The Practice Manager's Guide to Improving Treatment Acceptance Rates

If you're a dental practice manager, you live in the gap between what dentists recommend and what patients actually complete. That gap is your responsibility — and it's getting wider.

Treatment acceptance rates have been declining. According to a 2025 Inside Dentistry survey, only 46% of dental professionals reported that patients accepted the majority of complex treatment plans — down from 54% the previous year. Dental Intelligence data shows average case acceptance by dollar amount sits at 35–45% for most general dentistry practices.

This isn't just a number on a report. Every percentage point of improvement in treatment acceptance translates directly to recovered revenue. For a practice recommending $100,000/month in treatment, moving from 35% to 50% acceptance means an additional $15,000/month — $180,000 per year — without a single new patient walking through the door.

Understanding why patients say no (or say nothing at all)

Before diving into tactics, it's important to recognize that patients rarely reject treatment outright. More often, they don't decide at all — they leave the office intending to "think about it" and never follow through. The reasons cluster into predictable patterns.

Financial uncertainty: Patients don't know what their insurance will cover, and the out-of-pocket cost feels unknowable. This is especially true for high-value treatments like crowns, implants, and bridges where the cost difference between "insurance covers 80%" and "insurance covers 50%" can be thousands of dollars.

Lack of urgency: If it doesn't hurt today, it can wait. Patients don't understand that the $1,200 crown they're delaying now could become a $5,000 root canal and crown in 18 months. The clinical urgency is clear to the dentist — but not to the patient.

No follow-up: The patient left intending to call back. Nobody from the office followed up. A week became a month. The treatment plan sits in Dentrix as a permanent "pending." Research indicates that approximately 40% of patients who don't receive scheduling follow-up after a dental visit never return for the recommended treatment.

Poor handoff: The dentist explains the treatment, but the transition to the front desk for scheduling and insurance discussion is clumsy. The patient walks out with a printed treatment plan they don't fully understand and a vague instruction to "call us when you're ready."

The practice manager's playbook

As practice manager, you can't change how a dentist presents treatment (much). But you can control everything that happens after the patient leaves the operatory. That's where most cases are won or lost.

1. Submit Pre-Determinations immediately — and tell patients you're doing it

For any treatment over $300 that has insurance involvement, submit the Pre-D the same day the treatment is planned. Don't wait for the patient to "decide" — submit it proactively and tell the patient: "We're submitting this to your insurance today. Once we hear back, we'll call you with exactly what's covered and what your out-of-pocket will be."

This accomplishes three things simultaneously. It removes the financial uncertainty barrier (they'll know their actual cost before deciding). It creates a built-in follow-up reason (you'll be calling them with results). And it signals professionalism (you're actively managing their care, not waiting for them to figure it out).

2. Build a 48-hour follow-up rule

When insurance responds to a Pre-D, the patient should be contacted within 48 hours. Not "when someone gets around to it." Not "next week." Within 48 hours.

Why 48 hours? Because patient engagement with treatment decisions decays rapidly. The longer the gap between diagnosis and follow-up, the less likely the patient is to move forward. A patient who received their diagnosis yesterday and hears "your insurance approved 80% of your crown — your cost would be $240" is far more likely to schedule than one who gets that same call three weeks later.

Make this a tracked metric. Every week, review: how many Pre-D responses came back, and how many patients were contacted within 48 hours? If the number is below 90%, there's a process problem to fix.

3. Script the financial conversation

Front desk staff often avoid the follow-up call because they're uncomfortable discussing money. Give them a script that makes it easy:

"Hi [Patient Name], this is [Staff Name] from [Practice Name]. Great news — we heard back from your insurance about the [treatment] Dr. [Name] recommended. Your insurance is covering [X%], so your portion would be approximately [$amount]. We have openings on [date] and [date] — which works better for you?"

Notice the structure: positive framing ("great news"), concrete number (not "we'll figure it out"), and an assumptive close with specific dates (not "would you like to schedule?"). The difference between "would you like to schedule?" and "which date works better?" is measurable in conversion rates.

4. Track every case through every stage

You can't manage what you can't see. Every treatment plan that enters your system should be trackable through these stages: Treatment Planned → Pre-D Sent → Pre-D Received → Patient Contacted → Scheduled → Completed.

For each stage, you should know how many cases are there, how long they've been there, and which ones are overdue for the next action. If you're running a multi-location practice, you need this visibility across all clinics in a single view.

Whether you track this in a spreadsheet, your practice management software, or a dedicated tracking tool, the key is consistency. The tracking system is only as good as the data going into it, which means someone needs to own updating it daily.

5. Measure conversion weekly by cohort

Monthly production reports tell you what happened. Weekly cohort tracking tells you what's happening — in time to intervene.

A weekly cohort report tracks how many cases entered each funnel stage that week and what happened to them:

• Week of Feb 3: 28 treatments planned → 24 Pre-Ds sent → 18 received → 14 contacted → 9 scheduled → 6 completed
• Conversion rate: 21% (6/28)
• Biggest drop-off: Received → Contacted (4 cases lost = patients never called)

This kind of analysis pinpoints exactly where in the funnel your practice is losing cases. If the biggest drop is between "Pre-D Sent" and "Pre-D Received," you have an insurance follow-up problem. If it's between "Received" and "Contacted," you have a staff outreach problem. If it's between "Contacted" and "Scheduled," you may have a scripting or financial presentation issue.

6. Use morning huddles to drive daily accountability

The most effective practice managers use a 10-minute morning huddle to align the team on the day's priorities. A strong huddle includes three elements:

Today's action items: "We have 6 patients to contact about approved Pre-Ds, 4 follow-ups on patients who haven't scheduled, and 2 overdue cases that need escalation." This gives the front desk team a specific, prioritized task list before the first patient arrives.

Yesterday's wins: "We scheduled 3 cases worth $8,400 yesterday." Celebrating progress keeps the team motivated and reinforces that the tracking work matters.

This week's metrics: "Our contact-within-48-hours rate is at 78% this week — let's push for 90%." Sharing the number creates accountability without blame.

7. Compare clinics and providers

In multi-location practices, comparison data is one of the most powerful tools for improvement. When clinic managers can see that Location A converts at 45% while Location B converts at 28%, it creates healthy competition and surfaces best practices.

Similarly, provider-level data reveals coaching opportunities. If Dr. Smith's crown recommendations have a 60% acceptance rate while Dr. Jones has 25%, that's not just a number — it's a conversation about treatment presentation, patient communication, and chairside handoff to staff.

Present this data constructively. The goal isn't to shame underperformers — it's to identify what top performers are doing differently and replicate it across the group.

The technology question

Practice managers frequently ask whether they need new software to improve treatment acceptance. The honest answer: it depends on your scale.

A single-location practice with a dedicated office manager can implement most of this playbook using Dentrix reports, a well-maintained spreadsheet, and disciplined daily habits. It's labor-intensive but workable.

Multi-location practices — three or more clinics — hit a wall quickly. The manual tracking burden multiplies with each location, staff consistency varies widely, and the practice manager's time gets consumed by data collection instead of management. At this scale, automated tracking that syncs directly with your practice management system pays for itself in recovered revenue within the first month.

Start with what you can measure this week

You don't need to implement all seven strategies at once. Start with the highest-leverage action: pull your unscheduled treatment plan report today, identify the top 20 highest-value cases, and assign follow-up calls. Track how many convert to scheduled appointments by Friday.

That single exercise will tell you more about your practice's conversion opportunity than any consultant report. And it costs nothing but 30 minutes of your time.

The practices achieving 50%+ treatment acceptance rates aren't doing anything magical. They're doing the basics — consistently, systematically, with visibility, and with accountability. As a practice manager, that's exactly the kind of system you're built to create.