The plan on one page
PMS conversion: move the data before you need it
Dr. Ellis ran a server-based practice management system (PMS) installed in 2009. Bluebird converts the practice onto its cloud PMS in the first month, using the vendor’s conversion service, with three rules learned the hard way across the industry:- Convert before go-live, then verify. Demographics, insurance plans, and ledger balances usually convert cleanly. Periodontal charting, imaging, clinical notes, and especially recall intervals and due dates may convert only partially. Confirm the result for each data type before the first patient checks in.
- Keep the legacy system read-only for the retention period. The records-custody obligation from the close doesn’t care that the software is old. Bluebird keeps the old server accessible, read-only, for as long as state retention rules require.
- Use one system of record. At go-live, the new PMS becomes the ledger and the old system becomes an archive. Running active billing in both systems creates avoidable gaps.
Fee schedules: the silent under-collection
For every payer contract that is effective, the contracted fee schedule under the PC’s TIN gets loaded into the PMS before that payer’s first claim goes out. This is tedious and completely unforgiving:- Load the wrong schedule and every claim posts a wrong expected amount; write-offs quietly absorb underpayments, and nobody notices for months. Expected-vs-paid variance only works if “expected” is right.
- The schedules are not Dr. Ellis’s old ones. Bluebird’s contracts are new paper at new rates, including the Delta network question from diligence (Premier vs PPO schedule), now answered in ink.
- Pending payers are configured as out-of-network with the interim cost-sharing policy from the close, and re-configured the day each contract goes effective.
Retain the team and the patient relationships
The practice’s recurring revenue is its hygiene program, and the hygiene program is two hygienists whose patients rebook with them. If they leave, the annuity leaves. Bluebird’s moves in week one:- Meet every staff member individually; offer employment on day one with tenure honored, compensation at or above current, and benefits harmonized to Bluebird’s plan by day 90.
- Give the office manager a real role in the integration rather than a spectator’s seat; she knows where every skeleton is filed.
- No production quotas or per-sale bonuses for clinical staff. Beyond being bad medicine, production-linked incentives for hygienists and dentists are the recurring red flag in dental enforcement actions; the 2026 California Aspen settlement specifically banned per-sale incentive payments to hygienists.1 Bluebird pays for time and quality, and measures recall health at the practice level. See DSO enforcement and risk.
Patient communication
Patients receive the notice required by state law at closing. In week two, Bluebird sends a separate letter and email signed by Dr. Ellis and Dr. Okafor. It leads with continuity of care, then explains practical improvements such as online scheduling and extended hours. The new brand is secondary. The front desk gets one paragraph to say on the phone, because they will be asked forty times a day. And every hygiene visit in the first quarter ends the same way it always did: with the next one booked before the patient leaves.Re-run the diligence reports
Between days 30 and 60, Bluebird re-runs the diligence reports in its own PMS and compares them to the diligence baselines:
A gap between the baseline and rerun often points to a conversion problem, such as missing recall flags or plans mapped to the wrong payer. Finding those errors in month two reduces the risk of losing patients later in the year.
Re-anchor the hygiene recall
The single highest-value integration task. Recall due dates are exactly the data that converts worst, and a patient whose recall flag vanished doesn’t get a reminder, doesn’t book, and eighteen months later is someone else’s “active patient” problem. Bluebird’s sequence:- Rebuild recall intervals for every active patient in the new PMS, audited against the legacy system.
- Work the unscheduled recall list hardest for the first ninety days; patients past due at close are the ones most likely to drift in a transition.
- Make pre-booking the standing habit: reappointment percentage on the weekly scorecard, with the location-one playbook and an 84% target.
- Fold the location into Bluebird’s normal billing rhythm; daily eligibility, daily posting, weekly credit-balance review. So the new practice runs like the first one.
What Bluebird built
Ninety days after closing, Bluebird has two locations, one PC, one dental support organization (DSO), an MSA covering both sites, and a shared billing routine. The team can use the same checklist for the next deal while adapting it to the new facts. See Acquire a dental practice. Expansion into another state requires a new state-law analysis, covered in the next tutorial.Next
Tutorial: expanding to a second state
A new PC, a new CPOD analysis, and payer enrollment all over again.
Sources
- California AG, 2026 Aspen Dental settlement (bans per-sale incentive payments to hygienists, among other terms).
- Dental Economics / Levin Group, 2024 annual practice survey; Dental Economics, research report on hygiene.