How to Track Pre-Determinations Across Multiple Dental Clinics

Running a single dental clinic is hard. Running five or six is a different sport entirely. And one of the most challenging aspects of multi-location management is maintaining visibility into insurance pre-determinations across every site.

Each clinic has its own Dentrix installation. Each has its own front desk workflow. Each produces dozens of Pre-D submissions per month. And without a centralized tracking system, the practice manager is left stitching together a picture of what's happening from six different sources — if they can get the picture at all.

The multi-clinic Pre-D visibility problem

In a single-location practice, a diligent office manager can keep tabs on Pre-D status through direct involvement. She's in the office every day, she knows which claims went out, she can check Dentrix's document centre, and she can follow up with patients herself.

In a multi-location group, none of this scales. The practice manager faces several compounding challenges:

Siloed data

Dentrix operates as a local installation at each clinic. There is no built-in multi-location dashboard. To see Pre-D status at Clinic A, you need to access Clinic A's Dentrix. To compare that with Clinic B, you need to separately access Clinic B's system. For a six-clinic group, getting a complete picture requires six separate logins and manual data aggregation.

Inconsistent staff workflows

Each clinic develops its own habits. One location may diligently update claim statuses in Dentrix. Another may track Pre-Ds on a whiteboard. A third may not track them at all, trusting that "someone" will follow up. Without standardized workflows enforced by a system, consistency is impossible to maintain.

No cross-clinic comparison

Is Clinic A converting Pre-D approvals to scheduled appointments faster than Clinic C? Which location has the most Pre-Ds sitting in "sent" status past 7 days? Without centralized reporting, these questions go unanswered — and the underperforming locations fly under the radar.

Time-intensive manual tracking

Many multi-location practice managers resort to weekly Excel spreadsheets. They collect data from each clinic — how many Pre-Ds were sent, how many received, how many patients contacted, how many treatments booked — and compile it into a master tracker. This process can consume 4–8 hours per week across all locations, and the data is already stale by the time it's compiled.

The framework for effective multi-clinic Pre-D tracking

Whether you build a system, buy one, or assemble it from existing tools, effective multi-location Pre-D tracking requires five components.

1. Automated data collection from each clinic

The foundation is getting Pre-D data out of each clinic's practice management system automatically. Manual data collection breaks down — it's too slow, too error-prone, and too dependent on individual staff members.

For Dentrix practices, this means a sync agent at each location that reads the claims data (specifically the Pre-Determination claims) and sends it to a centralized system. The sync should happen automatically, at regular intervals (every 15–30 minutes), with no manual intervention required from clinic staff.

The key data points to capture per Pre-D:

• Patient name and contact information
• Procedure codes and descriptions
• Treatment value (dollar amount)
• Date Pre-D was submitted
• Insurance carrier
• Treating provider
• Submission method (electronic vs. mailed)
• Response status and date (if available)

2. Centralized status tracking with automatic updates

Once data flows into a central system, every case should have a clear status that tracks its position in the conversion workflow:

• Treatment Planned — Dentist recommended, awaiting Pre-D submission
• Pre-D Sent — Submitted to insurance, awaiting response
• Pre-D Received — Insurance responded (approved or declined)
• Patient Contacted — Staff reached the patient to discuss results
• Scheduled — Appointment booked for treatment
• Completed — Treatment performed

Critically, as many status transitions as possible should be automatic. If a Pre-D is submitted in Dentrix, the central system should detect it without staff having to re-enter the information. If an appointment is booked in Dentrix matching that patient and procedure, the status should auto-update to "Scheduled."

3. Automated reminders and escalation

Each status should have time-based rules:

• Pre-D Sent: If no response after 3 days (electronic) or 7 days (mailed), flag as overdue
• Pre-D Received: Contact patient within 24 hours — if not contacted within 48 hours, escalate to manager
• Patient Contacted: If not scheduled within 7 days, trigger follow-up reminder

These reminders should be delivered proactively — via daily email digests or dashboard alerts — so that staff start each day knowing exactly what needs their attention.

4. Multi-clinic dashboard with filtering

The practice manager needs a single screen that answers these questions instantly:

• How many active Pre-D cases are there across all clinics?
• How many are overdue at each stage?
• Which clinic has the most cases waiting for patient contact?
• What's the total dollar value in the pipeline?
• Which providers have the most open cases?

The dashboard should filter by clinic, provider, status, date range, and insurance carrier — enabling both the big-picture overview and the ability to drill into specifics.

5. Weekly cohort reporting

This is what replaces the manual Excel tracking. A weekly cohort report automatically generates the conversion funnel data:

• How many new cases entered the pipeline this week?
• How many moved from "Pre-D Sent" to "Pre-D Received"?
• How many patients were contacted?
• How many treatments were booked and completed?
• What's the conversion rate at each stage?

This report should be generated automatically, broken down by clinic and by provider, and optionally emailed to managers every Monday morning. No manual compilation needed.

The real-world impact

When a multi-location dental group moves from manual Pre-D tracking to an automated system, several things change immediately:

Visibility: The practice manager can see, for the first time, exactly how many cases are sitting at each stage across all locations. This alone often reveals that 20–30% of approved treatments have no follow-up activity — cases that were simply invisible before.

Accountability: When staff receive a daily digest showing "you have 6 patients to contact today," there's no ambiguity about priorities. When clinic-level conversion rates are visible, underperforming locations can't hide behind the group average.

Speed: The time between insurance approval and patient contact drops from "whenever someone remembers" to 24–48 hours. This matters because patient engagement with treatment decisions decays rapidly — the longer you wait to call, the less likely they are to schedule.

Recovered time: The 4–8 hours per week spent manually compiling spreadsheets goes to zero. That's 200–400 hours per year of practice manager time redirected from data collection to actually managing the practice.

Getting started

If you're currently tracking Pre-Ds manually across multiple clinics, the first step isn't buying software — it's quantifying the problem. Pull the data for one month and answer three questions:

1. How many Pre-Ds did each clinic submit last month?
2. How many of those received an insurance response?
3. Of those that were approved, how many resulted in a scheduled appointment?

If you can't easily answer those questions — or if the answers reveal a significant drop-off between approval and scheduling — you've identified the gap that needs closing. The dollar value of that gap will almost certainly justify the investment in a proper tracking system.