovery.
Growth
68/100
1,847 leads +18% YoY but 56% Frisco conversion vs 74% Plano. 142 stalled plans.
Clinical
84/100
Complication rate 0.9% (benchmark 1.5–2.2%). 28 full-arch cases at 62% margin. Frisco lab remake 4.2%.
Patients
66/100
Maintenance compliance 86% Plano · 71% Frisco · 38% Southlake. 532 lapsed cohort.
Payroll
70/100
Surgeon payroll 25.3% (target 22–26%). Southlake margin/hr negative $28. Coordinator hire needed Frisco.

3-site league table · core multispecialty KPIs

Trailing 90 days, sorted by health score
ALL PILLARS
Site Health Production T90 Chair util Visits T90 High-value Avg $/visit Case accept Prod/chair-hr Recare Recoverable
PlanoFlagship
88 $1.74M 91% 3,400 64 $512 71% $610 86% $186K
FriscoGrowth
71 $1.12M 78% 2,300 38 $487 56% $487 71% $412K
SouthlakeUrgent
48 $0.49M 51% 950 12 $516 41% $284 38% $452K
Group 71 $3.35M 75% 6,650 114 $504 63% $487 71% $1.05M

Key trends · trailing 12 months

Top 5 actions · ranked by impact

Unbilled completed restorations — group-wide
38 cases delivered Mar–Apr have no final invoice raised. Clinical notes confirm procedure done; finance ledger has no matching invoice. 7 days of receptionist work.
CLI · DATA FIN · ACTION P1 · WEEK 1
$127K
cash · easy
Frisco coordinator hire
One overloaded coordinator is the upstream cause of 130 missed calls, 170 cold leads, 204 stalled plans. Cost $42K/yr loaded · time 21 days.
PAY · HIRE OPS · CAPACITY P1 · WEEK 1
$186K
recovered · 90d
Southlake maintenance recall reactivation
304 lapsed patients at Southlake. Clinical risk (peri-implantitis 2.4%) + revenue moat. 25 calls/day × 12 days.
PAT · DATA CLI · OUTCOME P2 · WEEK 4
$73K/yr
recurring
Frisco lab supplier review & switch
Frisco remake rate 4.2% vs group 2.3%. Two alternates with quotes $680/case lower & <2% remake. Reversible 4-week trial.
CLI · PROTOCOL FIN · COST P2 · WEEK 5
$58K/yr
direct save
Stalled case-plan recovery (Frisco-dominant)
204 plans presented >30d but not accepted/declined. Scripted follow-up at days 7, 14, 30. New coordinator runs the list.
GRO CLI P2 · WEEK 5
$144K
recovered · 35% conv

Recoverable revenue · summary

$1.05M
T90 ACTIONABLE — STACKED IN CONSULT Cross-pillar leaks invisible from any one system. Bankable on the 90-day plan.
Stalled case plans >30d GROPAY
$412K39%
Missed inbound callbacks OPSGRO
$186K18%
Lapsed maintenance recall PATCLI
$148K14%
Unbilled restorations CLIFIN
$127K12%
Frisco full-arch leak CLIPAY
$104K10%
Other (coord gap, finance, stages) FIN
$75K7%

Opportunity Hub AI-Ranked

12 downstream patient worklists across all six pillars · each tile drills into a named patient list with action CTAs.
LIVE · 1,847 PATIENTS IN VIEW
URGENT · CLI+FIN

Unbilled restorations

38cases
$127,400 at stake
Run 2nd-stage billing flow this week
Open worklist →
URGENT · GRO+CLI

Stalled case plans >30d

204plans
$412,800 at stake
Scripted follow-up days 7/14/30
Open worklist →
URGENT · OPS+GRO

Missed inbound callbacks

428calls
$186,200 at stake
Outbound dialler · Southlake-weighted
Open worklist →
PRIORITY · PAT+CLI

Lapsed maintenance recall

532patients
$148,300/yr recurring
Hygienist-led reactivation campaign
Open worklist →
PRIORITY · CLI+GRO

CBCT done · no plan presented

125patients
$802K case potential
Coordinator follow-up within 7d
Open worklist →
PRIORITY · GRO+FIN

Plan accepted · no deposit

39cases
$64,200 stalled
Re-present finance options
Open worklist →
PRIORITY · CLI+PAY

Frisco full-arch leak

9cases T90
$104K margin recoverable
Lab supplier review + protocol pair-up
Open analysis →
WATCH · CLI+FIN

Lab remake watch (90d)

14remakes
$42,800 cost · Frisco dominant
Per-supplier breakdown in Clinical pillar
Open analysis →
WATCH · FIN

Stage payments overdue

27stages
$27,400 overdue >14d
Reception chases by Friday
Open worklist →
WATCH · PAT

High-LTV at-risk patients

86patients
$186K LTV exposure
Personal call from principal surgeon
Open worklist →
WATCH · GRO+FIN

Finance package declined

62applications
$128K case value
Re-submit via 2nd finance provider
Open worklist →
WATCH · OPS

No-show repeat offenders

18patients
≥2 no-shows in T90
Deposit-required flag at next book
Open worklist →

Top 10 opportunities ranked by recoverable value AI-Ranked

Pulled live from cross-pillar queries · PII masked per DentOps SEC-007 · click any row for full patient timeline
Live
# Patient Site Provider Opportunity Brand / Type Last touch Value Status
1 Patient-3284
Full-arch upper · restored Jun 2024
Southlake
Reyes Lapsed maintenance Straumann · Full-arch Dec 2024 $3,800 17mo lapsed
2 Patient-2917
Multi-tooth lower · restored Sep 2024
Southlake
Reyes Lapsed maintenance Nobel · Multi Mar 2025 $2,400 14mo lapsed
3 Patient-4012
All-on-4 case plan presented Mar 2026
Frisco
Lin Stalled plan 47d Straumann · Full-arch Mar 28 $28,400 Awaiting decision
4 Patient-3744
Restoration delivered Apr 2026 · uninvoiced
Frisco
Okafor Unbilled restoration Astra · Single Apr 14 $3,200 No invoice
5 Patient-2588
CBCT completed Feb 2026 · no plan
Frisco
Lin CBCT · no plan Feb 12 $14,800 98d aged
6 Patient-1842
Full-arch lower · Patterson finance declined
Plano
Whitfield Finance declined Straumann · Full-arch Apr 22 $26,800 Re-submit
7 Patient-4288
Full-arch lower · restored Oct 2024
Southlake
Reyes Lapsed maintenance Nobel · Full-arch Feb 2025 $3,600 15mo lapsed
8 Patient-3198
Bridge on 4 implants · restored May 2024
Southlake
Reyes Lapsed · high LTV Straumann · Multi Nov 2024 $2,900 17mo · risk
9 Patient-3552
Multi-tooth case · 2 reminders sent
Frisco
Okafor Stalled plan 34d Astra · Multi Apr 12 $8,400 Cold
10 Patient-4101
Single upper anterior · never returned post-restoration
Southlake
Reyes Lapsed maintenance Straumann · Single Nov 2024 $1,800 18mo · risk

Patient lifecycle partition · 1,847 post-restoration patients

One bucket per patient · click any segment to filter the dashboard to that cohort
42% Engaged
23% At Risk
18% Lapsing
14% Lost
3%
Engaged
776
42% · attending recalls
View cohort →
At Risk
425
23% · 6–9mo since last visit
View cohort →
Lapsing
332
18% · 9–12mo since last visit
Run reactivation →
Lost
259
14% · >12mo since last visit
Win-back campaign →
Never Returned
55
3% · post-resto no-show
Investigate →
PILLAR · OPERATIONS · TRAILING 90 DAYS

Operations — where the capacity actually goes

A busy multispecialty practice lives or dies on what happens between 8am and 6pm in front of the chair. This pillar answers one question: where is our chair capacity wasted, and why?

Operations filters
Surgeon All surgeons 6
Day
All Mon Tue Wed Thu Fri Sat
Time
All AM Mid-day PM Eve
Chair / Room All 13 chairs
FOCAL QUESTION · OPS

Where is our chair capacity wasted, and why?

894 hrs chair capacity wasted T90 · ≈ $412K opportunity at filled rates
Southlake
499 hrs$227K · 56%
Frisco
273 hrs$133K · 30%
Plano
122 hrs$52K · 14%

Operatory utilization · group · hour × day (T90 avg)

Mon
Tue
Wed
Thu
Fri
8–10am
88%
86%
91%
82%
78%
10am–12pm
92%
94%
95%
90%
81%
12–2pm
68%
71%
66%
72%
62%
2–4pm
82%
84%
88%
79%
66%
4–6pm
71%
68%
74%
62%
48%
≥90% (full)
75–89% (healthy)
60–74% (mid-day)
45–59% (waste)
<45% (bleed)
Bleed cell: Fri 4–6pm at 48% · Southlake-dominant · ≈ $18K/qtr

The same waste · three different stories

Meridian Plano · 2 surgeons · 6 chairs

Out of room

CEILING REACHED
91%
chair util
9.4hrs/wk
idle (7.2 protected admin)

Plano is operating at the physical ceiling of 6 chairs and 2 providers. Only 2.2 hrs/wk are true recovery opportunity — the rest is protected planning, team time, and CBCT review. The capacity lever here is case-mix shift (push more high-value cases), not more chair hours.

Lever · case-mix shift Push high-value case share from 13% to 18% of cases. Same chair time, +$82K/qtr.
Meridian Frisco · 2 surgeons · 4 chairs

Throttled

CONVERSION CAPACITY
78%
chair util
21hrs/wk
idle · 273 hrs T90

Frisco has the demand (386 leads T90, biggest in group) but is choking on conversion capacity. Surgeons sit idle Tue 2–4pm and Thu 11–1pm — precisely when the single coordinator is in back-to-back consults. The upstream coordinator bleed IS the schedule problem.

Lever · hire 2nd coordinator $42K/yr loaded. Recovers ~14 of 21 idle hrs/wk → $133K/qtr. 4.4× ROI in 90 days.
Meridian Southlake · 1.5 FTE · 3 chairs

Demand-starved

UPSTREAM LIMIT
51%
chair util
38.4hrs/wk
idle · 499 hrs T90

Southlake has the schedule capacity but not enough lead supply to fill it. Even at the group's avg 75% conversion, current lead volume (248 T90) caps Southlake at ~750 chair hrs/qtr — leaving 38.4 hrs/wk structurally unfillable. Lead pipeline is the lever, not schedule management.

Lever · marketing supply push Re-pitch Google + Meta with reduced CPL targets. +60% lead supply → fills 22 of 38 idle hrs/wk → $104K/qtr.

Why the capacity is wasted — four diagnostic lanes

Each lane is a different upstream failure feeding the chair-time loss. Click any lane to jump to the pillar that owns the fix.
1

Phone leak — calls that should have become chair hours

496 inbound calls T90 went to voicemail and were never returned. At the group's current consult-to-treatment conversion of 32%, those calls would have filled approximately 142 hrs of operatory time.

271 missed · Southlake 130 missed · Frisco 95 missed · Plano 14.8h median callback delay
142 hrs$142K · phone
Open Telephony
2

Cancellation cluster — slots not refilled in time

368 cancellations T90, of which 198 hrs of slots couldn't be refilled within 5 working days. Cost concerns ($42K cancelled value at 28% rebook) and 'no reason given' ($37K at 22% rebook) dominate the un-recovered tail.

142 short-notice (<24h) 22% no-reason rebook rate No waitlist module live
198 hrs$96K · schedule
Open Appointments
3

Coordinator hand-off failure — accepted plans that never reach the chair

204 case plans accepted in principle but never followed up to deposit + booked treatment date. Frisco owns 128 of the 204 — the bleed sits in the absent relay between "plan signed" and "date in schedule".

1.0 coord FTE Frisco vs 2.0 Plano $402K stalled plan value Avg 47d aged
148 hrs$148K · Growth
Open Growth pillar
4

Lead supply mismatch — Southlake structural ceiling

Southlake has 1,560 available chair hrs/qtr but only 248 leads/qtr to feed them. Even at perfect downstream conversion, current lead supply caps Southlake at ~750 chair hrs — leaving 810 hrs structurally unfillable. The constraint is marketing supply, not schedule.

Southlake CPL $118 vs group $89 71% leads from paid digital (single-channel risk) No referring-dentist activation
320 hrs$91K · Growth
Open Growth pillar

Capacity recovery worklist — ranked by hours returned

Eight specific actions across the four lanes. Sum: +808 hrs of chair capacity recoverable in 90 days ≈ $427K.
Live
#ActionLaneSiteOwnerHrs returned$ impactTime-to-recover
1 Run outbound campaign on 271 Southlake missed callbacks
Dialler-assisted · scripted · 2 hygienists × 4 days
Phone
Southlake
Reception lead 82 $82K 2 weeks
2 Hire 2nd coordinator at Frisco
Closes the consult-throttle bleed · $42K/yr loaded
Coord
Frisco
Frisco PM 182 $186K 21 days hire · 60 days fill
3 Block Tue 2–4pm & Thu 11–1pm at Frisco as call-protected
Interim until 2nd coord starts · existing coord on phone only
Phone
Frisco
Coordinator 26 $28K Week 1
4 Re-pitch Southlake Google + Meta with lower-CPL targets
CPL target $118 → $82 · +60% lead supply
Lead supply
Southlake
Marketing agency 286 $104K 30 days to ramp
5 Build CareStack waitlist module + tag 80 patients
Auto-SMS on cancellation · refill within 24h
Schedule
Frisco
Southlake
Group PM 142 $68K 14 days config
6 Run stalled-plan revival on 128 Frisco accepted plans
Scripted day-7/14/30 cascade · expected 35% conv
Coord
Frisco
New coordinator 62 $72K Weeks 5–10
7 Activate referring-dentist program at Southlake
3 perio + 4 GP relationships · referral pack + lunch
Lead supply
Southlake
Reyes 42 $38K 60 days
8 Push Plano high-value case mix from 13% → 18%
Existing chair time · case-mix shift only · same surgeons
Mix shift
Plano
Whitfield $82K 90 days
Total recoverable capacity · 90 days +808 hrs +$427K Phased Wk 1–12
Inbound calls T90
2,377
+14% YoY
Answer rate (group)
79.2%
Target 88%
Median callback time
14.8hrs
Target <4hrs
Abandoned in queue
6.4%
142 calls T90
After-hours capture
22%
Voicemail-only
Treatment-intent calls
62.1%
1,476 of 2,377

Frisco call answer rate · hour × day heatmap

T90 · darker = lower answer rate
OPS · BRIGHTON
Mon
Tue
Wed
Thu
Fri
9–11am
88%
85%
86%
78%
81%
11am–1pm
79%
68%
76%
51%
72%
1–2pm
61%
54%
63%
58%
66%
2–4pm
76%
42%
71%
58%
64%
4–6pm
82%
74%
84%
73%
85%

Two worst cells (Tue 2–4pm at 42%, Thu 11–1pm at 51%) are coordinator-overlap slots. 68 of 130 missed calls T90 sit in these two windows.

Call volume by site

Monthly, T12
OPS

Call disposition mix

T90 group
OPS

Top missed callbacks — Southlake-dominant AI-Ranked

271 calls T90 · ordered by estimated lead value · click row for call recording link
Live
#Patient / NumberSiteHourIntentVoicemailEst. valueStatus
1+1 (469) 555-••42
Returning Meridian enquiry · 2nd call
Southlake
Thu 12:14Full-arch consultYes · 0:42$24,000No callback
2+1 (469) 555-••18
New enquiry · Google Ads
Southlake
Tue 14:48Multi-toothYes · 0:28$8,400No callback
3+1 (469) 555-••73
Returning patient · maintenance Q
Southlake
Mon 13:22MaintenanceNo$480Callback 36hrs late
4+1 (469) 555-••55
New enquiry · referral
Frisco
Thu 11:34All-on-4 enquiryYes · 1:08$28,400No callback
5+1 (469) 555-••91
Existing post-resto patient
Southlake
Wed 16:10Concern raisedYes · 0:55$3,200No callback · clinical risk
Total chair hours T90
5,306
5.5 FTE providers
Booked chair hours
4,001
+8% vs prior 90d
White space hours
1,305
24.6% unbooked
Restorative hrs T90
3,420
2.5 chair-FTE equivalent
CBCT room util
62%
Single CBCT/site
Avg lead time to treatment
19days
Industry: 47 days

Surgical utilization heatmap · group · hour × day

T90 average — darker = higher booked
OPS
Mon
Tue
Wed
Thu
Fri
8–10am
88%
86%
91%
82%
78%
10am–12pm
92%
94%
95%
90%
81%
12–2pm
68%
71%
66%
72%
62%
2–4pm
82%
84%
88%
79%
66%
4–6pm
71%
68%
74%
62%
48%

Mid-day dip and Friday late-afternoon are protected for restorations and team admin. Southlake is the outlier site contributing most of the Friday-afternoon weakness.

Per-surgeon utilization

T90 vs target
OPS+PAY

Idle chair hours · 12-month trend

Per site
OPS
Total appts T90
3,842
+11% YoY
Completed
3,228
84% complete rate
No-shows
311
8.1% no-show
Cancellations
368
9.6%
Short-notice cancels
142
<24h notice
Avg lead time at book
11.4days
Down from 16

Appointment status mix

T90 group
OPS

No-show rate trend

Monthly by site
OPS

Top cancellation reasons

T90 group · with re-book follow-up rate
OPS
ReasonCount% of cancelsRe-book rateRecovered valueAction
Patient unwell9426%78%$42,800Standard
Cost / finance concern6818%28%$18,200Re-present finance
Work conflict5214%52%$26,400Offer eve/weekend slots
Anxiety / fear3810%48%$14,800Pre-op call protocol
No reason given6217%22%$8,400Deposit at next book
Bereavement / family185%88%$9,800Standard
Found alternate provider144%8%$1,200Win-back call
Other226%40%$4,800
Total368100%48%$126,400$140K not recovered
Post-resto patients
1,847
Active maintenance book
6mo recall compliance
71.2%
Southlake 38% drag
12mo recall compliance
62.4%
Target 80%
Lapsed cohort >9mo
532
$148K LTV exposure
Booked-at-checkout %
68%
Plano 92% vs Southlake 22%
Avg reminders to book
2.8
Email + SMS + call

Recare & hygiene recall funnel · T90 group

Due → reminded → booked → attended
PATIENTS + OPS
Recare due6mo since restoration delivered
748
Reminder sequence triggeredEmail + 2× SMS + call attempt
70494%
Recall appointment bookedIn schedule
53371%
Recall attendedMaintenance review delivered
47864% of due
Next maint pre-booked at checkoutCritical retention step
32568% of attended

Recall opportunity queues

Aging-segmented · with recovery probability per cohort
URGENT · PAT

Lapsed 9–12mo

228
60% est. recovery
SMS + call cascade
Open queue →
PRIORITY · PAT

Lapsed 12–18mo

186
35% est. recovery
Personal call from hygienist
Open queue →
WATCH · PAT

Lapsed 18mo+

118
15% est. recovery
Targeted incentive offer
Open queue →
WATCH · CLI

Peri-implantitis surveillance

42
Active clinical risk
Clinical review within 14d
Open list →
PILLAR · FINANCE · TRAILING 90 DAYS

Finance — what each case actually earns after costs

A multispecialty practice's P&L is built case by case. This pillar answers one question: what's the true unit economics of each implant case, and where does margin leak before it hits the bank?

Finance filters
Case type
All Single Multi Full-arch Zygomatic All-on-X
Finance package
All Cash up-front CareCredit Sunbit Patterson CarePay In-house plan
LTV segment
All High >$15K Mid $5–15K Low <$5K
FOCAL QUESTION · FIN

What does a high-value case earn — and where does the margin leak before the bank?

$15,307 56.1% net margin on the avg full-arch case · group T90
The single most lucrative product the practice sells.

Average full-arch case · $27,300 → $15,307 in 5 steps

Case revenue
$27,300
Materials
−$2,480
Lab
−$4,200
Surgeon time
−$3,205
Indirect
−$2,108
Net margin
$15,307

But the average hides where margin really varies · per-case anatomy

3 case types · T90 cases placed · avg margin per case · cost stack as proportion of revenue

Single-tooth implant
214 cases T90 · 68% of volume · avg case value $3,180
$1,650
52% margin · $1,530 cost
High volume · low absolute $ · simplest workflow. $353K T90 margin contribution.
Multi-tooth (2–4)
71 cases T90 · 23% of volume · avg case value $8,400
$4,360
52% margin · $4,040 cost
Volume play · highest-leverage capacity use. $310K T90 margin contribution.
Full-arch / All-on-4
28 cases T90 · 9% of volume · avg case value $27,300
$15,307
56% margin · $11,993 cost
9% of cases → 35% of total T90 margin. $429K margin contribution.

The same case · three different P&Ls

Meridian Plano

Margin compound

BEST-IN-CLASS
34.9%
net margin (site P&L)
$17,196
margin / full-arch case

Plano compounds three advantages: best surgeon hour ($610/hr), cheapest lab ($4,020/case, 1.2% remake), shortest surgery (8.2 hrs/full-arch). Net contribution T90: $608K. The lever is volume × full-arch share.

Lever · push case-mix Lift high-value case share from 13% to 18%. Same chair time → +$82K/qtr margin.
Meridian Frisco

Lab + time leak

SUPPLIER + PROTOCOL
20.7%
net margin · 14 pts gap to Plano
$13,365
margin / full-arch · −$3,831 vs Plano

Frisco bleeds $3,831 of margin per full-arch case: 42 min longer surgery time, $800 higher lab cost (Northstar 18.2% of rev), 4.2% remake rate vs Plano's 1.2%. Volume is healthy, unit economics are not.

Lever · supplier review + protocol pair-up Lab switch + 6-week Whitfield mentoring → close 60% of gap → +$138K/yr margin.
Meridian Southlake

Sub-scale economics

STRUCTURAL DRAG
−0.8%
net margin · operating loss T90
$11,890
margin / full-arch · 1 case T90

Southlake isn't unprofitable per case — it's unprofitable per quarter. Fixed costs ($417K T90) divided by sub-scale revenue ($490K) leaves $4K net contribution loss. The unit economics on a single-tooth case ($1,240 margin) are sound; the volume is the problem.

Lever · revenue → breakeven Lift T90 revenue from $490K to $700K = breakeven · drives off lead supply & full-arch capability build.

Where margin leaks before it hits the bank — four diagnostic lanes

Cases done, value earned, but the cash doesn't land. $346K of recoverable margin sitting in the gaps.
1

Unbilled completed restorations — cash literally on the floor

38 cases delivered Mar–Apr with final invoice never raised. Clinical notes show procedure complete; finance ledger has no matching invoice. Frisco owns 19, Southlake 11, Plano 8. Seven days of receptionist work to recover.

38 cases · 7 days work Avg case $3,355 No new clinical work
$127Kcash · easy
Run billing flow
2

Frisco lab waste — 4.2% remake rate vs 1.2% benchmark

Northstar Lab remake rate is 3.5× Plano's DentalCraft. $28K of remake cost T90. Two alternate suppliers have quoted $680/case lower with sub-2% remake. 4-week reversible trial on next 8 full-arch cases at Frisco.

14 remakes T90 $28K direct waste Trial fully reversible
$58K/yr · supplier
Open supplier scorecard
3

Finance package declines — 62 accepted plans where finance fell through

Patient said yes, finance company said no. 62 cases T90 sit in this gap. Patterson CarePay (64% approval, 4.4% default) is the biggest contributor. Re-submit via CareCredit or Sunbit in 28 of these cases recovers approximately 70% based on T12 data.

62 cases · $128K case value Patterson 64% approval drag 2nd-submit hist. 71% recovery
$64Krecoverable · finance
Open finance worklist
4

Stage payments overdue — multi-stage cases mid-flight

Multi-stage cases (full-arch · finance-funded over 12–48 mo) sometimes drop a stage payment. 27 stages overdue >14 days. $27K outstanding. Reception chase + auto-DD retry recovers ~95%.

27 stages overdue Median 19 days late In-house plan 4.4% default — tighten screening
$27Kcash · admin
Open chase list

Margin recovery worklist — ranked by $ impact

Six specific actions across the four leak lanes. Sum: $346K of margin recoverable inside 90 days with no new clinical work.
Live
#ActionLeakSiteOwner$ recovery% marginTime-to-cash
1 Run unbilled restoration billing flow on 38 cases
Clinical notes → invoice generation → email send · 7 days
Unbilled All 3 sites Reception leads $127K 100% 1 week
2 Switch Frisco lab supplier (4-week trial on 8 cases)
Northstar → Supplier B · $680/case lower · target <2% remake
Lab waste
Frisco
Group clinical lead $58K/yr 85% 4 weeks trial
3 Re-submit 28 Patterson-declined finance applications to CareCredit/Sunbit
2nd-submit historical recovery rate 71%
Finance All 3 sites Coordinators $64K 56% 14 days
4 Push Plano high-value case mix from 13% → 18%
Same chair time · case-mix shift only · existing surgeons
Mix shift
Plano
Whitfield $82K 56% 90 days
5 Run stage-payment chase on 27 overdue stages
Auto-DD retry + reception phone call · ~95% recovery
Collections All 3 sites Practice manager $26K 100% 5 days
6 Tighten in-house finance plan screening (4.4% default)
Credit check + min deposit · forward-looking · avoid future $21K/yr default
Policy All 3 sites Finance lead $21K/yr Policy change · this month
Total recoverable margin · 90 days (mix of one-off cash + annualised) $346K Phased Wk 1–12
FOCAL QUESTION · FIN · INDICATION ECONOMICS

What does each specialty generate — top-line vs gross margin?

★ HIGHEST MARGIN INDICATION
All-on-X
$18,560/case · 58% margin · $148K T90 from 8 cases
VOLUME DRIVER
Single-tooth
223 cases T90 · 71% of volume · $368K margin (31% of total)
CONCENTRATION (THE 80/20)
8% → 35%
Full-arch + All-on-X = 8% of cases · 35% of margin

Specialty × economics · T90 · all 3 sites

8 specialties · top-line vs cost vs margin · % contribution to total · $ per chair-hour
Total production · $3.35M (all specialties · 6,650 visits T90)
Specialty Cases T90 Avg case $ Top-line $ Direct cost $ Gross margin $ Margin % % of total margin $ / chair-hr
Impl/OSImplants & Oral Surgery 210 $4,310 $905K $398K $507K 56% 30% $642
OrthoOrthodontics (incl. aligners) 88 $6,480 $570K $274K $296K 52% 18% $410
ProsthoProsthodontics (crown & bridge, dentures) 430 $1,210 $520K $265K $255K 49% 15% $452
PerioPeriodontics (SRP, perio surgery) 540 $778 $420K $223K $197K 47% 12% $360
EndoEndodontics 270 $1,241 $335K $167K $168K 50% 10% $470
RestoRestorative (fillings, onlays) 1,290 $233 $300K $168K $132K 44% 8% $300
HygHygiene & Preventive (recare, exams, x-rays) 3,100 $65 $200K $124K $76K 38% 4% $210
CosmCosmetic (veneers, whitening) 95 $1,053 $100K $42K $58K 58% 3% $520
Group total (all specialties) 6,650 visits $504 $3.35M $1.66M $1.69M 50.4% 100% $470

THE INDICATION CONCENTRATION STORY

Full-arch (18 cases) + All-on-X (8 cases) = 8.3% of total volume but 35% of total gross margin. Single-tooth at 71% of cases generates 31% of margin — high-volume but margin-thin. Zygomatic (49% margin) and Adjunct (49% margin) are slower because of higher direct cost burden (Zygomatic implant fixtures alone are $6,400/case). The lever for the practice is case-mix shift toward full-arch + All-on-X: each 1% shift from single → full-arch is worth ~$24K/qtr of incremental gross margin.

Cost anatomy · Implants & Oral Surgery case types · % of revenue

SINGLE-TOOTH · 223 CASES
Avg case $3,180 · low complexity
$1,650
52% margin · per case
margin 52%cost 48%
T90 contribution: $368K margin · 31% of total
MULTI-TOOTH · 62 CASES
Avg case $8,400 · 2–4 implants
$4,360
52% margin · per case
margin 52%cost 48%
T90 contribution: $271K margin · 23% of total
★ FULL-ARCH · 18 CASES
Avg case $27,300 · single jaw
$15,307
56% margin · per case
margin 56%cost 44%
T90 contribution: $276K margin · 23% of total
★ ALL-ON-X · 8 CASES
Avg case $32,000 · immediate-load
$18,560
58% margin · highest in group
margin 58%cost 42%
T90 contribution: $148K margin · 12% of total
ZYGOMATIC · 2 CASES
Avg case $42,000 · rescue protocol
$20,580
49% margin · cost-heavy
margin 49%cost 51%
T90 contribution: $41K margin · 3% of total
ADJUNCT · OVERLAY ON 39 CASES
+$4,800 avg premium · graft / sinus on base case
$2,352
49% margin · materials drag
margin 49%cost 51%
T90 contribution: $92K margin · 8% of total

Specialty × site · case volume distribution

Specialty
Plano
Frisco
Southlake
Total
Implants & Oral Surgery
120
70
20
210
Orthodontics
48
32
8
88
Prosthodontics
210
150
70
430
Periodontics
260
200
80
540
Endodontics
130
90
50
270
Restorative (fillings, onlays)
560
480
250
1,290

Plano indexes premium — leads on implants, oral surgery, orthodontics and high-value prosthodontics. Southlake is overwhelmingly general/restorative · minimal implant, ortho or endo depth. The specialty-mix gap IS the per-chair-hour margin gap. Hygiene & preventive and cosmetic volumes are reported separately in the recare and revenue views.

Total revenue T90
$3.35M
+12.1% YoY
Implants & OS revenue
$905K
27% of total
Orthodontics revenue
$570K
17%
Prosthodontics revenue
$520K
16%
Hygiene & recare revenue
$200K
Recurring
Perio / Endo / Resto / cosmetic
$1,155K
34%

Revenue by case type · T12 trend

Monthly group
FIN

Per-provider revenue contribution

T90
FIN+PAY

Revenue per chair-hour · per provider per site

T90 actual vs internal benchmark
FIN+OPS+PAY
ProviderSiteChair hrs T90Revenue$/hrvs benchmarkHigh-value share
Dr. James Whitfield
Plano
1,124$940K$836+36%38%
Dr. Priya Mehta
Plano
1,058$800K$756+23%12%
Dr. Marcus Lin
Frisco
1,012$610K$603−2%22%
Dr. Sarah Okafor
Frisco
894$510K$570−7%8%
Dr. David Reyes
Southlake
832$280K$337−45%2%
Locum (Southlake)
Southlake
386$210K$544−12%0%
Group5.5 FTE5,306$3.35M$6319%
Collections efficiency
94.6%
Target 95%
Outstanding AR
$428K
+$42K vs prior 90d
DSO group
24days
Southlake 42 / Plano 18
Deposit collection
90.8%
All sites >88%
Write-offs T90
$14.8K
0.44% of revenue
Refunds T90
$8.4K
12 transactions

AR aging buckets

$ outstanding by days outstanding
FIN

Payment method mix

T90
FIN

Patient financing take-up & lender performance

T90 · approval rate, average term, default rate
FIN+GRO
ProviderApplicationsApproval rateAvg amountAvg termDefault T12Recommendation
CareCredit18682%$8,40024 mo1.2%Primary
Sunbit11478%$12,20036 mo2.1%Use for $10K+
Patterson CarePay4264%$18,40048 mo2.8%Use for $15K+ cases
Direct (in-house plan)28100%$4,20012 mo4.4%Tighter screening

Collections worklists

Live aging by patient
URGENT · FIN

AR >90 days

$46K
14 patients
Practice manager escalation
Open queue →
PRIORITY · FIN

AR 61–90 days

$82K
28 patients
Reception chase letter
Open queue →
WATCH · FIN

AR 31–60 days

$148K
62 patients · normal
Auto-reminder series
Open queue →
WATCH · FIN

Direct-debit failures

8
In-house plan defaults
Manual collection
Open queue →
Avg margin per case (group)
$3,294
51.3% margin
Single-tooth margin
$1,528
48.1% margin
Multi-tooth margin
$3,840
52.4% margin
Full-arch margin
$15,307
56.1% margin
Lab cost % revenue
15.6%
Frisco 18.2% high
Material cost / case
$642
Implant + abutment + comp.

Full-arch case anatomy · group average

Revenue, direct cost, indirect, margin
FIN+CLI+PAY
Component$Source% of revenue
Total case revenue$27,300100%
Implant fixtures (4×)($1,840)Materials6.7%
Abutments + components($640)Materials2.3%
Provisional lab fee($780)Lab2.9%
Definitive zirconia bridge lab($3,420)Lab12.5%
Surgeon time (8.5 hrs loaded)($2,565)Payroll9.4%
Surgical nurse + assistant($640)Payroll2.3%
Room + sterilisation overhead($980)Overhead3.6%
Coordinator + admin($340)Payroll1.2%
Finance company fee (2.4% on $18K)($432)Finance1.6%
Marketing attribution($280)Growth1.0%
Lab remake allowance (1.8%)($76)Provision0.3%
Total cost($11,993)43.9%
Net margin per case$15,30756.1%

Margin per case type · per site

$ contribution
FIN

Lab cost % revenue by supplier

T90
CLI+FIN
PILLAR · GROWTH · TRAILING 90 DAYS

Growth — the lead-to-bank journey

Every prospective patient walks a journey from first enquiry to treatment. This pillar answers one question: for every $1 of marketing, what's the lead-to-bank journey — and where does it leak?

Growth filters
Lead source
All Google Ads Meta Patient ref Dentist ref Organic SEO Walk-in
Funnel stage
All Lead Consult Plan Accepted Deposit
Finance package
All Cash CareCredit Sunbit Patterson CarePay Declined
FOCAL QUESTION · GRO

For every $1 of marketing, what's the lead-to-bank journey — and where does it leak?

37×

$94.6K marketing spend → $3.50M attributed revenue T90. Strong by industry standards (12–18× is benchmark). But the funnel below says we should be at 52× — the gap is one specific drop-off.

1,847
Inbound leads
426
Cases signed
$51
CPL group
$241
Cost / signed

The 10-step funnel · group T90 · $ leaked at each stage (avg case $6,420)

1Inbound leads
1,847
100%
2Call answered
1,463
−$81K−384 · 79%
3Consult booked
1,082
−$80K−381 · 59%
4Consult attended
994
−$19K−88 no-show · 54%
5Diagnostic records complete
806
−$40K−188 · 44%
6Case plan presented
681
−$26K−125 · 37%
7Case plan accepted
426
$1.64M−255 · 23%
8Deposit paid
387
−$250K−39 · 21%
9Treatment completed
358
−29 deferred
10Restoration delivered
312
in healing · ok

THE BIGGEST SINGLE LEAK · STAGE 6 → 7

From 681 case plans presented to 426 plans accepted — the practice loses 255 patients in a single step. That's 14% of every inbound lead. At the group's avg case value of $6,420, this represents $1.64M of treatment value that walked out of the consult room and never came back. Plano converts this step at 71%. Southlake at 41%. Closing the 30-point gap at Southlake alone is worth $185K–$240K. The coordinator hand-off (Lane 3 below) is the dominant cause.

The same funnel · three different stories

Meridian Plano

Compound channels

BENCHMARK
71%
case acceptance rate
38%
leads from patient referral

Plano compounds three advantages: lowest CPL ($68 vs $118 Southlake), highest referral share (38% — patients refer patients), and best conversion at every step. Marketing ROI: 49×. The funnel barely leaks below stage 5.

Lever · protect what works Maintain referral-incentive scheme. Lock the same-day-conversion protocol. No new spend needed.
Meridian Frisco

Demand without capture

MID-FUNNEL LEAK
56%
case acceptance · 15 pts gap to Plano
170
stalled leads · no contact >14d

Frisco has the biggest top-of-funnel (386 leads T90 · largest in group) and the worst mid-funnel leak. Of 258 plans presented, only 144 accepted; 62 still pending past 30 days. The Operations coordinator gap IS the Growth conversion gap.

Lever · close the coordinator gap 2nd coordinator hire (cross-ref Ops) recovers ~$186K of stalled-plan value. Already in the 90-day plan.
Meridian Southlake

Single-channel risk

SUPPLY + CONVERSION
71%
leads from paid digital
$118
CPL · 73% above group

Southlake depends on paid digital for 71% of leads at 1.7× the group's CPL. No active referring-dentist base (only 1 GP). When the ad budget pauses, the lead pipeline collapses. Single-channel concentration risk.

Lever · diversify channels Activate 3 perio + 4 GP referrer programme ($0 marginal cost). Rebalance Google CPL targets. Recover $91K T90.

Where every $1 of marketing actually goes T90 · spend → revenue per channel

Patient referrals ($8 CPL → $1.14M revenue) are the highest-ROI channel by 17×. We invest least in it.
Channel
Revenue attributed
Spend
Signed
ROI
Patient referrals
$3.2K
156
357×
Dentist referrals
$8.4K
88
86×
Walk-in / direct phone
$2.2K
24
42.7×
Google Ads
$42.8K
148
20.9×
Organic SEO
$9.6K
42
19.4×
Meta (FB + Instagram)
$28.4K
82
16.1×

Why the funnel leaks where it does — four diagnostic lanes

Each lane targets a specific funnel drop-off. Combined recovery: $612K of would-be revenue inside 90 days.
1

The "yes but…" leak — 255 plans presented, never accepted

The biggest single drop-off in the funnel: $1.64M of treatment value walked out of the consult room. Avg patient who declined: cost concerns (47%), spouse to decide (18%), wants 2nd opinion (12%). 35% of these are recoverable with scripted day-7/14/30 follow-up.

255 patients 204 still pending past 30d Avg case $6,420 35% historical recovery
$574Krecoverable · 90d
Open Case Acceptance
2

Coordinator gap — accepted plans that never become a deposit

Frisco owns 128 of the 204 stalled plans. The relay between "patient said yes" and "deposit booked" is missing because the single coordinator is in back-to-back consults. This is the same root cause as the Operations capacity leak — visible from a different angle.

128 stalled at Frisco 1.0 coord FTE vs 2.0 Plano Cross-ref Ops Lane 3
$148Krecoverable · Frisco
Open Ops capacity story
3

Cold lead drift — 296 leads not contacted within 14 days

Leads that arrive but never get a real conversation. 170 at Frisco, 98 at Southlake, 28 at Plano. Median age of cold leads: 22 days. Conversion rate drops 4× after day 7 — most of these are now effectively lost without an outbound re-touch sequence.

296 leads · $186K paid value Day-7 conv 18% → day-30 conv 4% Re-touch lift 11pp historical
$82Krecoverable · outreach
Open cold lead worklist
4

Referring-dentist dormancy — 86× ROI channel under-invested

Patient and consultant referrals deliver 86× and 357× ROI respectively. The group has 9 active referring-dentists — all in Plano. Zero active perio or GP referrers at Southlake. $8.4K in referral incentives across all sites — Plano spends 3× more than Southlake on this highest-ROI channel.

9 active referrers (8 Plano) Patient referral CPL $8 Referral CPL $50 No Southlake programme
$38Krecoverable · referral lift
Open referrer programme

Funnel recovery worklist — ranked by stage × $ impact

Six actions targeting the biggest leaks. Sum: $612K of attributed revenue recoverable in 90 days without raising marketing spend.
Live
#ActionStageSiteOwner$ recoveryCases liftedTime-to-cash
1 Run scripted day-7/14/30 follow-up on 204 stalled plans
Frisco 128, Southlake 50, Plano 26 · historical 35% recovery
Plan accept All 3 Coord team $458K 71 30 days
2 Activate Southlake referring-dentist program
3 perio + 4 GP · referral pack + lunch · zero ad spend
Referral
Southlake
Reyes $38K 12 60 days
3 Cold lead re-touch sequence on 296 unhandled leads
SMS + email + call cascade · expected 11pp lift
Lead All 3 Coord team $82K 14 21 days
4 Re-pitch Southlake Google + Meta with lower-CPL targets
CPL $118 → $82 · +60% lead supply at same spend
Lead
Southlake
Marketing agency $104K 22 30 days to ramp
5 Roll out Plano same-day-conversion protocol to Frisco + Southlake
Clinical → CBCT review → plan → deposit → date in one visit
Plan accept
Frisco
Southlake
Group clinical lead $220K/yr 34/yr Week 9 training
6 Switch Plano top 50 patients to active referral programme
$250 reward / completed referral · scales 357× channel
Referral
Plano
Reception lead $42K 8 90 days
Total recoverable revenue · 90 days $612K + $262K/yr run-rate 127 Phased Wk 1–12

Lead pipeline funnel · group T90

10 steps · drop-off per stage · click any stage to see the cohort
GRO+OPS+CLI
Inbound leadsAll channels · web, phone, referral, walk-in
1,847100%
Call answered / form actionedCoordinator picks up within SLA
1,463−384 lost
Consult bookedIn schedule with a date
1,082−381 lost
Consult attendedNo-show filtered
994−88 no-show
Diagnostic records completeRequired for case plan
806−188
Case plan presentedWith options + price + finance
681−125
Case plan acceptedPatient said yes
426−255
Deposit paidCash or finance executed
387−39
Treatment completedTreatment delivered
358−29 deferred
Restoration deliveredFinal crown / bridge / arch
312−46 in healing

Stalled case-plan aging

Plans presented but not accepted/declined, by days aged
GRO
Days agedPlanoFriscoSouthlakeGroup$ valueEst. recovery
0–7 days22381474$472K68%
8–14 days14421268$412K42%
15–30 days8581884$544K28%
31–60 days4682698$636K14%
61–90 days2281444$284K6%
90+ days281222$142K2%
Total5224296390$2.49M~$640K recoverable
Plans presented T90
681
+8% YoY
Acceptance rate (group)
62.6%
Range 41–71%
Avg accepted plan $
$12,820
+$640 YoY
Avg days to accept
11.4
Industry: 8 days
Same-day accept %
38%
Plano 58% / Southlake 18%
Declined T90
142
21% of presented

Acceptance rate by treatment value

T90 · single / multi / full-arch
GRO

Decline reasons

T90 group
GRO

Acceptance funnel by site

T90 · same-day vs delayed acceptance
GRO
SitePlans presentedSame-day acceptDelayed acceptDeclinedStill pendingAcceptance %Avg value
Plano
31218141484271%$14,400
Frisco
2586282526256%$12,180
Southlake
1111431422441%$9,400
Group68125715414212863%$12,820
Marketing spend T90
$94.6K
2.8% of revenue
Cost per lead (group)
$51
−$6 YoY
Cost per consult
$87
−$9 YoY
Cost per signed case
$241
−$42 YoY
Marketing ROI multiple
28.9x
Revenue / spend
Referral % of new pts
27%
Free leads

Channel performance · T90

Spend, leads, consults, signed cases, revenue attributed, ROI
GRO+FIN
ChannelSpendLeadsCPLConsultsSigned casesRevenue attrib.ROI
Google Ads$42,800612$70372148$894K20.9x
Meta (Facebook + Instagram)$28,400422$6722882$456K16.1x
Patient referrals$3,200388$8288156$1,142K357x
Referring dentist / GP$8,400168$5014288$724K86x
Organic web / SEO$9,600158$619442$186K19.4x
Walk-in / phone direct$2,20099$225824$94K42.7x
Total$94,6001,847$511,082540$3.50M36.9x

CAC by channel · 12-month trend

$ per signed case
GRO

Top referring dentists

T90 · cases referred · revenue attributed
GRO
PILLAR · CLINICAL · TRAILING 90 DAYS

Clinical — who's producing what outcomes

In a multispecialty group, "good clinical work" is not a feeling — it's a measurable matrix per provider. This pillar answers one question: which provider at which site is producing the right case mix with the right outcomes — and which lab is hurting us?

Clinical filters
Provider All 6 providers
Implant brand
All Straumann Nobel Astra Neodent
Specialty
All Implants/OS Ortho Perio Endo Prostho
Surgical technique
All Guided Free-hand
Lab supplier All 4 labs
FOCAL QUESTION · CLI

Which provider at which site is producing the right case mix with the right outcomes?

6,650 / 0.9% / 96%

6,650 procedures · 0.9% complication rate · 96% blended clinical success.
Group averages look benchmark-grade. But the average hides who is producing what.

98.4%
Implant survival
2.3%
Lab remake
114
High-value cases T90

Surgeon × Outcome matrix · T90 · cell color = performance vs group

Metric
WhitfieldPlano
MehtaPlano
LinFrisco
OkaforFrisco
ReyesSouthlake
LocumSouthlake
Specialty cases T90
88
54
72
46
42
11
High-value share
38%
12%
22%
8%
2%
0%
Complication % T12
0.6%
0.4%
0.9%
1.1%
1.9%
1.6%
Survival 24mo
99.4%
99.6%
98.6%
98.4%
97.1%
97.8%
Guided surgery %
92%
84%
82%
70%
62%
54%
Lab remake %
1.2%
1.0%
4.2%
3.8%
2.4%
2.6%
Avg chair time
2h 14m
1h 28m
1h 52m
1h 36m
1h 22m
1h 48m
Group-best
Above benchmark
At benchmark
Watch
Critical
★ outline = outlier needing review

Lab supplier scorecard — the $104K margin question

★ CLINICAL HEADLINE
Frisco's Northstar Lab has a remake rate 3.5× Plano's DentalCraft and is the single largest controllable hit to per-case margin. Switch decision is in motion.
Supplier
Cases T90
Avg $ / case
Remake %
Avg TAT
Recommendation
DentalCraft PremiumPlano primary
142
$580
1.2%
14 days
Roll out group-wide
Northstar LabFrisco current · contract review
118
$640
4.2%
21 days
★ Switch · 4-wk trial
Apex Dental LabSouthlake primary
42
$520
2.4%
18 days
Keep · monitor
Specialist Zirconia (3rd-party)Full-arch only · all sites
28
$3,420
1.8%
22 days
Keep for full-arch

Net Frisco impact if switched: 4-week trial on next 8 full-arch cases at Supplier B ($680/case lower, sub-2% remake) → projected $58K/yr direct cost saving + $46K/yr quality margin (fewer remakes, faster TAT, fewer patient re-visits). Trial is fully reversible. Cross-reference: Finance Lane 2.

Three sites · three clinical profiles

Meridian Plano · Whitfield + Mehta

Clinical reference

BEST-IN-CLASS
0.5%
complication rate (group avg 0.9%)
38%
full-arch share (Whitfield)

Plano is the group's clinical reference site: highest complexity (38% full-arch from Whitfield), lowest remake (1.2%), highest guided-surgery rate (88% avg), lowest peri-implantitis (0.4%). The clinical playbook here is what the other two sites should be benchmarked against.

Lever · export the playbook Document Whitfield's pre-op planning protocol, package as a 2-day workshop for Lin and Okafor.
Meridian Frisco · Lin + Okafor

Lab + protocol drag

FIXABLE LEAKS
98.5%
survival · solidly above 97% benchmark
4.2%
lab remake rate · 3.5× Plano

Frisco's clinical outcomes are mostly sound (1.0% complications, 98.5% survival). The drags are process-level not surgeon-level: lab remake rate, 38-min longer surgery per full-arch (Lin), 22% lower guided-surgery on Okafor. All three are operationally fixable inside 90 days.

Lever · supplier + protocol Lab switch (4-week trial) + 6-week Whitfield mentoring on full-arch protocol → close 60% of margin gap.
Meridian Southlake · Reyes + Locum

Specialty depth gap

SPECIALTY BUILD-OUT
2.4%
peri-implantitis · 2× group · clinical risk
12
high-value cases T90 (vs 64 Plano)

Reyes is competent on general restorative work (83% of his volume) but the site has minimal implant, ortho or endo depth and the lowest specialty case mix in the group. Combined with the highest recare-lapse rate, this is a specialty build-out + recall discipline gap, not a clinical-malpractice issue.

Lever · specialty capability build Add visiting endodontist + orthodontist days; refer complex implant cases to Plano. Tighten recare recall (cross-ref Patients). 6-month re-baseline.

Clinical risk & quality lanes

Four areas where outcomes are at risk or controllable cost is being lost. Each tied to a named surgeon, supplier or patient cohort.
1

Frisco lab remake — 14 remakes T90, $42K direct waste

Northstar Lab remake rate is 4.2% vs Plano DentalCraft's 1.2%. Every remake = 4 extra clinical hours + $580 material + delayed patient restoration. Two alternates quoted $680/case lower with sub-2% remake. Reversible 4-week trial.

14 remakes T90 $42K direct waste +56 hrs/qtr clinical time burnt Patient TAT impact 21 → 14 days
$104K/yr · supplier + protocol
Open supplier scorecard
2

Restorations stalled mid-pipeline — 18 cases past 120-day TAT

18 patients have completed surgical phase but no restoration delivered after >120 days post-surgery. Southlake owns 8, Frisco 7, Plano 3. Each one is clinical risk (peri-implantitis) + financial risk (unbilled second stage).

18 patients Avg 156 days since surgery $148K unbilled second stage Cross-ref Finance Lane 1
$148Kunbilled · 18 patients
Open patient list
3

Peri-implantitis surveillance — 42 active risk cases (Southlake-weighted)

42 patients show early peri-implantitis indicators (bleeding on probing > 3mm pocket). 27 are at Southlake — direct consequence of 38% recare compliance vs Plano's 86%. Without 14-day clinical review, ~20% will progress to bone loss requiring intervention (avg cost $1,840 to manage).

42 patients · clinical risk active 27 at Southlake (64%) Est. $15K cost-avoidance per cohort Cross-ref Patients pillar
$77K/yr cost avoidance + reputational
Open surveillance list
4

Reyes complication review — 1.9% vs group 0.9%

Reyes's complication rate is 2× the group average on a relatively narrow case mix (93% single-tooth). Guided-surgery rate is 62% vs group 78%. Pattern suggests technique gap on guided-surgery workflow, not skill deficit — addressable with 2 days of pair-up.

6 complications T12 5 of 6 on freehand cases Guided workflow gap 2-day mentoring fix
~3 cases/yr complication avoidance
Open case review

Clinical quality & protocol worklist — ranked by risk × value

Six actions across the four lanes. Mix of one-off clinical interventions and recurring protocol fixes. Sum: $249K/yr of margin + ~5 complications/yr avoided.
Live
#ActionLaneSite / ProviderOwnerClinical impact$ impactTime-to-effect
1 4-week trial: switch Frisco from Northstar to Supplier B
Reversible · 8 full-arch cases · measure remake + TAT + aesthetic outcome
Lab
Frisco
Group clinical lead −2.5pp remake $104K/yr Decision wk 8
2 Restoration delivery push on 18 stalled cases
Clinical schedule 8 Southlake + 7 Frisco + 3 Plano · 21-day window
Pipeline All 3 sites Site PMs −18 peri-implantitis risk-pts $148K cash 21 days
3 14-day clinical review on 42 peri-implantitis surveillance patients
27 at Southlake · BoP + radiograph · stage interventions
Surveillance All 3 sites Hygienist lead ~8 cases avoided $77K/yr 14 days
4 Whitfield mentors Lin: 6-week full-arch protocol pair-up
Reduce Frisco full-arch surgery time 8.9hrs → 8.3hrs · case-by-case observation
Protocol
Lin
Whitfield −42min/case $46K/yr 6 weeks
5 Reyes guided-surgery workflow upgrade
2-day pair-up with Whitfield · target lift guided % 62 → 80
Technique
Reyes
Whitfield ~3 complications/yr avoided $18K/yr 30 days
6 Document Plano pre-op planning protocol as group SOP
2-day workshop · roll out to Frisco + Southlake · quarterly re-cert
Protocol Group Clinical lead Group quality lift Long-term moat 60 days
Total clinical impact · 90 days ~11 complications avoided $249K + $148K cash Phased Wk 1–12
Implant / OS procedures
210
incl. 28 full-arch
Endodontic (RCT)
270
retreat rate 4.4%
Periodontal (SRP/surgery)
540
incl. 96 surgical
Restorative units
1,290
fillings + onlays
Prosthodontic units
430
crown / bridge / denture
Ortho starts
88
320 active

Implants & Oral Surgery · case mix by provider

T90 · single / multi / full-arch / adjuncts
CLI+PAY
ProviderSiteTotal implantsSingleMultiFull-archBone graftSinus liftGuided %Avg surgery time
Whitfield
Plano
88422818221492%2h 14m
Mehta
Plano
54381608484%1h 28m
Lin
Frisco
7244199161082%1h 52m
Okafor
Frisco
463610010470%1h 36m
Reyes
Southlake
4238406262%1h 22m
Locum
Southlake
1111010054%1h 48m
Group5.5 FTE3132097728623478%1h 44m

Implant fixture mix by brand

T90
CLI

Procedure volume by specialty

T90 group · what kinds of cases
CLI
Restorations delivered T90
312
+9 vs prior 90d
Avg TAT surgery → resto
122days
Target < 120
Lab remake rate
2.3%
Frisco 4.2% drag
Aesthetic re-do
4
1.3% of restorations
Avg lab cost / case
$642
Material + lab fees
Materials in pipeline
$82K
Awaiting delivery

Lab supplier scorecard

T90 · remake rate, TAT, cost, recommendation
CLI+FIN
SupplierPrimary siteCases T90Avg costRemake %Avg TATAesthetic re-do %Recommendation
DentalCraft PremiumPlano142$5801.2%14 days0.8%Primary group-wide
Northstar LabFrisco118$6404.2%21 days2.1%Switch under review
Apex Dental LabSouthlake42$5202.4%18 days1.2%Keep · monitor
Specialist Zirconia (3rd party)Full-arch only28$3,4201.8%22 days0%Keep for full-arch

Restoration TAT trend

Monthly group avg days surgery → delivery
CLI

Restoration type mix

T90 deliveries
CLI
Implant survival 24mo
98.4%
Industry 95–97%
Endo success (RCT)
95.6%
Industry 90–94%
Ortho on-time completion
84%
Industry 75–80%
Perio pocket-reduction
91%
Benchmark 85%
Complication rate (all)
0.9%
Below 1.5–2.2%
Patient satisfaction (NPS)
+68
Top decile dental

Implant survival · cohort analysis

By implant year, survival at 3 / 6 / 12 / 24 months
CLI
Placement cohortImplants placed3mo survival6mo survival12mo survival24mo survivalComplications
2026 H1 (T90)31399.4%3
2025 H268499.3%99.0%9
2025 H162899.4%99.1%98.9%11
2024 H256299.5%99.2%98.9%98.8%12
2024 H141899.6%99.3%99.0%98.7%10

Complication rate by provider

12-month rolling
CLI

Peri-implantitis incidence by site

T12 cohort review
CLI+PAT
PILLAR · PATIENTS · TRAILING 90 DAYS

Patients — the lifecycle moat

A multispecialty practice's most valuable asset is its post-restoration patient book: high-trust, low-acquisition-cost, recurring-revenue, referral-generating. This pillar answers one question: are we keeping our patients for life — and reactivating the ones drifting away?

Patient filters
Cohort
All Engaged At Risk Lapsing Lost Never
LTV segment
All High >$15K Mid $5–15K Low <$5K
Case type
All Single Multi Full-arch Zygomatic All-on-X
Patient vintage
All 2026 2025 2024 < 2024
FOCAL QUESTION · PAT

Are we keeping our patients for life — and reactivating the ones drifting away?

$15.6M
Total cohort LTV locked in
1,847 post-restoration patients · the moat we're protecting
$3.2M
At-risk LTV exposure
Lapsing (332) + Lost (259) cohorts · drifting from active care
$195
Recurring revenue per active pt / yr
Maintenance + hygiene + interventions · pure-margin

Patient lifecycle partition · 1,847 post-restoration patients · one bucket per patient

42%
Engaged
23%
At Risk
18%
Lapsing
14%
Lost
3%
Never
Engaged · 776
$198K/yr
Attending recalls on schedule · protect with checkout-rebooking
Protect →
At Risk · 425
$82K LTV
6–9mo gap · re-engage with SMS + email before crossing into Lapsing
Re-engage →
Lapsing · 332
$148K LTV
9–12mo gap · 60% recoverable with hygienist phone call
★ Reactivate →
Lost · 259
$189K LTV
>12mo gap · 15% recoverable with targeted incentive
Win-back →
Never · 55
Trust gap
Post-resto no-show · investigate satisfaction
Investigate →

The recare moat · per site

An implant patient who attends their 6-month review for 5 years generates $1,200 of high-margin recurring revenue and is 4.2× less likely to develop peri-implantitis. The moat is the practice's most defensible asset — and it's leaking at 2 of 3 sites.

Meridian Plano
A · Benchmark
86%
6-month recare
compliance
Post-resto patients782
12-month compliance81%
Recurring rev / pt / yr$256
Total recurring (Plano)$200K/yr
Peri-implantitis T120.4%
Lapsed >9mo cohort62
Lever — defend the lead: Lock the "next-recall-at-checkout" SOP. No change needed. Use as the group training reference.
Meridian Frisco
C+ · Drifting
71%
6-month recare
compliance
Post-resto patients578
12-month compliance62%
Recurring rev / pt / yr$198
Total recurring (Frisco)$114K/yr
Peri-implantitis T121.1%
Lapsed >9mo cohort166
Lever — workflow enforcement: Roll out Plano's "next-recall-at-checkout" SOP. Daily compliance check by practice manager. Target lift 71 → 80% in 90 days.
Meridian Southlake
F · Hemorrhaging
38%
6-month recare
compliance
Post-resto patients487
12-month compliance29%
Recurring rev / pt / yr$94
Total recurring (Southlake)$46K/yr
Peri-implantitis T122.4%
Lapsed >9mo cohort304
Lever — urgent reactivation: 304-patient hygienist call campaign + workflow build. Worth $73K/yr recurring + $16.5K/yr clinical cost avoidance.

Three sites · three cohort stories

Meridian Plano

Locked-in cohort

FORTRESS
28%
high-value (>$15K LTV) share
157
patient referrals T90

Plano's cohort is the financial fortress: 86% compliance, 28% high-LTV share, 157 patient-driven referrals (highest in group). The patient flywheel is working — engaged patients refer engaged patients. Defend, don't disrupt.

Lever · scale what works Activate top-50 patient referral programme ($250 incentive). Compound the flywheel.
Meridian Frisco

Drifting cohort

RECOVERABLE
166
lapsing patients ($42K/yr recurring at risk)
62%
12-mo compliance · 19 pts gap to Plano

Frisco's cohort is drifting, not yet hemorrhaging. The 166 lapsing patients are mostly recoverable — they haven't crossed the 12-month threshold where re-engagement gets hard. Time-sensitive: every month delayed = 8% drop in recovery probability.

Lever · structured re-engagement SMS + email + call cascade on 166 lapsing patients within 30 days. 60% expected recovery → $25K/yr.
Meridian Southlake

Hemorrhaging cohort

URGENT
304
lapsed >9mo (62% of post-resto book)
2.4%
peri-implantitis incidence (group 1.1%)

Southlake is hemorrhaging on both axes: revenue ($73K/yr recurring at risk) and clinical (2.4% peri-implantitis = 11 patients with active bone loss this year). The cohort isn't just lapsing — it's at active clinical risk. This is the most urgent intervention in the entire dashboard.

Lever · hygienist-led reactivation 304-patient call campaign · 25/day × 12 days · expected 30% reactivation · $73K/yr + $16.5K cost avoidance.

Patient cohort risk & reactivation lanes

Four cohort-level actions. Each tied to a named-patient worklist below.
1

Southlake lapsed cohort — 304 patients, both clinical & financial risk

304 patients at Southlake have not attended recare for >9 months. 27 of them show active peri-implantitis indicators (BoP > 3mm pocket). Without intervention, an estimated 8 will progress to bone loss requiring $1,840 avg intervention.

304 patients 27 active clinical risk 30% expected reactivation $89.5K combined value
$89.5K/yr · clinical + financial
Open callback list
2

High-LTV at-risk — 86 patients, $186K LTV exposure

86 patients with LTV >$15K (full-arch + multi-implant) crossed from Engaged into At Risk in the last 60 days. This cohort costs 9× more to replace than to retain. A personal call from the treating provider recovers 78% historical.

86 patients · avg LTV $2,170 78% historical recovery Principal surgeon call (15 min each)
$145KLTV protected
Open high-LTV list
3

Frisco lapsing cohort — 166 patients, time-sensitive

Frisco's lapsing 166 are in the 9–12 month window where reactivation is still 60% probable. Cross into 12+ months and probability drops to 15%. Every month of delay loses ~14 patients. Structured SMS + email + call cascade closes the leak.

166 patients 60% recovery probability now 14 patients lost/month delayed
$25K/yr recurring · time-bound
Open lapsing list
4

Patient referral programme dormancy — 357× ROI channel under-fed

Patient referrals deliver 357× marketing ROI (cross-ref Growth). Meridian runs no formal referral incentive programme. Top 50 high-LTV patients (avg 4.8 social referrals available each) refer 1.4 patients/yr on average without incentive. With $250 incentive: industry avg lifts to 3.2/yr.

388 patient referrals T90 (organic) No formal programme +1.8/yr lift with incentive
$42K/yr · referral compound
Open programme brief

Top 10 reactivation priorities · Southlake lapsed cohort AI-Ranked

304-patient cohort · top 10 ranked by combined LTV protection + clinical risk · PII masked per SEC-007 · "Launch" generates SMS + assigns to hygienist
Live
#PatientRestoration · BrandLast attendedLapsedClinical riskLTV at stakeAction
1Patient-3284
Reyes · Jun 2024
Full-arch upper · StraumannDec 202417 moBoP active$3,800Welfare call · clinical
2Patient-4288
Reyes · Oct 2024
Full-arch lower · NobelFeb 202515 moBoP active$3,600Welfare call · clinical
3Patient-3198
Reyes · May 2024
Bridge on 4 · StraumannNov 202417 mo3mm pocket$2,900High-LTV call
4Patient-2917
Reyes · Sep 2024
3 lower implants · NobelMar 202514 moNo flags$2,400SMS + call
5Patient-3552
Locum · Aug 2024
2 upper molars · AstraCancelled9 moNo flags$2,200Reschedule offer
6Patient-3744
Reyes · Jul 2024
2 lower premolars · NobelNever18 moNo flags$2,000Welfare check
7Patient-4101
Reyes · Nov 2024
Single upper anterior · StraumannNever18 mo3mm pocket$1,800Welfare call · clinical
8Patient-4012
Reyes · Jan 2025
Single lower molar · StraumannCancelled10 moNo flags$1,600Reschedule offer
9Patient-3641
Locum · Sep 2024
Single upper · NeodentFeb 202514 moNo flags$1,400SMS + call
10Patient-2873
Reyes · Apr 2024
Single lower · StraumannAug 202421 mo3mm pocket$1,800Welfare call

Cohort recovery worklist — ranked by cohort × LTV

Six actions across the four lanes. Sum: $302K of recurring + LTV revenue protected/recovered + ~8 clinical complications avoided.
Live
#ActionCohortSiteOwner$ impactPatientsTime-to-effect
1 304-patient hygienist reactivation campaign · Southlake lapsed
25 calls/day × 12 days · clinical-risk prioritised
Lapsed
Southlake
Hygienist lead $89K/yr ~91 reactivated 21 days
2 Principal-provider personal call on 86 high-LTV at-risk patients
15min each · spread across 6 providers · 78% historical recovery
High-LTV at-risk All 3 sites Principal providers $145K LTV 67 retained 14 days
3 Frisco lapsing cascade · 166-patient SMS+email+call sequence
Time-sensitive · 60% recovery probability NOW · drops 8pp/month
Lapsing
Frisco
Frisco reception $25K/yr 100 retained 30 days
4 Roll out Plano "next-recall-at-checkout" SOP to Frisco + Southlake
Workflow + training + daily compliance check by site PM
Engaged retention
Frisco
Southlake
Group PM $58K/yr Cohort-wide Wk 1 training
5 Activate top-50 Plano patient referral programme
$250/referral · compound the 357× ROI channel
Referral
Plano
Reception lead $42K/yr ~8 new pts 90 days
6 Investigate 55 "Never Returned" post-resto patients · satisfaction call
Trust gap signal · NPS deep-dive · close any clinical loops
Never returned All 3 sites Practice managers Trust signal 55 30 days
Total cohort impact · 90 days $302K + 8 complications avoided ~166 retained Phased Wk 1–12
New implant pts T90
358
+22% YoY
Active patients
3,284
All sites
Net growth T90
+184
New - churned
Churn rate (12mo)
22%
Mostly Southlake
Avg patient tenure
2.8yrs
Group avg
Reactivation rate T90
14%
From lost → re-engaged

Patient demographics · group

Age, gender, insurance payer mix (PPO / FFS / out-of-network), referral source
PAT
Age bandPatients% of cohortAvg LTVImplants placedFull-arch %
Under 3541213%$4,840820%
35–4978424%$6,4201862%
50–641,16836%$9,24042812%
65–7468221%$12,40034222%
75+2387%$8,2009814%

New patient trend by site

T12
PAT

Cohort retention curve

% retained at M0/3/6/9/12/18/24
PAT
Post-resto patients
1,847
Active maintenance book
6mo compliance (group)
71.2%
Southlake 38% drag
12mo compliance
62.4%
Target 80%
Lapsed >9mo
532
$148K LTV exposure
Avg maint $/visit
$148
High-margin recurring
Recurring rev/pt/yr
$195
+$12 YoY

Maintenance compliance by site · T12

Monthly attended-recall %
PAT

Lapsed maintenance recall · Southlake priority cohort AI-Ranked

304 patients · ranked by LTV at risk · PII masked
Live
#PatientRestoration typeBrandLast attendedMonths lapsedRemaining LTVAction
1Patient-3284
Restored Jun 2024 · Reyes
Full-arch upperStraumannDec 202417 mo$3,800Call · clinical risk
2Patient-2917
Restored Sep 2024 · Reyes
3 lower implantsNobelMar 202514 mo$2,400SMS + call
3Patient-4288
Restored Oct 2024 · Reyes
Full-arch lowerNobelFeb 202515 mo$3,600Call · clinical risk
4Patient-3198
Restored May 2024 · Reyes
Bridge on 4 implantsStraumannNov 202417 mo$2,900High-LTV call
5Patient-4101
Restored Nov 2024 · Reyes
Single upper anteriorStraumannNever18 mo$1,800Welfare check
6Patient-3552
Restored Aug 2024 · Locum
2 upper molarsAstracancelled 19 mo$2,200Standard SMS
7Patient-3744
Restored Jul 2024 · Reyes
2 lower premolarsNobelNever18 mo$2,000Welfare check
8Patient-4012
Restored Jan 2025 · Reyes
Single lower molarStraumanncancelled 6mo10 mo$1,600Reschedule offer
Group avg LTV
$8,420
+$420 YoY
High-value (>$15K LTV)
412
22% of cohort
Mid-value ($5–15K)
1,082
59%
Low-value (<$5K)
353
19%
Total cohort LTV
$15.6M
Locked-in value
At-risk LTV exposure
$3.2M
Lapsing + Lost cohorts

LTV distribution by site

Cohort patient counts
PAT+FIN

LTV trend · new cohort vintage

Avg LTV per intake vintage
PAT+FIN
PILLAR · PAYROLL · TRAILING 90 DAYS

Payroll — profitability per clinician per day per chair

The single most important question for a multispecialty practice. This pillar answers it: what is the fully-loaded profitability per clinician per day per chair — and which clinicians are above, at, or below break-even?

Payroll filters
Clinician All 6 providers
Role
All Providers Coordinator Nurse Hygienist Admin
Cost line
All Payroll Lab Materials Overhead
Implant brand
All Straumann Nobel Astra Neodent
Lab supplier All 4 labs
FOCAL QUESTION · PAY

What is the fully-loaded profitability per clinician per day per chair?

★ BEST · WHITFIELD (MAYFAIR)
+$538/hr
+$4,498/day · +$17,196/full-arch case · 93% utilised at $298/hr loaded cost
GROUP AVERAGE
+$329/hr
+$2,762/utilised day · 5.5 provider FTE · $302/hr loaded cost
⚠ WORST · KORHONEN (LEEDS)
−$28/hr
−$234/utilised day · $365/hr loaded cost vs $337/hr revenue · 53% util

Profitability per clinician · per hour × per day × per surgery type · T90

Clinician · Site
UtilOPS
Cost / hrloaded
Rev / hrFIN
Margin / hr★ key
Margin / dayutilised
Margin / singleper case
Margin / full-archper case
Annual contribrun-rate
Dr. James WhitfieldPlano · Principal · Full-arch
93%
$298
$836
+$538
+$4,498
$1,820
$17,196
+$604K
Dr. Priya MehtaPlano · Associate · Single+multi
88%
$262
$756
+$494
+$4,128
$1,820
+$522K
Dr. Marcus LinFrisco · Principal · Multi+full-arch
82%
$285
$603
+$318
+$2,658
$1,480
$13,365
+$322K
Dr. Sarah OkaforFrisco · Associate · Single+multi
74%
$241
$570
+$329
+$2,754
$1,480
+$294K
Dr. David ReyesSouthlake · Principal · Single only
53%
$365
$337
−$28
−$234
$1,240
$11,890
−$23K
Locum (rota)Southlake · 0.5 FTE · Single
48%
$420
$544
+$124
+$1,038
$1,240
+$48K
Group total · 5.5 FTE
75%
$302
$631
+$329
+$2,762
$1,528
$15,307
+$1.77M
Loaded cost / hr = salary + employer NI + pension + allocated overhead (room, sterilisation, nurse, software, insurance) ÷ billed chair hours. Margin / day assumes 8 utilised hours. The $566/hr spread between Whitfield and Reyes is the practice's single biggest controllable lever. Reyes's negative margin isn't a skill issue — it's util at 53%. Push to 70% and margin/hr moves from −$28 to +$138.

Support staff efficiency · cost per throughput unit

Each support role has a productivity metric that scales (or doesn't). Cost per unit answers: are we appropriately staffed for the work?

★ Treatment Coordinator

$ per consult delivered
$35
group avg · per consult
Plano · 2.0 FTE$51 / consult
Frisco · 1.0 FTE$27 (overload)
Southlake · 0.5 FTE$27 (overload)
Group target$40–50 / consult
Read: Frisco and Southlake look cheaper per consult but that's the under-staffing signal — the coordinator can't do the follow-up work (cross-ref Growth Lane 2). Hire 1 Frisco + 0.5 Southlake. Cost: $63K/yr loaded. ROI: ~$224K recoverable.

Hygienist

$ per recare visit
$62
group avg · per visit
Plano · 2.0 FTE$62 (680 visits)
Frisco · 1.0 FTE$50 (420 visits)
Southlake · 1.0 FTE$114 (184 visits)
Cost / pt / yr (Plano)$124
Read: Southlake hygienist is ~50% productive — direct consequence of the 38% recare compliance (cross-ref Patients). Fix demand-side first, not staffing.

Surgical Nurse

$ per surgery supported
$277
group avg · per case
Plano · 3 nurses$245 / case
Frisco · 2 nurses$250 / case
Southlake · 2 nurses$438 / case
Group target$260 / case
Read: Southlake nurse cost is 1.8× per case — sub-scale fixed cost. Cuts only after surgical volume justified (cross-ref Ops capacity lane).

Three sites · three cost structures

Meridian Plano

Cost discipline

22.4% PAYROLL
+$516
margin per chair-hour
$1.12M
provider contribution T90

Plano's payroll % of revenue is best-in-group (22.4% vs 25.3% group). High utilization + tight materials cost ($580 lab) + low remake rate (1.2%) compound into +$516/hr provider margin. The cost structure is the benchmark.

Lever · case-mix shift compound Lift full-arch share 13% → 18%. Same payroll, same overhead. +$82K/qtr direct to bottom line.
Meridian Frisco

Throttled by support

26.1% PAYROLL
+$323
margin per chair-hour
18.2%
lab + materials (vs 14% Plano)

Frisco's surgeons are productive (+$323/hr) but two cost lines bleed margin: lab at 18.2% (vs Plano 14%) and coordinator under-staffing (1.0 FTE for 386 consults). Fix both and Frisco's payroll % drops 4 pts.

Lever · lab switch + coord hire $58K/yr direct + $42K/yr coord = $100K cost shift unlocking $186K of stalled revenue.
Meridian Southlake

Sub-scale loss

31.8% PAYROLL
−$28
margin / hr · only negative provider
−$23K
Reyes T90 contribution

Southlake is the only site with a surgeon producing negative contribution per hour. The diagnosis: not the provider, the utilization. At 53% util, $365/hr loaded cost beats $337/hr revenue. Lift util to 70% (the Phase 1 plan target) and margin/hr swings +$166 to a healthy +$138.

Lever · feed the chair Lead supply push (Growth Lane 4) + recare reactivation (Patients Lane 1). No payroll change. Utilization does the work.

Cost-side levers — four diagnostic lanes

Each lane targets a different P&L line. $406K/yr of margin recoverable through cost-side interventions alone.
1

Southlake negative margin — Reyes at −$28/hr

The only clinician at the practice producing negative contribution. Not a skill issue, not a pricing issue — a utilization issue compounding a sub-scale site. At 53% util × 832 hrs T90, Reyes loses $23K of contribution. At 70% util (Phase 1 plan target), same surgeon, same cost structure, swings to +$23K positive.

53% util (target 75%) $365/hr loaded cost $337/hr revenue Solution = lead supply, not payroll cut
+$46K/qtr swing
Open util plan
2

Frisco coordinator under-staffing — 1 FTE doing the work of 2

1.0 coord FTE at Frisco supports 386 consults T90. Plano runs 2.0 coord FTE for 412 consults. The throughput gap ($27 vs $51 per consult) looks efficient on paper but it's the under-staffing signal — the coordinator can't do follow-up, plans stall, deposits stall, chair hours sit idle. $42K/yr hire → $186K/yr revenue unlocked.

1.0 FTE vs 2.0 Plano 204 stalled plans Frisco-dominant 21 idle chair-hrs/wk Cross-ref Ops + Growth
+$186K/yr revenue · $42K cost
Open hiring brief
3

Frisco lab+materials drag — 18.2% of revenue

Frisco's lab+materials cost is 18.2% of revenue vs Plano's 14.0%. Northstar Lab (4.2% remake rate) is the dominant driver. Switching to alternate supplier (4-week trial in motion) closes $58K/yr direct cost. Materials side is bulk-negotiated already; no further lever.

Lab 18.2% (vs Plano 14.0%) 4.2% remake = $42K T90 direct waste Supplier B quoted $680/case lower
$58K/yr · direct cost
Open lab scorecard
4

Southlake hygienist productivity — $114 per visit

Southlake hygienist cost is 1.8× group average per visit ($114 vs $62 Plano). This is a demand problem, not a cost problem: 184 visits T90 vs Plano's 680. Fixing the recare compliance (Patients pillar) raises hygienist visit volume to ~400, dropping cost/visit to $53. Don't cut the role — feed it.

$114 / visit (group $62) 184 visits T90 (target 400) 38% recare compliance Cross-ref Patients Lane 1
+$14K/qtr efficiency
Open Patients moat

Cost-structure worklist — ranked by $ impact

Six actions. Some are cost cuts; most are cost shifts (e.g., +$42K coord hire unlocks $186K revenue). Sum: $406K/yr margin + $210K cost-shift unlock.
Live
#ActionLeverSiteOwnerCost$ impactTime-to-effect
1 Hire 2nd coordinator at Frisco
Unlocks 21 idle chair hrs/wk + 204 stalled plans recovery
Hire
Frisco
Frisco PM +$42K/yr +$186K/yr 21d hire · 60d fill
2 Switch Frisco lab supplier (4-week reversible trial)
Northstar → Supplier B · $680/case lower · sub-2% remake
Supplier
Frisco
Group clinical lead $0 (trial) $58K/yr 4 weeks trial
3 Push Reyes util 53% → 70% via lead + recall plan
No payroll change · drives margin/hr from −$28 → +$138
Utilization
Southlake
Reyes + marketing $0 +$138K/yr swing 90 days
4 Hire 0.5 FTE coordinator at Southlake
Combined role with marketing analyst · supports Phase 1 momentum
Hire
Southlake
Group HR +$21K/yr +$38K/yr Day 61 of plan
5 Annual contract review on Straumann fixture pricing
5% bulk discount achievable at current volume · $142K spend
Materials Group Group procurement $0 $28K/yr Quarterly review
6 6-week Whitfield → Lin full-arch protocol mentoring
Cuts Frisco full-arch surgery time 8.9hrs → 8.3hrs
Protocol
Frisco
Whitfield · Lin $0 $46K/yr 6 weeks
Total cost-side impact · annualised +$63K/yr +$494K/yr margin 7.8× ROI
Group margin / chair-hr
$329
Target $290
Best · Whitfield
+$538
Flagship benchmark
Worst · Reyes
−$28
Util-driven
Group rev/surg day
$5,420
Avg 8-hr day
Top surgeon rev/day
$6,990
Whitfield Plano
Margin / full-arch case
$15,307
Avg group

Provider profitability matrix · per-hour, per-day, per-case

T90 · the answer to "profitability per clinician per day per chair"
PAY+OPS+CLI+FIN
Provider Site Loaded cost/hr PAY Util % OPS Revenue/hr FIN Margin/hr Revenue/day Margin/day Margin/single-tooth case Margin/full-arch case
Whitfield
Plano
$29893%$836+$538$6,990$4,498$1,820$17,196
Mehta
Plano
$26288%$756+$494$6,318$4,128$1,820
Lin
Frisco
$28582%$603+$318$5,040$2,658$1,480$13,365
Okafor
Frisco
$24174%$570+$329$4,770$2,754$1,480
Reyes
Southlake
$36553%$337−$28$2,820−$234$1,240$11,890
Locum
Southlake
$42048%$544+$124$4,560$1,038$1,240
Group5.5 FTE$30275%$631+$329$5,420$2,762$1,528$15,307

Margin per surgeon · 12-month trend

$ per hour
PAY

Surgeon revenue / cost ratio

T90 · target >2.0x
PAY+FIN
Support staff cost T90
$492K
14.7% of revenue
Coordinators
3.5 FTE
Target 5.0
Surgical nurses
7 FTE
2/site Plano+Frisco
Hygienists
4 FTE
Implant maintenance
Admin / reception
5 FTE
Including practice manager
Staff turnover T12
9%
Industry avg 23%

Support staff cost · per FTE per site

T90 loaded cost · with productivity ratio
PAY+OPS
RoleSiteFTELoaded cost T90Cost / FTEThroughput metricCost / unit
Treatment coordinatorPlano2.0$21,000$10.5K412 consults$51 / consult
Treatment coordinatorFrisco1.0$10,500$10.5K386 consults$27 / consult
Treatment coordinatorSouthlake0.5$5,250$10.5K196 consults$27 / consult
Surgical nursePlano3$48,000$16K196 surgeries$245
Surgical nurseFrisco2$32,000$16K128 surgeries$250
Surgical nurseSouthlake2$28,000$14K64 surgeries$438
HygienistPlano2$42,000$21K680 maint visits$62 / visit
HygienistFrisco1$21,000$21K420 maint visits$50
HygienistSouthlake1$21,000$21K184 maint visits$114
Reception / adminAll sites5$82,000$16.4K994 consult check-ins$82
Lab spend T90
$348K
10.4% of revenue
Materials T90
$176K
5.2% of revenue
Total cost of goods
$524K
15.6% (Frisco drag)
Avg lab $/case
$642
Group avg
Avg material $/case
$480
Bulk-negotiated
Lab remake waste T90
$28K
14 remakes

Materials cost breakdown · per case type

T90 · fixtures + abutments + bone graft material
PAY+CLI
ComponentSingleMultiFull-archGroup T90 spend
Implant fixtures (Straumann premium)$460$1,380$1,840$128,400
Abutments + healing caps$140$420$640$42,800
Bone graft material$0$180$420$24,200
Surgical kit / consumables$62$94$148$18,200
Other (drapes, sutures, anaesthetic)$28$44$68$8,400
Avg materials per case$690$2,118$3,116$222,000

Lab spend by supplier · T90

All sites
PAY+CLI

Materials spend trend · 12mo

$K/month
PAY
CROSS-CUT · LOCATION COMPARE

Location Compare — benchmark, gap, lever

Operations is one site's story · Finance another's · Patients another's. This cross-cut view asks: which site sets the benchmark on each pillar, and what's the value of closing the gap on the other two?

CROSS-PILLAR · ALL 6 · TRAILING 90 DAYS

Which site sets the benchmark on each pillar — and what's the value of closing the gap on the other two?

★ FLAGSHIP · BENCHMARK
Meridian Plano
London W1 · 2 surgeons · 6 chairs · est. 2014
88
/100
Health score
T90 revenue $1.74M · margin +$516/hr · leads on 5 of 6 pillars
GROWTH · UNBLOCK
Meridian Frisco
Frisco BN1 · 2 surgeons · 4 chairs · est. 2020
71
/100
Health score
T90 revenue $1.12M (+28% YoY) · margin +$323/hr · leads on cost/hr only
⚠ STRUGGLING · URGENT
Meridian Southlake
Southlake LS1 · 1.5 FTE · 3 chairs · est. 2024
48
/100
Health score
T90 revenue $0.49M · margin +$48/hr · benchmark on 0 pillars

BENCHMARK MAP · CLOSE THE GAP TO LEADER ON EACH PILLAR Total gap-closure value · $2.43M (gross, before cross-pillar de-dup)

Pillar
Marquee metric
Benchmark
Other-site gap
What the gap-close unlocks
Gap-closure
Operations
Operatory util
MAY 91%
Frisco −13pp · Southlake −40pp
+808 hrs/qtr chair capacity
$427K
Finance
Net margin %
MAY 34.9%
Frisco −14pp · Southlake −36pp
Margin recovery (unbilled, finance, lab)
$346K
Growth
Case acceptance rate
MAY 71%
Frisco −15pp · Southlake −30pp
Funnel leak closure (255 walked patients)
$612K
Clinical
Lab remake rate
MAY 1.2%
Frisco +3.0pp · Southlake +1.2pp
Quality + 11 complications avoided
$249K
Patients
Recare compliance
MAY 86%
Frisco −15pp · Southlake −48pp
532 lapsed patients reactivated
$302K
Payroll
Margin per chair-hour
MAY +$516
Frisco −$193 · Southlake −$468
Cost-side shift (+$63K cost → +$494K)
$494K
Plano is the playbook · Frisco beats Plano on loaded surgeon cost/hr ($263 vs $280); Southlake is benchmark on nothing.
$2.43M
Focus pillar
All pillars Operations Finance Growth Clinical Patients Payroll
View
Side-by-side Benchmark vs gap Gap-rank

Side-by-side · marquee metrics from each bespoke pillar

30 KPIs across 6 pillars · benchmark cell highlighted · click any Lever to jump to that pillar's action plan
T90 · all 3 sites · click pillar header to collapse
KPI Plano Frisco Southlake Gap to benchmark Lever (jump to pillar)
Operations Gap-closure · $427K
Operatory utilization91%78%51%Frisco −13pp · Southlake −40pp→ Capacity Story
White space hrs/week (lower = better)9.421.038.4Frisco +11.6 · Southlake +29.0→ Schedule & Util
Call answer rate92%81%51%Frisco −11pp · Southlake −41pp→ Telephony
No-show rate (lower = better)4.8%8.6%12.4%Frisco +3.8pp · Southlake +7.6pp→ Appointments
Same-day book at consult64%48%28%Frisco −16pp · Southlake −36pp→ Capacity Story
Finance Gap-closure · $346K
Net margin %34.9%20.7%−0.8%Frisco −14pp · Southlake −36pp→ Case Economics
Revenue per chair-hour$610$487$284Frisco −$123 · Southlake −$326→ Revenue
Avg case value$7,240$6,150$4,820Frisco −$1,090 · Southlake −$2,420→ Revenue
Full-arch margin per case$17,196$13,365$11,890Frisco −$3,831 · Southlake −$5,306→ Unit Economics
DSO (days sales outstanding) (lower = better)182642Frisco +8d · Southlake +24d→ Collections
Growth Gap-closure · $612K
Case acceptance rate71%56%41%Frisco −15pp · Southlake −30pp→ Lead-to-Bank Journey
Lead → consult conversion74%56%41%Frisco −18pp · Southlake −33pp→ Lead Pipeline
Marketing ROI multiple49×29×16×Frisco −20× · Southlake −33×→ Marketing ROI
Patient referral % of leads38%22%14%Frisco −16pp · Southlake −24pp→ Marketing ROI
Stalled plans >30d (lower = better)2612850Frisco +102 · Southlake +24→ Case Acceptance
Clinical Gap-closure · $249K + 11 complications avoided
Lab remake rate (lower = better)1.2%4.2%2.4%Frisco +3.0pp · Southlake +1.2pp→ Performance Matrix
Complication rate (lower = better)0.7%0.8%1.9%Frisco +0.1pp · Southlake +1.2pp→ Outcomes & Survival
Guided surgery %88%76%62%Frisco −12pp · Southlake −26pp→ Surgeries
Implant / OS cases T9014211853Frisco −24 · Southlake −89→ Surgeries
High-value cases T901891Frisco −9 · Southlake −17→ Surgeries
Patients Gap-closure · $302K + 8 complications avoided
Recare compliance86%71%38%Frisco −15pp · Southlake −48pp→ Recare & Recall
Recurring rev / pt / yr$256$198$94Frisco −$58 · Southlake −$162→ LTV & Segmentation
Peri-implantitis T12 (lower = better)0.4%1.1%2.4%Frisco +0.7pp · Southlake +2.0pp→ Lifecycle Moat
Lapsed >9mo cohort (lower = better)62166304Frisco +104 · Southlake +242→ Recare & Recall
Patient referrals T901578635Frisco −71 · Southlake −122→ Lifecycle Moat
Payroll Gap-closure · $494K/yr at +$63K cost
Margin per chair-hour+$516+$323+$48Frisco −$193 · Southlake −$468→ Profitability Matrix
Surgeon payroll % rev (lower = better)22.4%26.1%31.8%Frisco +3.7pp · Southlake +9.4pp→ Provider Economics
Lab + materials % rev (lower = better)14.0%18.2%15.6%Frisco +4.2pp · Southlake +1.6pp→ Lab & Materials
Loaded cost / surgeon / hr (lower = better · Frisco leads!)$280$263$392Plano +$17 · Southlake +$129→ Provider Economics
Coordinator FTE per 200 consults0.970.520.51Frisco −0.45 · Southlake −0.46→ Support Staff Costs
TOTAL GAP-CLOSURE OPPORTUNITY · all 3 sites brought to benchmark$2.43M gross · $1.4–1.8M net of cross-pillar overlap

Specialty mix × site · case volume + margin contribution

Each site sells a different case-mix. Plano indexes premium (high-value implants, oral surgery + ortho dominance); Frisco mid-mix (balanced, ortho + hygiene heavy); Southlake general-led (restorative + hygiene, minimal specialty depth). This is the structural reason for the per-chair-hour margin spread.

Specialty
Plano cases · margin
Frisco cases · margin
Southlake cases · margin
Group margin
Implants & Oral Surgery
120 · $300K
70 · $172K
20 · $35K
$507K
Orthodontics
48 · $165K
32 · $108K
8 · $23K
$296K
Prosthodontics
210 · $128K
150 · $90K
70 · $37K
$255K
Periodontics
260 · $98K
200 · $74K
80 · $25K
$197K
Endodontics
130 · $84K
90 · $58K
50 · $26K
$168K
Restorative (fillings, onlays)
560 · $58K
480 · $48K
250 · $26K
$132K
Plano
$833K margin
54% of core-specialty margin · implants, oral surgery + ortho depth drives the premium
Frisco
$550K margin
35% of core-specialty margin · balanced mid-mix · ortho + hygiene heavy
Southlake
$172K margin
11% of core-specialty margin · restorative + hygiene led · specialty-depth gap, not a clinical skill gap

Ask Effie Scope: Meridian Dental Partners · all 3 sites · T90

DEMO MODE · canned responses · 50 Q types · v0.4 connected to Meridian PMS + CRM + finance + payroll · Effie can also take actions (SMS campaigns, exports, alerts)