A dental hygienist explains that practice numbers reveal whether dentists are actually getting paid for their work, with four key benchmarks -- collection percentage, adjustments and write-offs, insurance aging, and patient aging -- that expose financial problems hiding behind seemingly healthy reports.
- Collection percentage should be 98% or better; suspiciously high numbers like 120% often hide reporting problems and money leaking out.
- Adjustments and write-offs should stay close to zero when fee schedules are correct; ballooning numbers indicate money walking out as unintended courtesy discounts.
- Insurance aging over 90 days should be 5% or less, indicating claims are being work.ed regularly rather than sitting untouched
- Patient aging over 90 days should stay at 10% or below to catch money that should have been collected long ago.
- A practice analysis is a no-cost review of your real numbers to reveal what's happening outside your line of sight as a clinician.
Math is my Achilles heel. It always has been. If I’m really telling on myself, as a high schooler, I only mastered the basic theories, never making it to the “real” math classes.
I know teeth, patient connection, and getting claims paid. Ask me about scaling and root planing or getting a crown buildup paid for by insurance and I’m right at home. But put a column of numbers in front of me and my brain goes quiet, or at least it did until I fell in love with the numbers.
Unexpected, I know, yet here I am, the hygienist who now gets a little too excited when a doctor lets me dive into their collections. Let me tell you how that happened, because it has almost nothing to do with math and almost everything to do with people.
The numbers are your patients, counted a different way
Lauren Stanford, RDH.
Here’s the thing that flipped a switch for me: A production number isn’t abstract. It represents every person who sat in your chair and trusted you.
A collections number answers one crucial question: Did you actually get paid for the good dentistry you already did?
That question matters because the answer is often no. And the heartbreaking part is that doctors usually can’t tell because the numbers can look beautiful while money is quietly walking out the door.
The day that made all of this click
I sat down not long ago with a young dentist, sharp, conscientious, the kind of person who reads every estimation of benefits (EOB). More importantly, the kind of doctor who has passion and wants to help patients. On paper, her practice looked incredible. The collection percentage was over 120%. Most people would high-five and move on.
But not me. When a number looks too good, my suspicious brain lights up, because in this industry, too good is rarely just good.
We dug in together, and the picture underneath was the opposite of the picture on top: Wrong fee schedules attached, ledgers that never got reconciled to match the EOBs, and balances that should’ve been collected were being quietly written off as if they were contractual. Despite appearances, the practice wasn’t thriving. It was losing money every single month, and the reporting was dressing it up to look healthy.
She had felt in her gut that something was wrong. She’d raised the concern and was told she “didn’t understand insurance.” Reading and understanding the numbers handed her back her own instincts -- they confirmed what she knew.
This is what I want doctors to hear, understand, and take to heart. Numbers can look good, but whether you’re getting paid is a completely different story. And if you’re doing great dentistry that could be collected and isn’t, you’re not running a healthy practice, you’re being stolen from.
This isn't the case for every office. You can have the best team, a team that truly cares, and still be in trouble. So often the cards are stacked against them, with real blockers in the way every day: waiting on hold for 45 minutes to work one claim, fighting a constant stream of denials, the never-ending job of treading water to keep collections healthy. More often than not, it isn’t that a team member has bad intentions. It’s a shift in the dental world, and insurance is often at the center.
Why you can’t see this from the chair
I’m not here to knock on doctors or add more to your plate. You’re clinicians first, heads down all day, taking care of patient after patient. That focus is exactly what makes you good at the part that actually matters.
But that same focus is why the bigger picture slips out of view. I've sat with brilliant doctors who told me that they have no idea what their collection percentage is. One was cooking dinner and wrangling kids while we talked, because that is real life in a private practice: building your legacy and never having enough time, all of the weight on your shoulders as an owner. Nobody chose to let revenue leak. It happens slowly, the way a drip happens, and you don’t notice until someone points it out.
A practice analysis is me pointing it out. It’s not an audit, and it’s definitely not a judgment. It’s a no-cost look at your numbers so you can see what has been happening outside your line of sight.
The 4 numbers I get excited about
When I sit with a practice, there are four benchmarks I return to. They’re simple, and together, they tell me almost the whole story:
1. Collection percentage. I want this number at 98% or better. Too low means money owed to you isn't coming in. Suspiciously high, like that 120%, usually means the reporting is hiding something.
2. Adjustments and write-offs. I always measure these against gross production, never net. If your fee schedules live correctly in the ledger, this number should sit close to zero. When it balloons, that’s often real money walking out the door.
3. Insurance aging over 90 days. I aim for this number to be 5% or below that of your total aging. A large number over 90 days signals claims are sitting untouched instead of being worked every couple of weeks.
4. Patient aging over 90 days. I want this number at 10% or below. This is the one that quietly balloons when claims get closed and forgotten, and it’s where I catch a lot of the money that should’ve been collected long ago.
None of these are about blame. Each one is an opportunity. Behind each number is a habit that drifted or a system that broke, and once a doctor sees it, they can decide what to do. The numbers don’t corner anyone; they only turn the lights on.
Why I care
This isn’t professional for me, it’s personal in a way I still feel. It was my dad’s practice. A family practice, with my dad as the dentist, and he was excellent. His clinical skills were the kind you can’t teach. His whole legacy, the thing that got him out of bed, was helping people, and he did. But helping people and getting paid for it turned out to be two very different things, and the gap between them was quietly eating him alive.
I watched it up close, because I was drowning in it too. I was trying to train the team, trying to figure out why our collections were so low, writing appeals, calling insurance companies, and seeing my own patients in between.
I wore every hat, and I was still going under. Meanwhile, my dad was waking up at 4 a.m., stress weighing on him before the sun was up, locking himself in the consult room with reports that overwhelmed him.
We joke now, but you could hear him at that keyboard -- when he was stressed, I swear he was trying to break it. A great dentist, a good and honest man, carrying something that should never have been his to carry alone.
And here’s the part that still makes my stomach turn: My dad was a victim of embezzlement. Unfortunately, it’s more common than anyone wants to admit.
When the numbers are already a mess and nobody is reading them closely, it becomes far too easy to hide. The money he worked for and the procedures he did to near perfection didn’t all leak out by accident; some of it was taken. A man whose entire legacy was helping people got quietly robbed inside his own practice, and broken systems let it happen.
That’s the soil Wisdom grew from. Long before my sister, Ashley Bond, co-founded Wisdom and changed everything with her systems, I watched my dad struggle day after day. I wanted so badly to help and never was quite able to keep up myself.
As his daughter, I begged numerous times to consider retirement because I knew the stress would slowly kill him. My sister dreamt up Wisdom to save us from drowning, and she did. I came in as one of the early auditors, the hygienist who finally learned to read the reports my dad could never quite stomach.
So when I tell a doctor I want them to get paid for their work and sleep at night, I’m not reciting a pitch. I’ve lived on the other side of those 4 a.m. wake-ups. It’s a shame that any doctor has to live this way, and that’s exactly where my passion comes from. If you’re living it right now, helping you is the reason I do this.
With every doctor I meet with, I see a little bit of my dad in them. You shouldn't hate what you love doing, and you deserve to get paid for it.
This is care, at a different scale
People sometimes assume that loving the financial side means I drifted away from the patient side, but it’s the opposite. When SRPs were getting denied left and right, the hygienist in me didn’t shrug. I built a checklist so those claims would get paid. My patients were family and they deserved to have their insurance pay for the treatment they needed.
A practice that gets paid is a practice that can keep its people, hold its standard of care, and keep saying yes to the patients who need it. The chair taught me to look closely at one patient at a time. The numbers taught me to look closely at the whole practice, so it can be there for every patient still to come.
So, yes, I’m a hygienist who fell hard for the numbers, not because I stopped caring about people, but because I finally understood that this is one more way to take care of them. You’re doing great dentistry, and you deserve to be paid for it.
When you let me walk you through your own figures, I treat it like exactly what it is, which is a chance to help.
Lauren Stanford, RDH, began in dentistry at 15 as a "reluctant" assistant in her father's practice. After years caring for patients, she fell for the numbers, seeing that reports reveal whether doctors get paid for the good dentistry they do. As one of Wisdom's earliest team members, she guides practice owners through practice analysis, honoring her father's legacy with one belief: Good dentistry deserves to be paid for, and every doctor deserves to sleep at night.
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