Pearly — Patient Billing & A/R Implementation Playbook

For DSOs & Multi-Location Groups

Executive Summary

Pearly is a dental patient-financial workflow platform focused on patient balance billing, A/R follow-up, payment plans, and payment processing. Its value is in automating repetitive patient-balance outreach after insurance responsibility is known: digital statements, text/email reminders, payment links, plan enrollment, payment retries, pre-collection communication, and follow-up actions on unresolved balances.

Pearly should not be treated as an insurance-verification platform. For a DSO, the implementation question is whether it can standardize patient financial follow-up across locations while improving collections and reducing staff time without creating a poor patient experience.

Best Fit

Pearly is most relevant when a group has:

• Meaningful patient A/R and aging balances.
• Inconsistent follow-up cadence across locations.
• Manual statement, text, call, or payment-plan workflows.
• A need for centralized reporting on patient collections.
• Multiple locations that would benefit from one financial-communication standard.

Pre-Implementation Baseline

Capture 60–90 days of current patient-balance performance:

• Patient A/R by aging bucket.
• Average days from first patient statement to payment.
• Digital-payment adoption.
• Payment-plan utilization and default rate.
• Staff hours spent on patient-balance follow-up.
• Statement/postage costs.
• Bad-debt or collection-agency placements.
• Patient complaints tied to billing communication.

Phase 1 — Pilot Design

Choose 3–5 locations with representative patient volume and stable front-office leadership. Start with a defined balance cohort rather than the entire enterprise.

Recommended pilot controls:

• Set minimum balance thresholds.
• Define reminder cadence and tone.
• Define payment-plan eligibility.
• Define pre-collection escalation timing.
• Decide which balances require human review.
• Confirm how payments post back into the PMS.

Phase 2 — Patient Communication Governance

At DSO scale, message governance matters as much as automation. Standardize:

• Statement language.
• SMS/email cadence.
• Hours when messages may be sent.
• Dispute/escalation workflows.
• Payment-plan terms.
• Collection-agency handoff rules.
• Location versus central-team ownership.

Keep local teams informed so a patient who replies or calls receives the same answer the automated workflow gave them.

Phase 3 — Scale and Centralize

After the pilot, expand in waves based on:

• PMS/payment integration readiness.
• Patient-contact data quality.
• Location adoption.
• Collection lift.
• Complaint rate.
• Payment-posting accuracy.

For multi-location groups, create a central dashboard review cadence for aging balances, failed payments, plan defaults, disputes, and collection exceptions.

What to Measure

• Patient A/R reduction by aging bucket.
• Percentage of balances paid digitally.
• Average days to patient payment.
• Dollars collected per 1,000 outreach messages.
• Staff hours removed from follow-up.
• Payment-plan completion/default rate.
• Failed-payment recovery.
• Cost per dollar collected.
• Patient opt-out / complaint rate.

DSO Evaluation Questions

1. Which PMS systems support balance and payment write-back today?
2. How are payments reconciled across locations?
3. Can central teams govern messaging while locations retain visibility?
4. Can cadence vary by balance size, aging, or location?
5. How are disputes and hardship situations routed to humans?
6. What payment-plan controls are available?
7. How are failed payments retried and surfaced?
8. Can pre-collection letters and handoffs be standardized?
9. What reporting exists by location and aging bucket?
10. What fees apply to software, payment processing, and communications?

Red Flags

• Payment activity does not reconcile cleanly to the PMS.
• Patient messages can be triggered without clear governance.
• Staff cannot see the communication history when a patient calls.
• Payment-plan rules are too rigid for your financial policy.
• Collection lift is measured without accounting for normal payment timing.

Avized Take

Pearly is best evaluated as a patient financial follow-up and billing automation layer. The strongest DSO use case is standardizing patient A/R workflows across locations while shifting routine reminders, payments, plans, and pre-collection steps away from manual staff work. Measure the product on patient A/R movement and staff time—not on insurance-verification outcomes.