Practice Management

A four-clinic dental group with 30 staff using Dentally or Praktika pays $4,500–9,000/month in seat licenses. Add booking-transaction fees (1.5–2.5%), per-appointment charges for treatment plans, and SMS recall fees, and you're bleeding $36,000+/year on software that doesn't integrate Medicare claims. A custom system — appointment booking with chair-time logic, 6-month recall automation, treatment plans, HICAPS/Medicare claims, digital consent forms — costs $35–45k upfront. You own it forever. Payback: 14–18 months. Year three onwards: you've saved $120k+.

Why Dentally and Praktika Drain Practice Margin

Dentally's model: $200–300/mo base + $60–150/seat × staff count + 2% on booking fees + $0.50 per SMS recall. A 30-person practice (dentists, hygienists, admin, receptionists) across 4 clinics runs: base $250/mo, 30 seats @ $90 = $2,700/mo, 2% on $8k/month appointment value = $160/mo, SMS recalls @ $0.50 × 200/month = $100/mo. That's $3,210/month = $38,520/year. Praktika is steeper: $250/mo + $80–120/seat + per-feature unlocks (treatment plans, digital forms, claims integration all cost extra). Neither handles HICAPS integration properly — you're still manually keying Medicare rebates or paying a third-party clearinghouse $200–500/month.

Real cost for a 4-clinic, 30-person practice:

• Base subscription (per clinic): $250/mo × 4 = $1,000/mo ($12,000/yr)
• Per-seat licenses: $90/mo × 30 = $2,700/mo ($32,400/yr)
• Booking transaction fees: 2% on $32k/mo appointment value = $640/mo ($7,680/yr)
• SMS recall fees: $0.50 × 400/month = $200/mo ($2,400/yr)
• Treatment plan module (Praktika): $100/mo extra ($1,200/yr)
• HICAPS clearinghouse (workaround): $300/mo ($3,600/yr)
• Total: ~$59,280/year

Custom system: build once ($40k), deploy to all 4 clinics, own forever. Booking happens in your app, no transaction fees. Recalls are automated rules (6 months for checkups, 12 for perio). HICAPS integration is native — claims process locally, no clearinghouse tax. Year one: $40k build + hosting ($500/yr) + SMS (Twilio @ $0.01/msg, ~$50/mo). Year two: just $600/yr hosting + $600/yr SMS. A 30-person, 4-clinic group breaks even by month 18. Year three onwards, you've pocketed $55k+/year in SaaS savings.

What Custom Replaces: Six Core Modules

1. Appointment Booking With Chair-Time Logic

Receptionists book via a calendar showing chair availability, dentist schedules, and hygienist rotation. A 30-minute checkup blocks one chair; a 90-minute crown blocks two (dentist + hygienist prep). Overbooking rules prevent double-booking. Dentally's booking is clunky. A lean custom interface shows all 12 chairs across 4 clinics on one view, drag-to-book, colour-coded by procedure type. Staff train in 10 minutes.

2. Automated Recall System

Patient last visited 6 months ago? Auto-trigger an SMS reminder, email, or WhatsApp notification. No manual recall list. Rules vary: checkup patients get 6-month recalls, perio patients 3-month, implant patients 12-month. Custom logic hooks to your data — one query sets it up forever. Dentally charges per SMS. You pay $0.01/SMS via Twilio and run it natively.

3. Treatment Plans & Procedure Estimating

Dentist diagnoses an issue in the chair: "root canal + crown, estimated $3,200". Custom software generates a treatment plan with itemised procedures, estimated costs, insurance coverage (based on fund codes), and patient out-of-pocket. Patient signs digitally on tablet. The plan syncs to invoicing. Dentally charges extra for this. You build it once — 200 lines of code — and run forever.

4. HICAPS and Medicare Claims Integration (AU)

Dentist links a treatment code (01.01.01 = basic checkup) to a fund code. When invoiced, the system auto-calculates the rebate, submits to HICAPS (or direct to fund), and nets out the patient's out-of-pocket cost. No manual batching, no clearinghouse. Custom systems hook Stripe + patient fund data + treatment codes and auto-claim. Praktika charges $200+/mo for this. You own it.

5. Digital Consent and Treatment Forms

Patient arrives, receptionist hands them a tablet. They sign a confidentiality form, consent for X-rays, and confirm medical history — all digital, no paper. Forms live in the patient record. If they later dispute a treatment cost, you have signed digital proof. Dentally offers this, but it's slow. Custom: React form + Supabase signature capture = 2 hours to implement, infinite reuse.

6. Reporting and Multi-Clinic Analytics

Practice principal sees: revenue by clinic, procedures completed, outstanding treatment plans, patient acquisition cost, recall conversion rate (how many patients rebook after recall?). Slice by dentist, hygienist, or procedure type. Dentally gives you basic reports; custom systems feed data into Superset or Metabase for real dashboards. You see trends by clinic and make staffing decisions fast.

The ROI Math: 4-Clinic, 30-Person Practice

Item	Year 1	Year 2+
Custom build (one-time)	$40,000	$0
Hosting (Netlify/Vercel + Postgres)	$600	$600
SMS (Twilio @ $0.01/msg × 400/mo)	$600	$600
Total Custom	$41,200	$1,200
Dentally (est.)	$59,280	$59,280
Annual Savings	$18,080	$58,080

Year one breaks even by month 18. Year two: $58k in savings. Extend to 5 clinics and you save $72k+/year — the build cost stays the same, the Dentally seat licenses and SMS bills don't.

Six FAQs

Will staff use custom software or default back to Dentally?

If it's simpler than Dentally, they will. Receptionists book faster. Dentists type treatment plans quicker. Hygienists see recalls without hunting. The incentive is built-in. Dentally is the default only because every practice already has it; your custom app just needs to be lean and focused.

What happens if the server goes down during a clinic session?

Hosting on Netlify or Vercel means 99.95%+ uptime. Downtime is rare. If it happens, staff have pen-and-paper backup (they always do). Modern systems are resilient enough that a single outage won't derail a practice. Dentally claims similar uptime but charges you for that reliability.

How do we migrate patient data from Dentally?

Dentally lets you export patient records, appointment history, and treatment plans as CSV. A custom system imports that data in a few hours — map columns, validate phone numbers, seed the database. No patients lost. Switching back later is equally frictionless.

Does HICAPS integration work smoothly?

HICAPS integration is a REST API call. When you invoice a treatment, your system looks up the fund code, submits the claim, and receives the rebate amount in real-time. No clearinghouse delays. No manual batching. Dentally doesn't do this natively — you pay extra for a clearinghouse or do it manually.

What if we want to add a fifth clinic later?

Onboard 10 more staff, zero licensing cost. Custom systems scale at marginal cost — hosting grows $5–10/mo, Twilio SMS maybe $10/mo. Dentally charges you $1,500/mo per clinic base + seats again. Custom software is built for multi-site scaling.

Who maintains it — bugs, updates, features?

Three models: (1) you hire a developer 8 hrs/month ($1–2k/mo part-time maintenance), (2) vendor SLA for $400–600/mo uptime + patches, (3) you run it as-is and live with occasional slowness. Most practices pick option 2. Still $55k/year cheaper than Dentally by year three.

The Bottom Line

Dentally is the default because every practice knows it. But a 4-clinic, 30-person group doesn't need SaaS seat licensing. They need appointment booking (with chair logic), 6-month recalls, treatment plans, HICAPS claims, and consent forms. Custom software costs $40k upfront and $1,200/year to run. Dentally costs $59,280/year, forever, and locks you in. Year two, your custom system is $58k ahead. Year five, you've saved $260k. You control appointment rules, recall schedules, and HICAPS claims. No per-seat licensing. No booking fees. No clearinghouse tax.

Ready to replace Dentally with appointment software built for your practice? Check Aidxn's packages for practice management, or book a 20-min call to map your current workflow and ROI timeline.