Implementation PlaybookDSO · Group Practice

NexHealth

Step-by-step implementation guide — pre-implementation checklist, onboarding, staff training, go-live runbook, and ROI tracking.

Contents

NexHealth — Implementation Playbook (DSO)

NexHealth Implementation Playbook for DSOs

Patient Communication AI Platform

1. Executive Summary

What NexHealth Does

NexHealth is a patient communication and engagement platform that unifies online scheduling, automated appointment reminders, two-way patient messaging, digital forms, reviews management, and waitlist automation into a single system that integrates directly with your practice management software. The platform uses intelligent automation to reduce no-shows, fill schedule gaps, and eliminate manual front desk communication tasks.

Why DSOs Specifically Benefit from Patient Communication AI

At 15–50 locations, manual patient communication creates compounding inefficiencies that directly impact your bottom line:

Scale Advantages: A 1% reduction in no-show rates across 40 locations with 200 daily appointments each translates to 14,600 recovered appointments annually. NexHealth's automated confirmation sequences achieve this consistently without adding FTE.
Standardization: Inconsistent patient communication creates brand fragmentation and compliance exposure. Centralized template management ensures every location delivers identical messaging quality while allowing regional customization where appropriate.
Data Aggregation: Cross-location visibility into confirmation rates, online booking adoption, and patient response patterns enables evidence-based operational decisions impossible with siloed location data.
Labor Arbitrage: Front desk staff currently spend 2–3 hours daily on outbound calls and manual confirmations. Automation redirects this capacity toward revenue-generating activities like treatment coordination and insurance verification.

Expected Timeline: Decision to Full Deployment

Portfolio Size	Pilot Phase	Wave Deployment	Full Deployment
15–25 locations	Weeks 1–4	Weeks 5–12	10–14 weeks
26–40 locations	Weeks 1–4	Weeks 5–16	14–18 weeks
41–50 locations	Weeks 1–5	Weeks 6–20	18–22 weeks

Timeline assumes dedicated internal project management and vendor responsiveness. Add 20% buffer for organizations with complex PMS environments or significant IT infrastructure variation.

2. Pre-Implementation Checklist (Weeks 1–2)

Technical Requirements

Hardware Requirements

☐ Front desk workstations: Modern browser (Chrome 90+, Edge 90+, Safari 14+) — no dedicated hardware required ☐ Internet connectivity: Minimum 25 Mbps download/10 Mbps upload per location ☐ Staff mobile devices (optional): iOS 14+ or Android 10+ for NexHealth mobile app

Software Requirements

☐ Practice Management System: Verify PMS version compatibility

Dentrix G6.2 or higher
Eaglesoft 21.0 or higher
Open Dental 21.1 or higher
Other PMS: Confirm API availability with NexHealth ☐ Email service: Verify no firewalls blocking NexHealth domains ☐ SMS capability: Confirm 10DLC registration status (required for SMS compliance)

Network Requirements

☐ Whitelist NexHealth IP ranges and domains (provided during onboarding) ☐ Verify firewall rules allow outbound API connections ☐ Test VPN/remote access compatibility if applicable

🔵 Vendor Onboarding Steps

Step	Owner	Timeline	Deliverable
Execute enterprise MSA and BAA	Legal/Vendor	Day 1–5	Signed agreements
Schedule kickoff call	Project Lead/Vendor	Day 3	Kickoff meeting scheduled
Receive dedicated CSM assignment	Vendor	Day 5	CSM contact + escalation path
Complete enterprise discovery questionnaire	Project Lead	Day 5–7	Completed intake form
Receive technical implementation guide	Vendor	Day 7	Documentation package
Establish vendor Slack/Teams channel	IT/Vendor	Day 7	Communication channel live

Key Contacts to Establish

☐ Dedicated Customer Success Manager (CSM) ☐ Technical Implementation Specialist ☐ Enterprise Support escalation contact ☐ Executive sponsor at NexHealth (for DSO accounts) ☐ After-hours emergency support line

Data/Access Prerequisites

For Each Location (Compile Master List)

☐ PMS administrator credentials (read/write access required) ☐ PMS server IP address and port (for on-premise installations) ☐ API keys or sync agent installation access ☐ Patient data export capability confirmation ☐ Current recall/recare list export

Enterprise-Level Access

☐ Master location list with PMS versions, server types, IT contacts ☐ Centralized domain management access (for email configuration) ☐ SSO identity provider admin access (Okta, Azure AD, Google Workspace) ☐ 10DLC brand registration information (legal business name, EIN, address)

🟣 Internal Stakeholder Alignment

Stakeholder Alignment Map

Stakeholder	Role in Implementation	Required Action	Timing
Board/Investors	Awareness	Briefing on AI investment and expected ROI	Pre-decision
CEO/COO	Executive Sponsor	Approve budget, timeline, success metrics	Week 1
Chief Dental Officer	Clinical Governance	Approve patient communication standards	Week 1
VP of Operations	Project Owner	Own rollout execution, wave decisions	Week 1
VP of IT/CTO	Technical Authority	Approve integrations, security, infrastructure	Week 1
Regional Managers	Wave Execution Leaders	Coordinate location readiness, champion selection	Week 2
Office Managers	Location Implementation Leads	Prepare staff, manage local change	Week 2–3
Lead Providers per Location	Clinical Champions	Model adoption, provide feedback	Week 3+
Front Desk Staff	Primary Users	Complete training, execute daily workflows	Pre-go-live

🟣 Approvals Required Before Proceeding

☐ Budget approval for enterprise license (estimated $200–400/location/month) ☐ IT security sign-off on vendor assessment ☐ Legal approval of BAA and data processing terms ☐ CDO approval of patient-facing message templates ☐ HR alignment on training time allocation

Baseline Metrics to Capture

⚠️ Critical: These metrics MUST be captured before go-live to demonstrate ROI. Inconsistent measurement across locations will undermine your business case.

Standardized Metrics Collection Template

Metric	Definition	Data Source	Collection Method	Frequency
No-Show Rate	Missed appointments / Total scheduled appointments	PMS	Automated report	Monthly, trailing 3 months
Confirmation Rate	Confirmed appointments / Total confirmations sent	Manual tracking or PMS	Staff log	Monthly, trailing 3 months
Online Booking %	Online-booked appointments / Total appointments	PMS or website analytics	Automated report	Monthly, trailing 3 months
Front Desk Call Volume	Inbound + outbound calls	Phone system	Automated report	Weekly average
Avg. Time to Schedule	Days from patient request to booked appointment	Manual sampling	20-patient sample	One-time
Recall Reactivation Rate	Patients returning from recall / Recall list size	PMS	Automated report	Quarterly
Google Review Volume	New reviews per month	Google Business Profile	Manual count	Monthly, trailing 3 months
Avg. Google Rating	Current aggregate rating	Google Business Profile	Manual capture	Point-in-time
Patient Wait List Size	Patients waiting for appointments	Manual or PMS	Staff count	Point-in-time

⚠️ Standardization Requirements

☐ Use identical date ranges across all locations (recommend: trailing 90 days) ☐ Confirm PMS report definitions are consistent (e.g., "no-show" vs. "cancelled" classification) ☐ Create central data repository (Excel, Google Sheets, or BI tool) for cross-location comparison ☐ Assign single owner responsible for data collection integrity

Enterprise-Level Requirements

Network Standards Across Locations

☐ Document current network topology for each location (on-premise server vs. cloud-hosted PMS) ☐ Verify minimum bandwidth at each location ☐ Identify locations requiring network upgrades (flag for Wave 3 or later) ☐ Confirm consistent firewall policies or document exceptions needed

Hosting Model Decision

🟣 Decision Required: Centralized vs. Location-Level Configuration

Approach	Pros	Cons	Recommendation
Centralized Admin	Single pane of glass, consistent settings, easier auditing	Less local flexibility, central team bottleneck	✅ Recommended for DSOs
Location-Level Admin	Local autonomy, faster small changes	Configuration drift, inconsistent patient experience	Not recommended

SSO Configuration

☐ Confirm NexHealth supports your identity provider (SAML 2.0 required) ☐ Plan SSO provisioning: auto-provisioning vs. manual user creation ☐ Define role-based access levels:

Enterprise Admin (central team)
Location Admin (office managers)
Standard User (front desk staff)
View-Only (regional managers, reporting access)

Centralized Credentialing

☐ Create master user provisioning template ☐ Establish onboarding/offboarding workflow for NexHealth access ☐ Define password policies consistent with organizational standards

3. Location Readiness Assessment

Scoring Framework

Rate each location on the following factors (1 = Low readiness, 5 = High readiness):

Factor 1: IT Infrastructure Maturity (Weight: 25%)

Score	Criteria
5	Cloud-hosted PMS, modern hardware (<3 years), consistent 50+ Mbps internet
4	Cloud-hosted PMS, adequate hardware, 25–50 Mbps internet
3	On-premise server (maintained), mixed hardware age, 15–25 Mbps internet
2	On-premise server (outdated), aging hardware, unreliable internet
1	Legacy PMS version, significant hardware issues, <15 Mbps internet

Factor 2: Staff Tenure and Adaptability (Weight: 20%)

Score	Criteria
5	<15% annual turnover, prior successful tech adoption, proactive staff
4	15–25% turnover, neutral tech adoption history, willing staff
3	25–35% turnover, mixed tech adoption results, some resistance
2	35–50% turnover, prior tech adoption struggles, significant resistance
1	>50% turnover, failed prior implementations, active resistance

Factor 3: Patient Volume (Weight: 20%)

Score	Criteria	Note
5	150–250 patients/week	High volume, high impact, manageable scale
4	250–350 patients/week	Very high impact, requires strong champion
3	100–150 patients/week	Moderate volume, good for pilot
2	350+ patients/week	⚠️ Highest impact but highest risk — not for Wave 1
1	<100 patients/week	Lower impact, limited ROI demonstration

Factor 4: Existing Tech Stack Compatibility (Weight: 20%)

Score	Criteria
5	NexHealth-supported PMS, no conflicting tools, clean data
4	Supported PMS, minor integration adjustments needed
3	Supported PMS, existing reminder system to decommission
2	Supported PMS but outdated version, significant cleanup needed
1	Unsupported PMS or major integration blockers

Factor 5: Local Champion Availability (Weight: 15%)

Score	Criteria
5	Identified tech-forward office manager + provider champion, both enthusiastic
4	Strong office manager champion, provider supportive
3	Willing office manager, provider neutral
2	No clear champion, need to develop one
1	Office manager resistant, provider uninvolved

Composite Score Calculation

Composite Score = (IT × 0.25) + (Staff × 0.20) + (Volume × 0.20) + (Tech Stack × 0.20) + (Champion × 0.15)

Readiness Tiers

Composite Score	Tier	Wave Assignment
4.0–5.0	High Readiness	Wave 1 (Pilot)
3.0–3.9	Medium Readiness	Wave 2
2.0–2.9	Low Readiness	Wave 3
<2.0	Not Ready	Remediation required before rollout

Sample Scoring Matrix

Location	IT (×.25)	Staff (×.20)	Volume (×.20)	Tech (×.20)	Champion (×.15)	Composite	Wave
Oakwood	5 (1.25)	4 (0.80)	3 (0.60)	5 (1.00)	5 (0.75)	4.40	Wave 1
Riverside	4 (1.00)	5 (1.00)	4 (0.80)	4 (0.80)	4 (0.60)	4.20	Wave 1
Downtown	3 (0.75)	3 (0.60)	5 (1.00)	4 (0.80)	3 (0.45)	3.60	Wave 2
Westside	3 (0.75)	2 (0.40)	2 (0.40)	3 (0.60)	2 (0.30)	2.45	Wave 3

Rollout Sequence Recommendations

Wave 1 Selection Criteria (2–3 Locations)

☐ Composite score ≥4.0 ☐ Represents portfolio diversity (geography, specialty mix, provider profile) ☐ Strong office manager willing to participate in feedback loops ☐ Not highest-volume locations (avoid excessive risk during pilot) ☐ IT infrastructure requires no pre-work

Wave 2 Expansion Criteria (5–8 Locations)

☐ Composite score 3.0–4.0 ☐ Learn from Wave 1 before deployment ☐ Group geographically for regional manager efficiency

Wave 3 and Beyond

☐ Remaining locations ☐ Address remediation items identified in assessment ☐ Consider acquisition-timeline locations — delay if integration pending

4. Rollout Strategy

Wave Structure Overview

Week 1–2    : Pre-implementation (all locations baseline, Wave 1 prep)
Week 3–4    : Wave 1 Pilot (2–3 locations)
Week 5–6    : Wave 1 Stabilization + Learning Capture
Week 7–10   : Wave 2 Deployment (5–8 locations)
Week 11–12  : Wave 2 Stabilization
Week 13–18  : Wave 3 Deployment (remaining locations)
Week 19–20  : Full portfolio stabilization
Week 21+    : Optimization phase

Wave 1: Pilot (Weeks 3–6)

Selection Criteria for Wave 1 Locations

🟣 Selection requires VP Operations + Regional Manager alignment

☐ Highest readiness scores (4.0+) ☐ Enthusiastic, articulate office manager (will serve as reference for other locations) ☐ Moderate patient volume (100–200/week) — enough to validate but not overwhelming ☐ Provider willing to be visible champion ☐ Geographic accessibility for in-person support if needed ☐ Represents dominant PMS in portfolio (if 80% of locations use Dentrix, Wave 1 should be Dentrix)

Wave 1 Timeline

Week	Activities
Week 3, Day 1–2	🔵 Integration installation, initial sync
Week 3, Day 3–4	Configuration and template setup
Week 3, Day 5	Staff training (2 hours)
Week 4, Day 1	Go-Live
Week 4, Days 2–5	Daily check-ins, issue resolution
Week 5	Weekly optimization review
Week 6	Wave 1 retrospective, documentation

Wave 1 Deliverables Before Proceeding

☐ Documented integration process (for replication) ☐ Finalized message templates (tested with real patients) ☐ Training materials validated and refined ☐ Common issues log with resolutions ☐ Staff feedback collected and addressed

Go/No-Go Criteria: Wave 1 → Wave 2

🟣 Executive Gate Review Required

Criterion	Go Threshold	Measurement
Technical stability	<2 integration errors per day by Week 6	Vendor error log
Staff adoption	100% of trained staff using system daily	Activity log
Patient delivery	>95% message delivery rate	NexHealth dashboard
Confirmation improvement	≥5% improvement vs. baseline	Confirmation rate report
Staff satisfaction	≥3.5/5 average on pulse survey	Internal survey
No critical issues	Zero unresolved P1 issues	Issue tracker

If criteria not met: Extend Wave 1 by 2 weeks, address gaps, re-evaluate.

Wave 2: Expansion (Weeks 7–12)

Wave 2 Timeline Per Location

Day	Activities
Day 1	🔵 Integration installation (streamlined from Wave 1 learnings)
Day 2	Configuration using standardized template
Day 3	Champion training (1.5 hours) — train-the-trainer model
Day 4	Champion trains local staff
Day 5	Go-Live
Days 6–10	Daily check-ins
Week 2	Transition to weekly check-ins

Wave 2 Parallel Deployment

Deploy 2–3 locations per week
Stagger go-live days (Monday, Wednesday, Friday) to distribute support load
Regional managers coordinate within their portfolios

Buffer Between Waves

⚠️ Mandatory 1-week buffer between last Wave 1 go-live and first Wave 2 deployment for:

Retrospective completion
Template refinements
Training material updates
Support documentation updates

Wave 3: Full Deployment (Weeks 13–18)

Wave 3 Acceleration

By Wave 3, process should be highly efficient:

4–5 locations per week capacity
Remote-first deployment (no on-site vendor support)
Champions trained via video + existing champion mentorship

Wave 3 Considerations

☐ Lower-readiness locations may require pre-work (network upgrades, PMS updates) ☐ Acquisition locations may require delayed integration ☐ High-volume locations (flagged in readiness assessment) require extra support allocation

Rollback Plan

Triggers for Rollback

Integration causing PMS instability
10% patient complaints about communication changes
Critical HIPAA or compliance concern
Staff unable to function after 5 business days

⚠️ Rollback Procedure (Per Location)

Disable automated messaging in NexHealth (maintain sync for data continuity)
Reactivate prior reminder system (if still available) or revert to manual process
Communicate to patients: "We're updating our communication systems. You may receive a call from our team directly."
Document failure mode for root cause analysis
Do NOT proceed with additional locations until resolved

Rollback Impact Isolation

NexHealth architecture allows location-level disabling without affecting other locations
Central admin can pause individual location from enterprise dashboard
Patient data sync can continue even if messaging is paused

5. Configuration & Integration (Weeks 2–3)

Practice Management System Integration

🔵 Dentrix Integration (Step-by-Step)

Prerequisites: ☐ Dentrix G6.2 or higher installed ☐ Server access credentials ☐ 10–15 minutes for installation ☐ Dentrix closed during agent installation

Installation Steps:

☐ Download NexHealth Sync Agent from provided link
☐ Run installer as administrator on Dentrix server
☐ Enter API key provided by NexHealth CSM
☐ Configure sync frequency (recommended: every 5 minutes)
☐ Restart Dentrix
☐ Verify sync status in NexHealth dashboard (green = connected)

⚠️ Common Issues:

Firewall blocking outbound connection → Whitelist NexHealth IPs
Sync agent service not starting → Check Windows services, verify "Run as Administrator"
Duplicate patient records → Enable merge rules in NexHealth settings

Estimated Time: 30 minutes per location (first time); 15 minutes (subsequent)

🔵 Eaglesoft Integration (Step-by-Step)

Prerequisites: ☐ Eaglesoft 21.0 or higher ☐ API access enabled (Patterson support may be needed) ☐ Server access credentials

Installation Steps:

☐ Request API activation from Patterson (allow 48–72 hours)
☐ Download NexHealth Sync Agent
☐ Install on Eaglesoft server
☐ Configure API connection with credentials from Patterson
☐ Set sync frequency
☐ Verify in dashboard

⚠️ Common Issues:

Patterson API not activated → Confirm API status before scheduling install
Time zone misalignment → Verify server time zone matches location

Estimated Time: 45 minutes per location (excluding Patterson lead time)

🔵 Open Dental Integration (Step-by-Step)

Prerequisites: ☐ Open Dental 21.1 or higher ☐ API key generated in Open Dental (Program Links > API) ☐ Server or cloud connection details

Installation Steps:

☐ Generate API key in Open Dental admin panel
☐ Provide API key to NexHealth via secure portal
☐ NexHealth configures cloud-to-cloud connection (no local install for cloud-hosted)
☐ For server-based: Install sync agent similar to Dentrix process
☐ Verify sync

Estimated Time: 20 minutes (cloud-hosted); 30 minutes (server-based)

Test Environment Setup

Pre-Go-Live Validation Checklist

☐ Patient sync validation

Verify 100 random patients synced correctly (name, DOB, contact info, upcoming appointments)
Confirm appointment history pulled accurately

☐ Appointment sync validation

Create test appointment in PMS → Confirm appears in NexHealth within sync cycle
Cancel/reschedule in PMS → Confirm updates in NexHealth

☐ Message delivery test

Send test reminder to staff phone numbers
Verify email delivery (check spam folders)
Test SMS reply functionality

☐ Online scheduling test

Book test appointment via patient portal
Verify appointment appears in PMS correctly
Verify confirmation message sent

☐ Forms test (if using digital forms)

Submit test form
Verify data flows to PMS patient record

Data Migration/Historical Data

What Syncs Automatically

Future appointments (starting from sync date)
Patient demographics
Provider schedules
Recall/recare lists

What Requires Manual Configuration

☐ Historical appointment data (optional — mainly for analytics) ☐ Patient communication preferences (opt-out lists from prior system) ☐ Custom appointment types mapping

⚠️ Critical: Opt-Out List Migration

If migrating from another reminder system:

Export opt-out list from existing system
Import to NexHealth before go-live
Verify opt-outs are honored (send test messages, confirm suppression)

Failure to migrate opt-outs = TCPA compliance risk and patient complaints

Security and HIPAA Compliance Verification

Enterprise-Level HIPAA Checklist

Item	Owner	Notes
☐ BAA executed	Legal	Required before any data sync
☐ SOC 2 Type II report reviewed	IT/Security	Request current report from vendor
☐ Data encryption verification (at-rest and in-transit)	IT	AES-256 required
☐ Access logging enabled	IT	Required for audit trail
☐ Role-based access configured	IT	Minimize access to PHI
☐ SSO integration complete	IT	Centralized access management
☐ User provisioning/deprovisioning process documented	IT/HR	Critical for terminations
☐ Data retention policy aligned	Compliance	Verify vendor retention matches org policy
☐ Incident response process documented	IT/Compliance	Know who to contact if breach suspected
☐ Subprocessor list reviewed	Legal	Verify acceptable third parties

🔵 Vendor Security Documentation to Request

☐ Current SOC 2 Type II report ☐ Penetration test summary (within last 12 months) ☐ Data processing addendum ☐ Subprocessor list ☐ Incident response SLA

DSO-Specific Configuration

Standardized Configuration Template

The following settings should be IDENTICAL across all locations:

Setting	Standard Configuration	Rationale
Appointment reminder sequence	7 days (email), 3 days (SMS), 1 day (SMS), 2 hours (SMS)	Consistent patient experience
Confirmation required reply	"C" to confirm, "R" to reschedule	Brand consistency
No-show follow-up timing	1 hour post-missed appointment	Rapid rebooking
Online scheduling window	8 weeks out	Capacity management
Minimum booking notice	24 hours	Prevent same-day chaos
Review request timing	2 hours post-appointment	Optimal response rate
Message sender name	"[Practice Name] Dental"	Brand compliance
Business hours for SMS	8 AM – 7 PM local time	Respect patient preferences

Location-Specific Configuration

The following can/should vary by location:

Setting	Allow Variation	Example Variations
Office hours	Yes	Different hours per location
Provider-specific scheduling rules	Yes	Dr. Smith: 30-min new patient; Dr. Jones: 45-min
Specialty-specific messaging	Yes	Ortho locations: different recall cadence
Language preferences	Yes	Spanish-language messaging where appropriate
Holiday schedules	Yes	State-specific holidays
Waitlist priority rules	Optional	Some locations prioritize by insurance type

Centralized Test Environment

🟣 Recommended Approach: Single test environment with multi-location simulation

Setup:

☐ Create "Test DSO" organization in NexHealth sandbox
☐ Add 3 simulated locations representing PMS variety
☐ Populate with synthetic patient data (no real PHI)
☐ Test configuration changes in sandbox before production deployment

Benefits:

Validate changes before pushing to any live location
Train champions without risk
Test edge cases (e.g., power outages, sync failures)

6. Team Training Plan

Train-the-Trainer Model

Champion Selection Criteria

Each location should have one designated champion who will:

Receive advanced training from central team/vendor
Train local staff
Serve as first-line support for questions
Participate in weekly check-ins during rollout
Provide feedback for process improvement

Ideal Champion Profile: ☐ Office manager or lead front desk coordinator ☐ 1+ year tenure at location ☐ Demonstrated tech comfort (uses smartphone apps, comfortable with software) ☐ Positive attitude toward change ☐ Influence with peers ☐ Available for 4 hours of training + ongoing 2 hours/week during rollout

Champion Certification Requirements: ☐ Complete 3-hour champion training program ☐ Pass proficiency assessment (90% score) ☐ Successfully deliver training to test group ☐ Signed acknowledgment of responsibilities

Champion Responsibilities

Phase	Responsibility	Time Commitment
Pre-Go-Live	Attend champion training	3 hours
Pre-Go-Live	Train location staff	2–3 hours
Go-Live Week	Available for real-time support	4 hours/day
Weeks 2–4	Daily check-ins with central team	15 min/day
Ongoing	Answer staff questions, escalate issues	2 hours/week

Standardized Training Materials

Materials to Create Centrally

Material	Format	Audience	Owner
Champion Training Deck	PowerPoint + video recording	Champions	Central Ops Team
Front Desk Training Guide	PDF + 20-min video	Front desk staff	Central Ops Team
Provider Quick Reference	1-page PDF	Dentists/Providers	Central Ops Team
Quick Reference Cards	Laminated cards	All staff	Central Ops Team
FAQ Document	Living Google Doc	All staff	Central Ops Team (updated by champions)
Troubleshooting Guide	PDF	Champions + IT	Central IT Team

Materials Champions Customize Locally

Material	Customization Allowed
Training schedule	Fit to location calendar
Role assignments	Who handles what at this location
Escalation contacts	Location-specific IT and manager contacts
Office-specific examples	"At our location, we typically see..."

Role-Specific Training Outlines

Front Desk / Office Manager Training

Duration: 2 hours (delivered by champion)

Module 1: Platform Overview (30 minutes)

What NexHealth does and why we're implementing it
How it connects to our PMS
What's changing in your daily workflow

Module 2: Daily Workflows (45 minutes)

Monitoring the NexHealth dashboard
Handling patient replies (confirmations, reschedules, questions)
Managing the waitlist
Processing online booking requests
Reviewing and responding to patient messages

Module 3: Administrative Functions (30 minutes)

Running reports
Managing patient communication preferences
Handling opt-outs
Troubleshooting common issues

Module 4: Practice Session (15 minutes)

Hands-on walkthrough with test patients

Common Resistance Points:

"This is going to make more work for me." → Address: This reduces calls and manual confirmations; you're shifting to higher-value tasks.
"Patients prefer talking to a real person." → Address: Patients still can call; this handles routine confirmations so you have more time for complex conversations.
"What if the system sends wrong messages?" → Address: Review the message templates together; show how approval workflows work.

Front Desk Day 1 Cheat Sheet

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║                    NEXHEALTH QUICK REFERENCE                      ║
╠══════════════════════════════════════════════════════════════════╣
║ LOGIN: nexhealth.com → SSO with your [company]

AI-generated implementation guide based on public vendor information. Verify specifics directly with NexHealth.

Implementation Playbook — DSO · Group Practice

NexHealth

avized.com

Generated May 28, 2026

AI-generated guide based on public vendor information. Verify specifics directly with NexHealth.

NexHealth — Implementation Playbook (DSO)

NexHealth Implementation Playbook for DSOs

Patient Communication AI Platform

1. Executive Summary

What NexHealth Does

Why DSOs Specifically Benefit from Patient Communication AI

At 15–50 locations, manual patient communication creates compounding inefficiencies that directly impact your bottom line:

Scale Advantages: A 1% reduction in no-show rates across 40 locations with 200 daily appointments each translates to 14,600 recovered appointments annually. NexHealth's automated confirmation sequences achieve this consistently without adding FTE.
Standardization: Inconsistent patient communication creates brand fragmentation and compliance exposure. Centralized template management ensures every location delivers identical messaging quality while allowing regional customization where appropriate.
Data Aggregation: Cross-location visibility into confirmation rates, online booking adoption, and patient response patterns enables evidence-based operational decisions impossible with siloed location data.
Labor Arbitrage: Front desk staff currently spend 2–3 hours daily on outbound calls and manual confirmations. Automation redirects this capacity toward revenue-generating activities like treatment coordination and insurance verification.

Expected Timeline: Decision to Full Deployment

Portfolio Size	Pilot Phase	Wave Deployment	Full Deployment
15–25 locations	Weeks 1–4	Weeks 5–12	10–14 weeks
26–40 locations	Weeks 1–4	Weeks 5–16	14–18 weeks
41–50 locations	Weeks 1–5	Weeks 6–20	18–22 weeks

Timeline assumes dedicated internal project management and vendor responsiveness. Add 20% buffer for organizations with complex PMS environments or significant IT infrastructure variation.

2. Pre-Implementation Checklist (Weeks 1–2)

Technical Requirements

Hardware Requirements

Software Requirements

☐ Practice Management System: Verify PMS version compatibility

Dentrix G6.2 or higher
Eaglesoft 21.0 or higher
Open Dental 21.1 or higher
Other PMS: Confirm API availability with NexHealth ☐ Email service: Verify no firewalls blocking NexHealth domains ☐ SMS capability: Confirm 10DLC registration status (required for SMS compliance)

Network Requirements

☐ Whitelist NexHealth IP ranges and domains (provided during onboarding) ☐ Verify firewall rules allow outbound API connections ☐ Test VPN/remote access compatibility if applicable

🔵 Vendor Onboarding Steps

Step	Owner	Timeline	Deliverable
Execute enterprise MSA and BAA	Legal/Vendor	Day 1–5	Signed agreements
Schedule kickoff call	Project Lead/Vendor	Day 3	Kickoff meeting scheduled
Receive dedicated CSM assignment	Vendor	Day 5	CSM contact + escalation path
Complete enterprise discovery questionnaire	Project Lead	Day 5–7	Completed intake form
Receive technical implementation guide	Vendor	Day 7	Documentation package
Establish vendor Slack/Teams channel	IT/Vendor	Day 7	Communication channel live

Key Contacts to Establish

Data/Access Prerequisites

For Each Location (Compile Master List)

Enterprise-Level Access

🟣 Internal Stakeholder Alignment

Stakeholder Alignment Map

Stakeholder	Role in Implementation	Required Action	Timing
Board/Investors	Awareness	Briefing on AI investment and expected ROI	Pre-decision
CEO/COO	Executive Sponsor	Approve budget, timeline, success metrics	Week 1
Chief Dental Officer	Clinical Governance	Approve patient communication standards	Week 1
VP of Operations	Project Owner	Own rollout execution, wave decisions	Week 1
VP of IT/CTO	Technical Authority	Approve integrations, security, infrastructure	Week 1
Regional Managers	Wave Execution Leaders	Coordinate location readiness, champion selection	Week 2
Office Managers	Location Implementation Leads	Prepare staff, manage local change	Week 2–3
Lead Providers per Location	Clinical Champions	Model adoption, provide feedback	Week 3+
Front Desk Staff	Primary Users	Complete training, execute daily workflows	Pre-go-live

🟣 Approvals Required Before Proceeding

Baseline Metrics to Capture

⚠️ Critical: These metrics MUST be captured before go-live to demonstrate ROI. Inconsistent measurement across locations will undermine your business case.

Standardized Metrics Collection Template

Metric	Definition	Data Source	Collection Method	Frequency
No-Show Rate	Missed appointments / Total scheduled appointments	PMS	Automated report	Monthly, trailing 3 months
Confirmation Rate	Confirmed appointments / Total confirmations sent	Manual tracking or PMS	Staff log	Monthly, trailing 3 months
Online Booking %	Online-booked appointments / Total appointments	PMS or website analytics	Automated report	Monthly, trailing 3 months
Front Desk Call Volume	Inbound + outbound calls	Phone system	Automated report	Weekly average
Avg. Time to Schedule	Days from patient request to booked appointment	Manual sampling	20-patient sample	One-time
Recall Reactivation Rate	Patients returning from recall / Recall list size	PMS	Automated report	Quarterly
Google Review Volume	New reviews per month	Google Business Profile	Manual count	Monthly, trailing 3 months
Avg. Google Rating	Current aggregate rating	Google Business Profile	Manual capture	Point-in-time
Patient Wait List Size	Patients waiting for appointments	Manual or PMS	Staff count	Point-in-time

⚠️ Standardization Requirements

Enterprise-Level Requirements

Network Standards Across Locations

Hosting Model Decision

🟣 Decision Required: Centralized vs. Location-Level Configuration

Approach	Pros	Cons	Recommendation
Centralized Admin	Single pane of glass, consistent settings, easier auditing	Less local flexibility, central team bottleneck	✅ Recommended for DSOs
Location-Level Admin	Local autonomy, faster small changes	Configuration drift, inconsistent patient experience	Not recommended

SSO Configuration

☐ Confirm NexHealth supports your identity provider (SAML 2.0 required) ☐ Plan SSO provisioning: auto-provisioning vs. manual user creation ☐ Define role-based access levels:

Enterprise Admin (central team)
Location Admin (office managers)
Standard User (front desk staff)
View-Only (regional managers, reporting access)

Centralized Credentialing

☐ Create master user provisioning template ☐ Establish onboarding/offboarding workflow for NexHealth access ☐ Define password policies consistent with organizational standards

3. Location Readiness Assessment

Scoring Framework

Rate each location on the following factors (1 = Low readiness, 5 = High readiness):

Factor 1: IT Infrastructure Maturity (Weight: 25%)

Score	Criteria
5	Cloud-hosted PMS, modern hardware (<3 years), consistent 50+ Mbps internet
4	Cloud-hosted PMS, adequate hardware, 25–50 Mbps internet
3	On-premise server (maintained), mixed hardware age, 15–25 Mbps internet
2	On-premise server (outdated), aging hardware, unreliable internet
1	Legacy PMS version, significant hardware issues, <15 Mbps internet

Factor 2: Staff Tenure and Adaptability (Weight: 20%)

Score	Criteria
5	<15% annual turnover, prior successful tech adoption, proactive staff
4	15–25% turnover, neutral tech adoption history, willing staff
3	25–35% turnover, mixed tech adoption results, some resistance
2	35–50% turnover, prior tech adoption struggles, significant resistance
1	>50% turnover, failed prior implementations, active resistance

Factor 3: Patient Volume (Weight: 20%)

Score	Criteria	Note
5	150–250 patients/week	High volume, high impact, manageable scale
4	250–350 patients/week	Very high impact, requires strong champion
3	100–150 patients/week	Moderate volume, good for pilot
2	350+ patients/week	⚠️ Highest impact but highest risk — not for Wave 1
1	<100 patients/week	Lower impact, limited ROI demonstration

Factor 4: Existing Tech Stack Compatibility (Weight: 20%)

Score	Criteria
5	NexHealth-supported PMS, no conflicting tools, clean data
4	Supported PMS, minor integration adjustments needed
3	Supported PMS, existing reminder system to decommission
2	Supported PMS but outdated version, significant cleanup needed
1	Unsupported PMS or major integration blockers

Factor 5: Local Champion Availability (Weight: 15%)

Score	Criteria
5	Identified tech-forward office manager + provider champion, both enthusiastic
4	Strong office manager champion, provider supportive
3	Willing office manager, provider neutral
2	No clear champion, need to develop one
1	Office manager resistant, provider uninvolved

Composite Score Calculation

Composite Score = (IT × 0.25) + (Staff × 0.20) + (Volume × 0.20) + (Tech Stack × 0.20) + (Champion × 0.15)

Readiness Tiers

Composite Score	Tier	Wave Assignment
4.0–5.0	High Readiness	Wave 1 (Pilot)
3.0–3.9	Medium Readiness	Wave 2
2.0–2.9	Low Readiness	Wave 3
<2.0	Not Ready	Remediation required before rollout

Sample Scoring Matrix

Location	IT (×.25)	Staff (×.20)	Volume (×.20)	Tech (×.20)	Champion (×.15)	Composite	Wave
Oakwood	5 (1.25)	4 (0.80)	3 (0.60)	5 (1.00)	5 (0.75)	4.40	Wave 1
Riverside	4 (1.00)	5 (1.00)	4 (0.80)	4 (0.80)	4 (0.60)	4.20	Wave 1
Downtown	3 (0.75)	3 (0.60)	5 (1.00)	4 (0.80)	3 (0.45)	3.60	Wave 2
Westside	3 (0.75)	2 (0.40)	2 (0.40)	3 (0.60)	2 (0.30)	2.45	Wave 3

Rollout Sequence Recommendations

Wave 1 Selection Criteria (2–3 Locations)

Wave 2 Expansion Criteria (5–8 Locations)

☐ Composite score 3.0–4.0 ☐ Learn from Wave 1 before deployment ☐ Group geographically for regional manager efficiency

Wave 3 and Beyond

☐ Remaining locations ☐ Address remediation items identified in assessment ☐ Consider acquisition-timeline locations — delay if integration pending

4. Rollout Strategy

Wave Structure Overview

Week 1–2    : Pre-implementation (all locations baseline, Wave 1 prep)
Week 3–4    : Wave 1 Pilot (2–3 locations)
Week 5–6    : Wave 1 Stabilization + Learning Capture
Week 7–10   : Wave 2 Deployment (5–8 locations)
Week 11–12  : Wave 2 Stabilization
Week 13–18  : Wave 3 Deployment (remaining locations)
Week 19–20  : Full portfolio stabilization
Week 21+    : Optimization phase

Wave 1: Pilot (Weeks 3–6)

Selection Criteria for Wave 1 Locations

🟣 Selection requires VP Operations + Regional Manager alignment

Wave 1 Timeline

Week	Activities
Week 3, Day 1–2	🔵 Integration installation, initial sync
Week 3, Day 3–4	Configuration and template setup
Week 3, Day 5	Staff training (2 hours)
Week 4, Day 1	Go-Live
Week 4, Days 2–5	Daily check-ins, issue resolution
Week 5	Weekly optimization review
Week 6	Wave 1 retrospective, documentation

Wave 1 Deliverables Before Proceeding

Go/No-Go Criteria: Wave 1 → Wave 2

🟣 Executive Gate Review Required

Criterion	Go Threshold	Measurement
Technical stability	<2 integration errors per day by Week 6	Vendor error log
Staff adoption	100% of trained staff using system daily	Activity log
Patient delivery	>95% message delivery rate	NexHealth dashboard
Confirmation improvement	≥5% improvement vs. baseline	Confirmation rate report
Staff satisfaction	≥3.5/5 average on pulse survey	Internal survey
No critical issues	Zero unresolved P1 issues	Issue tracker

If criteria not met: Extend Wave 1 by 2 weeks, address gaps, re-evaluate.

Wave 2: Expansion (Weeks 7–12)

Wave 2 Timeline Per Location

Day	Activities
Day 1	🔵 Integration installation (streamlined from Wave 1 learnings)
Day 2	Configuration using standardized template
Day 3	Champion training (1.5 hours) — train-the-trainer model
Day 4	Champion trains local staff
Day 5	Go-Live
Days 6–10	Daily check-ins
Week 2	Transition to weekly check-ins

Wave 2 Parallel Deployment

Deploy 2–3 locations per week
Stagger go-live days (Monday, Wednesday, Friday) to distribute support load
Regional managers coordinate within their portfolios

Buffer Between Waves

⚠️ Mandatory 1-week buffer between last Wave 1 go-live and first Wave 2 deployment for:

Retrospective completion
Template refinements
Training material updates
Support documentation updates

Wave 3: Full Deployment (Weeks 13–18)

Wave 3 Acceleration

By Wave 3, process should be highly efficient:

4–5 locations per week capacity
Remote-first deployment (no on-site vendor support)
Champions trained via video + existing champion mentorship

Wave 3 Considerations

Rollback Plan

Triggers for Rollback

Integration causing PMS instability
10% patient complaints about communication changes
Critical HIPAA or compliance concern
Staff unable to function after 5 business days

⚠️ Rollback Procedure (Per Location)

Disable automated messaging in NexHealth (maintain sync for data continuity)
Reactivate prior reminder system (if still available) or revert to manual process
Communicate to patients: "We're updating our communication systems. You may receive a call from our team directly."
Document failure mode for root cause analysis
Do NOT proceed with additional locations until resolved

Rollback Impact Isolation

NexHealth architecture allows location-level disabling without affecting other locations
Central admin can pause individual location from enterprise dashboard
Patient data sync can continue even if messaging is paused

5. Configuration & Integration (Weeks 2–3)

Practice Management System Integration

🔵 Dentrix Integration (Step-by-Step)

Prerequisites: ☐ Dentrix G6.2 or higher installed ☐ Server access credentials ☐ 10–15 minutes for installation ☐ Dentrix closed during agent installation

Installation Steps:

☐ Download NexHealth Sync Agent from provided link
☐ Run installer as administrator on Dentrix server
☐ Enter API key provided by NexHealth CSM
☐ Configure sync frequency (recommended: every 5 minutes)
☐ Restart Dentrix
☐ Verify sync status in NexHealth dashboard (green = connected)

⚠️ Common Issues:

Firewall blocking outbound connection → Whitelist NexHealth IPs
Sync agent service not starting → Check Windows services, verify "Run as Administrator"
Duplicate patient records → Enable merge rules in NexHealth settings

Estimated Time: 30 minutes per location (first time); 15 minutes (subsequent)

🔵 Eaglesoft Integration (Step-by-Step)

Prerequisites: ☐ Eaglesoft 21.0 or higher ☐ API access enabled (Patterson support may be needed) ☐ Server access credentials

Installation Steps:

☐ Request API activation from Patterson (allow 48–72 hours)
☐ Download NexHealth Sync Agent
☐ Install on Eaglesoft server
☐ Configure API connection with credentials from Patterson
☐ Set sync frequency
☐ Verify in dashboard

⚠️ Common Issues:

Patterson API not activated → Confirm API status before scheduling install
Time zone misalignment → Verify server time zone matches location

Estimated Time: 45 minutes per location (excluding Patterson lead time)

🔵 Open Dental Integration (Step-by-Step)

Prerequisites: ☐ Open Dental 21.1 or higher ☐ API key generated in Open Dental (Program Links > API) ☐ Server or cloud connection details

Installation Steps:

☐ Generate API key in Open Dental admin panel
☐ Provide API key to NexHealth via secure portal
☐ NexHealth configures cloud-to-cloud connection (no local install for cloud-hosted)
☐ For server-based: Install sync agent similar to Dentrix process
☐ Verify sync

Estimated Time: 20 minutes (cloud-hosted); 30 minutes (server-based)

Test Environment Setup

Pre-Go-Live Validation Checklist

☐ Patient sync validation

Verify 100 random patients synced correctly (name, DOB, contact info, upcoming appointments)
Confirm appointment history pulled accurately

☐ Appointment sync validation

Create test appointment in PMS → Confirm appears in NexHealth within sync cycle
Cancel/reschedule in PMS → Confirm updates in NexHealth

☐ Message delivery test

Send test reminder to staff phone numbers
Verify email delivery (check spam folders)
Test SMS reply functionality

☐ Online scheduling test

Book test appointment via patient portal
Verify appointment appears in PMS correctly
Verify confirmation message sent

☐ Forms test (if using digital forms)

Submit test form
Verify data flows to PMS patient record

Data Migration/Historical Data

What Syncs Automatically

Future appointments (starting from sync date)
Patient demographics
Provider schedules
Recall/recare lists

What Requires Manual Configuration

☐ Historical appointment data (optional — mainly for analytics) ☐ Patient communication preferences (opt-out lists from prior system) ☐ Custom appointment types mapping

⚠️ Critical: Opt-Out List Migration

If migrating from another reminder system:

Export opt-out list from existing system
Import to NexHealth before go-live
Verify opt-outs are honored (send test messages, confirm suppression)

Failure to migrate opt-outs = TCPA compliance risk and patient complaints

Security and HIPAA Compliance Verification

Enterprise-Level HIPAA Checklist

Item	Owner	Notes
☐ BAA executed	Legal	Required before any data sync
☐ SOC 2 Type II report reviewed	IT/Security	Request current report from vendor
☐ Data encryption verification (at-rest and in-transit)	IT	AES-256 required
☐ Access logging enabled	IT	Required for audit trail
☐ Role-based access configured	IT	Minimize access to PHI
☐ SSO integration complete	IT	Centralized access management
☐ User provisioning/deprovisioning process documented	IT/HR	Critical for terminations
☐ Data retention policy aligned	Compliance	Verify vendor retention matches org policy
☐ Incident response process documented	IT/Compliance	Know who to contact if breach suspected
☐ Subprocessor list reviewed	Legal	Verify acceptable third parties

🔵 Vendor Security Documentation to Request

☐ Current SOC 2 Type II report ☐ Penetration test summary (within last 12 months) ☐ Data processing addendum ☐ Subprocessor list ☐ Incident response SLA

DSO-Specific Configuration

Standardized Configuration Template

The following settings should be IDENTICAL across all locations:

Setting	Standard Configuration	Rationale
Appointment reminder sequence	7 days (email), 3 days (SMS), 1 day (SMS), 2 hours (SMS)	Consistent patient experience
Confirmation required reply	"C" to confirm, "R" to reschedule	Brand consistency
No-show follow-up timing	1 hour post-missed appointment	Rapid rebooking
Online scheduling window	8 weeks out	Capacity management
Minimum booking notice	24 hours	Prevent same-day chaos
Review request timing	2 hours post-appointment	Optimal response rate
Message sender name	"[Practice Name] Dental"	Brand compliance
Business hours for SMS	8 AM – 7 PM local time	Respect patient preferences

Location-Specific Configuration

The following can/should vary by location:

Setting	Allow Variation	Example Variations
Office hours	Yes	Different hours per location
Provider-specific scheduling rules	Yes	Dr. Smith: 30-min new patient; Dr. Jones: 45-min
Specialty-specific messaging	Yes	Ortho locations: different recall cadence
Language preferences	Yes	Spanish-language messaging where appropriate
Holiday schedules	Yes	State-specific holidays
Waitlist priority rules	Optional	Some locations prioritize by insurance type

Centralized Test Environment

🟣 Recommended Approach: Single test environment with multi-location simulation

Setup:

☐ Create "Test DSO" organization in NexHealth sandbox
☐ Add 3 simulated locations representing PMS variety
☐ Populate with synthetic patient data (no real PHI)
☐ Test configuration changes in sandbox before production deployment

Benefits:

Validate changes before pushing to any live location
Train champions without risk
Test edge cases (e.g., power outages, sync failures)

6. Team Training Plan

Train-the-Trainer Model

Champion Selection Criteria

Each location should have one designated champion who will:

Receive advanced training from central team/vendor
Train local staff
Serve as first-line support for questions
Participate in weekly check-ins during rollout
Provide feedback for process improvement

Champion Responsibilities

Phase	Responsibility	Time Commitment
Pre-Go-Live	Attend champion training	3 hours
Pre-Go-Live	Train location staff	2–3 hours
Go-Live Week	Available for real-time support	4 hours/day
Weeks 2–4	Daily check-ins with central team	15 min/day
Ongoing	Answer staff questions, escalate issues	2 hours/week

Standardized Training Materials

Materials to Create Centrally

Material	Format	Audience	Owner
Champion Training Deck	PowerPoint + video recording	Champions	Central Ops Team
Front Desk Training Guide	PDF + 20-min video	Front desk staff	Central Ops Team
Provider Quick Reference	1-page PDF	Dentists/Providers	Central Ops Team
Quick Reference Cards	Laminated cards	All staff	Central Ops Team
FAQ Document	Living Google Doc	All staff	Central Ops Team (updated by champions)
Troubleshooting Guide	PDF	Champions + IT	Central IT Team

Materials Champions Customize Locally

Material	Customization Allowed
Training schedule	Fit to location calendar
Role assignments	Who handles what at this location
Escalation contacts	Location-specific IT and manager contacts
Office-specific examples	"At our location, we typically see..."

Role-Specific Training Outlines

Front Desk / Office Manager Training

Duration: 2 hours (delivered by champion)

Module 1: Platform Overview (30 minutes)

What NexHealth does and why we're implementing it
How it connects to our PMS
What's changing in your daily workflow

Module 2: Daily Workflows (45 minutes)

Monitoring the NexHealth dashboard
Handling patient replies (confirmations, reschedules, questions)
Managing the waitlist
Processing online booking requests
Reviewing and responding to patient messages

Module 3: Administrative Functions (30 minutes)

Running reports
Managing patient communication preferences
Handling opt-outs
Troubleshooting common issues

Module 4: Practice Session (15 minutes)

Hands-on walkthrough with test patients

Common Resistance Points:

"This is going to make more work for me." → Address: This reduces calls and manual confirmations; you're shifting to higher-value tasks.
"Patients prefer talking to a real person." → Address: Patients still can call; this handles routine confirmations so you have more time for complex conversations.
"What if the system sends wrong messages?" → Address: Review the message templates together; show how approval workflows work.

Front Desk Day 1 Cheat Sheet

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