A dental practice management consultant who logs in to your practice software will see patient records. If you send insurance claims or other standard transactions electronically, that makes the firm a business associate under HIPAA, and you need a signed agreement before the first login.
Judge any consultant or coach by two things: what lands on your desk each month, and whether numbers from your own software moved.
Quick answer
- Ask each firm what you will hold at the end of month one.
- Save your starting numbers from the practice software before the first call.
- Get a business associate agreement signed before anyone gets a login.
- Get the first year's total and the last day you can cancel.
- Have a lawyer read any fee that moves with your collections.
Coach, consultant or agency: what lands on your desk
| Offer | You get | How it is priced | How long |
|---|---|---|---|
| Coach | Calls, team training, accountability on a schedule | Spear Education's All Access plan, with six hours of coaching a month: $3,000 billed monthly or $33,000 a year | Annual commitment at Spear |
| Consultant | A review of scheduling, hygiene and collections, then a plan or hands-on changes | The Paragon page gives no figures and points to a free one-hour call | Ask: one-off or ongoing |
| One-off assessment | A written review and a list of fixes | Ask for a fixed price before work starts | Ends at delivery |
| Marketing agency | Ads, website, Google profile, reports | See my agency questions | Ask for the term and notice period |
Spear's page says memberships "are annual commitments" that can be billed monthly. Paid monthly, a year of All Access comes to $36,000 (12 × $3,000), against $33,000 paid yearly. Monthly billing is not a monthly contract, so ask whether you can stop in month four.
Starting numbers to save before the first meeting
Pull these five from your software, with dates, and keep the file. Without them, a consultant's promise cannot be checked.
| Number | Where to find it in Open Dental | The catch |
|---|---|---|
| Production and collections by provider | Standard Reports, Production and Income, Provider type | Scheduled work can count; see the card below |
| Unscheduled treatment | Treatment Finder | Two default filters; see below |
| Broken and cancelled visits | Unscheduled List | By default, shows only visits staff sent there that are not yet rebooked |
| Recall due | Recall List | Reminded patients drop off for a set number of days; tick Include Reminded |
| New patients by source | Your referral field | If you have none, add one now |
The Treatment Finder leaves out patients with a scheduled appointment unless you tick "Include patients with upcoming appointments". It also skips procedures with a $0 fee.
By default it lists only patients whose insurance year follows the calendar year; tick "Include secondary insurance and no insurance" to add uninsured patients and drop that filter. A count taken with the defaults is lower than the work waiting on your shelf.
Hygiene reappointment is the share of cleaning patients who leave with their next visit booked. I found no report by that name in the Open Dental manual pages I read. Ask your software vendor which report gives it, or count it by hand for one month from your recall list. My software post compares what each system records.
New patients by source is my line of work: I set up booking and tracking that record it. I don't coach or consult on running a practice.
Whoever opens your software needs the agreement first
The federal definition of a business associate includes people who provide "consulting" and "management" services involving patient information. The same section counts giving someone access to the information as a disclosure, so a login is enough.
The practice and the consultant must then sign a contract that meets 45 CFR 164.504(e). This binds a practice that is a covered entity, which includes any provider that sends insurance claims or other standard transactions electronically.
Ask which tools the consultant uses to store your reports, since the company behind any tool that stores your patient information for them counts as a subcontractor. And put the end date in the contract, so you know when your files must come back or be deleted.
HIPAA covers US practices. In Ontario, a consultant who handles patient records on a dentist's behalf is the dentist's agent under PHIPA, and the dentist stays responsible for what the agent does with them. Other provinces have their own laws or PIPEDA, so ask which one the consultant's agreement follows.
Terms that decide what it costs
- How many months the term runs, and whether it renews on its own.
- How many days before the renewal date you must cancel, and how.
- What the guarantee promises, and what you must do to qualify. Quote the firm's own words back to them.
- Who keeps the scripts, training videos and reports after you stop.
A fee tied to your collections needs a lawyer. Ontario's dental college lets a dentist split fees or income with four groups only. They are employed associate dentists, dentists who come in as contractors, dentist partners, and Ontario-registered hygienists for their work in your practice.
Consultants are not among them. The guideline was approved in March 2018. Each US state sets its own rules. I am not a lawyer, and this is not legal advice.
What the fee has to earn
Use this formula with your own numbers: fee for the year ÷ (12 × monthly collections × share you keep) = the lift needed.
Questions to put to each firm
- Which numbers will you commit to, and how will each side read them?
- Who on your side logs in to my software, and where are the reports stored?
- How many days after the contract ends do my exports come back and your logins close?
- Does any part of your fee rise with my collections?
- Are you a paid partner of any software, lab or vendor you will suggest?
Prices and rules checked on 2026-11-03.
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Frequently asked questions
What is the difference between a dental coach and a dental consultant?
A coach usually works with you and your team on a schedule, with calls, training and accountability. A consultant usually studies your numbers and systems, then hands you a plan or builds changes. Titles overlap, so ignore the label and ask what you will hold at the end of month one.
How much does a dental consultant cost?
Of the firms named in this post, only Spear Education publishes a price. Its All Access plan, which includes six hours of coaching a month, is $3,000 a month billed monthly or $33,000 billed yearly, and both are annual commitments. That is one firm's page. Any other firm: ask what the first year costs all in.
Is dental coaching worth it?
It is worth what it adds to numbers you can already count. Pull production, collections and new patients by source before you start, then compare at month 6 and month 12. If the firm will not agree to those numbers up front, you have nothing to judge it by.
When does a dental consultant count as a business associate?
If your practice sends insurance claims or other standard transactions electronically, a consultant is one when the work gives them patient information, and a login to your practice software counts as access. The federal definition of a business associate lists consulting and management services. A consultant who only sees totals you export, with no patient names, may not be one, so ask your privacy officer.
Can a consultant be paid a percentage of my collections?
Rules differ by state and province, so a lawyer who knows your state's dental law should read that clause. In Ontario, for one, the dental college limits fee or income splitting to dentists who work with you as associates, contractors or partners, and to hygienists in your practice. A consultant is not on that list. This is not legal advice.
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