Trojan Professional Services
Implementation PlaybookDSO · Group Practice

Trojan Professional Services

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

Trojan Professional Services — Implementation Playbook (DSO)

Trojan Professional Services Implementation Playbook

Revenue Cycle AI for Dental Support Organizations


1. Executive Summary

What This Tool Does

Trojan Professional Services is a revenue cycle optimization platform that uses AI-driven insurance verification, benefits analysis, and fee schedule management to maximize collections and reduce administrative burden. The system automates insurance eligibility verification, identifies optimal fee schedules, and provides real-time benefits breakdowns to improve case acceptance and accelerate reimbursement.

Why DSOs Specifically Benefit

At scale, revenue cycle inefficiencies compound dramatically. A 2% improvement in collections across 30 locations with average annual revenue of $1.5M each represents $900,000 in recovered revenue annually. DSOs gain three distinct advantages from AI-powered revenue cycle tools:

  1. Data Aggregation Intelligence: Cross-location data reveals payer behavior patterns, regional fee schedule variations, and denial trends that single practices cannot detect.
  2. Standardization at Scale: Centralized fee schedule management and verification protocols eliminate location-by-location inconsistencies that leak revenue.
  3. Administrative Leverage: One centralized team can manage insurance verification for dozens of locations, reducing per-practice overhead by 40-60%.

Expected Timeline

Phase Timeline Milestone
Decision to Contract Week 0 Signed agreement
Pre-Implementation Weeks 1-2 Technical readiness confirmed
Wave 1 Pilot (2-3 locations) Weeks 3-5 Pilot locations live
Wave 2 (5-8 locations) Weeks 6-9 Second cohort live
Wave 3+ (remaining locations) Weeks 10-16 Full deployment
Optimization Weeks 17-24 ROI validation complete

Total timeline from decision to full deployment: 16-20 weeks for a 25-location DSO; add 4-6 weeks for portfolios exceeding 35 locations.


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

Technical Requirements

Hardware

☐ Workstations with minimum 4GB RAM, dual monitors recommended for billing staff (reduces toggling time by 35%) ☐ Stable internet connection: minimum 25 Mbps download/10 Mbps upload per location ☐ Scanner capability for paper EOBs (if applicable)

Software

☐ Supported Practice Management System version:

  • Dentrix G6.2 or higher
  • Eaglesoft 21.0 or higher
  • Open Dental 22.1 or higher
  • Other PMS: confirm compatibility with vendor 🔵 ☐ Modern web browser (Chrome, Edge, Firefox — latest two versions) ☐ PDF reader for reports

Network

☐ Firewall allowlist: Trojan server IP ranges (provided during onboarding) 🔵 ☐ Outbound ports 443 (HTTPS) and 8443 open ☐ VPN compatibility confirmed if locations use VPN for PMS access

Vendor Onboarding Steps

Task Owner Timeline Vendor Required
☐ Execute BAA and service agreement Legal/Compliance Day 1-3 🔵
☐ Receive implementation welcome packet Project Lead Day 3 🔵
☐ Schedule kickoff call Project Lead Day 3-5 🔵
☐ Assign dedicated implementation manager Vendor Day 5 🔵
☐ Establish escalation contacts Project Lead Day 5 🔵

Key Vendor Contacts to Establish

☐ Implementation Manager (primary contact for rollout) ☐ Technical Support (Tier 1 and Tier 2 escalation paths) ☐ Customer Success Manager (post-launch relationship owner) ☐ Emergency/after-hours support line

Data/Access Prerequisites

☐ PMS superuser credentials for integration testing (one per location or centralized if using cloud PMS) ☐ Current fee schedule exports from all locations (CSV or PDF) ☐ Payer mix report from each location (last 12 months) ☐ API keys if PMS supports direct integration (Open Dental API key, Dentrix G7 connector credentials) ☐ Read access to claims history (minimum 6 months) for baseline analysis 🔵

⚠️ Common Failure Point: Locations often lack administrative-level PMS credentials. Start this credential audit in Week 1 to avoid delays.

Enterprise-Level Requirements

Network Standards

🟣 ☐ Decision: Centralized cloud hosting vs. location-level instances

  • Recommendation: Centralized hosting for DSOs with homogeneous PMS; hybrid for mixed PMS environments ☐ Network latency requirements: <200ms round-trip to Trojan servers from all locations ☐ Bandwidth allocation: ensure revenue cycle traffic doesn't compete with imaging uploads

Authentication

☐ SSO integration (SAML 2.0 or OAuth 2.0) — confirm Trojan supports your identity provider 🔵 ☐ If no SSO: centralized credentialing process for user provisioning/deprovisioning ☐ Role-based access control mapping (billing manager, billing staff, provider view-only, regional admin)

Data Governance

🟣 ☐ Data residency requirements confirmed (all PHI stored in US-based servers) ☐ Data retention policy aligned with organizational standards ☐ Audit logging enabled for compliance reporting

Stakeholder Alignment Map

Stakeholder Role Alignment Need Timing
Board/Investors Approve budget, expect ROI reporting Budget approval, ROI framework agreement Week 1
CEO/COO Executive sponsor Champion initiative, remove blockers Week 1
CFO Financial oversight Approve fee schedule changes, review ROI metrics Week 1
Chief Dental Officer Clinical sign-off Ensure clinical workflow isn't disrupted Week 1-2
VP of Operations Operational lead Own rollout execution Week 1
VP of IT Technical lead Own infrastructure readiness Week 1
Regional Managers Regional execution Cascade plan to locations, troubleshoot Week 2
Office Managers Location execution Prepare teams, manage local change Week 2
Revenue Cycle/Billing Director Process owner Define standardized workflows Week 1

Baseline Metrics to Capture

⚠️ Critical: Capture these metrics BEFORE go-live from ALL locations using standardized methodology. Without baselines, ROI measurement is impossible.

Metric Definition Source Capture Method
Claim Denial Rate % of claims denied on first submission PMS/Clearinghouse Pull 90-day report
Days in A/R Average days from service to payment PMS Aging Report Pull snapshot
Insurance Verification Time Minutes per patient verification Time study Sample 20 patients/location
Fee Schedule Accuracy % of procedures billed at optimal rate Fee schedule audit Compare current vs. UCR
Collection Rate Net collections / net production PMS Pull 12-month report
Case Acceptance Rate % of presented treatment accepted PMS Pull 12-month report
Write-off Percentage Total write-offs / gross production PMS Pull 12-month report

Standardization Protocol for Cross-Location Comparison

🟣 ☐ Define universal metric definitions (document in shared playbook) ☐ Establish single report template for all locations ☐ Set common reporting period (recommend: trailing 90 days) ☐ Assign one analyst to pull/validate all location data to ensure consistency ☐ Store baseline data in centralized repository (suggest: shared drive or BI tool)


3. Location Readiness Assessment

Scoring Framework

Rate each location 1-5 on each factor. Composite score determines rollout wave placement.

Factor 1: IT Infrastructure Maturity

Score Criteria
1 Network <10 Mbps, hardware >7 years old, unsupported PMS version
2 Network 10-25 Mbps, hardware 5-7 years old, PMS one version behind
3 Network 25-50 Mbps, hardware 3-5 years old, current PMS version
4 Network 50-100 Mbps, hardware 1-3 years old, current PMS, one other integration
5 Network >100 Mbps, hardware <1 year old, current PMS, multiple integrations, IT support on-site

Factor 2: Staff Tenure and Adaptability

Score Criteria
1 >50% turnover last year, no tech training history, documented resistance to past changes
2 30-50% turnover, minimal tech training, mixed reception to past changes
3 15-30% turnover, some tech training, neutral reception to changes
4 <15% turnover, regular tech training, positive reception to past changes
5 <10% turnover, continuous learning culture, team has championed past tech rollouts

Factor 3: Patient Volume

Score Criteria Notes
1 <200 patients/month Low impact, low risk
2 200-400 patients/month Moderate impact
3 400-600 patients/month Good balance of impact and manageability
4 600-800 patients/month High impact, moderate risk
5 >800 patients/month Highest impact, highest risk — not recommended for Wave 1

Factor 4: Tech Stack Compatibility

Score Criteria
1 Unsupported PMS, no clearinghouse integration, paper-based EOBs
2 Supported PMS but outdated version, basic clearinghouse
3 Current PMS version, standard clearinghouse integration
4 Current PMS, advanced clearinghouse, one other revenue cycle tool
5 Current PMS, full clearinghouse suite, existing API integrations, proven integration history

Factor 5: Local Champion Availability

Score Criteria
1 No candidate identified, all staff skeptical of tech
2 Possible candidate but lacks time or full commitment
3 Willing champion but limited tech experience
4 Enthusiastic champion with tech experience and peer influence
5 Dedicated champion with tech background, leadership skills, and protected time for rollout

Scoring Calculator

Location IT Infra (1-5) Staff (1-5) Volume (1-5)* Tech Stack (1-5) Champion (1-5) Composite
Location A
Location B

*Note: For Wave 1, treat Volume score of 5 as a negative — ideal pilots are 3-4 (meaningful volume without excessive risk).

  • IT Infrastructure: 25%
  • Staff Adaptability: 20%
  • Patient Volume: 15%
  • Tech Stack: 25%
  • Champion: 15%

Composite Score Formula: (IT × 0.25) + (Staff × 0.20) + (Volume × 0.15) + (Tech × 0.25) + (Champion × 0.15)

Rollout Wave Recommendations

Composite Score Wave Assignment Rationale
4.0 - 5.0 Wave 1 (Pilot) High readiness, can absorb early friction
3.0 - 3.9 Wave 2 Solid foundation, will benefit from pilot learnings
2.0 - 2.9 Wave 3 Needs additional preparation; use buffer time for remediation
<2.0 Remediation Required Do not deploy until specific factors addressed

Remediation Actions by Factor

Low-Scoring Factor Remediation Action Owner Timeline
IT Infrastructure Hardware upgrade, PMS update, network upgrade IT 4-8 weeks
Staff Adaptability Change management workshops, early involvement in pilot observations HR/Operations 2-4 weeks
Tech Stack PMS upgrade, clearinghouse migration IT 6-12 weeks
Champion Recruit, interview candidates; consider incentive structure Regional Manager 2 weeks

4. Rollout Strategy

Wave Structure

Wave Locations Criteria Timeline
Wave 1 (Pilot) 2-3 locations Highest readiness scores (4.0+), variety of PMS types represented, geographic diversity, strong champions Weeks 3-5
Wave 2 5-8 locations Scores 3.5+, apply lessons from Wave 1, include at least one "challenging" location to test playbook robustness Weeks 6-9
Wave 3 8-10 locations Scores 3.0+, bulk of portfolio Weeks 10-13
Wave 4 Remaining locations All remaining, including remediated locations Weeks 14-16

Wave 1 Selection Criteria (Pilot Locations)

🟣 Select 2-3 locations that meet ALL of the following: ☐ Composite readiness score ≥ 4.0 ☐ Office manager tenure ≥ 2 years ☐ At least one tech-forward provider willing to champion ☐ Representative of broader portfolio (e.g., if DSO has Dentrix and Eaglesoft locations, pilot should include both) ☐ NOT the highest-volume location (avoid maximum stress during learning phase) ☐ NOT a location currently undergoing other major changes (renovation, leadership change) ☐ Regional manager for this location is engaged and available

Timeline Per Wave

Phase Duration Activities
Pre-Wave Prep 3 days Champion briefing, final credential verification, local communication
Configuration 3-5 days Integration completion, test environment validation
Training 2-3 days Champion certification, staff training delivery
Go-Live 1 day Monitored launch
Stabilization 5-7 days Daily check-ins, rapid issue resolution
Buffer 5-7 days Lessons captured, playbook updated, next wave prep

Critical: Do not compress buffer periods. These learning loops are where playbook refinements happen.

Go/No-Go Criteria Between Waves

🟣 Advance to next wave only when ALL criteria met:

Criterion Threshold Measurement
System Uptime ≥ 99% during stabilization Vendor dashboard
Staff Confidence ≥ 80% of staff rate confidence 3+ on 1-5 scale Pulse survey
Critical Issues Zero unresolved P1 issues Issue tracker
Process Compliance ≥ 90% of verifications using new workflow Audit of 20 random patients
Champion Certification 100% of next-wave champions trained Training tracker
Baseline Metrics Captured 100% of next-wave locations Data repository

Rollback Plan

If a wave fails go/no-go criteria:

  1. Pause: No new locations begin implementation
  2. Assess: Within 48 hours, categorize issues:
    • Technical (vendor-dependent)
    • Process (training gap)
    • Environmental (location-specific)
  3. Communicate: Regional managers inform affected and upcoming locations
  4. Remediate:
    • Technical issues: vendor escalation with defined SLA 🔵
    • Process issues: retrain, update materials
    • Environmental issues: location-specific intervention
  5. Revalidate: Re-run go/no-go assessment before resuming
  6. Resume: Maximum 2-week pause; if exceeds 2 weeks, conduct formal project review with executive sponsor 🟣

⚠️ Common Failure Point: DSOs often rush through waves to hit deployment targets. Failed waves that aren't properly addressed create compounding problems.


5. Configuration & Integration (Weeks 2–3)

PMS Integration: Step-by-Step

Dentrix Integration

Step Action Owner Time Notes
1 ☐ Confirm Dentrix version ≥ G6.2 Location IT 10 min
2 ☐ Export current fee schedules (Office Manager > Fee Schedules > Export) Billing 30 min
3 ☐ Enable Dentrix Connector Service IT 15 min Requires admin rights
4 🔵 ☐ Install Trojan Dentrix bridge application Vendor + IT 45 min Vendor provides installer
5 ☐ Configure data mapping (procedure codes, provider IDs) Billing + Vendor 60 min 🔵
6 ☐ Test patient pull (verify 10 random patients sync correctly) Billing 20 min
7 ☐ Test insurance verification on 5 patients Billing 30 min
8 ☐ Validate fee schedule recommendations display correctly Billing 20 min

Eaglesoft Integration

Step Action Owner Time Notes
1 ☐ Confirm Eaglesoft version ≥ 21.0 Location IT 10 min
2 ☐ Enable Eaglesoft API access (Setup > API Configuration) IT 20 min Requires Patterson credentials
3 🔵 ☐ Obtain Patterson API authorization Vendor 2-5 days Start early — can delay
4 🔵 ☐ Configure Trojan-Eaglesoft connection string Vendor + IT 30 min
5 ☐ Map fee schedule tables Billing + Vendor 60 min 🔵
6 ☐ Test bi-directional sync (create test patient, verify appears in Trojan) IT 30 min
7 ☐ Validate insurance eligibility workflow end-to-end Billing 45 min

⚠️ Common Failure Point: Patterson API authorization can take up to 5 business days. Initiate in Week 1.

Open Dental Integration

Step Action Owner Time Notes
1 ☐ Confirm Open Dental version ≥ 22.1 IT 10 min
2 ☐ Enable API (Setup > Program Links > API) IT 15 min
3 ☐ Generate API key IT 10 min Store securely
4 🔵 ☐ Provide API key to Trojan implementation team Project Lead 5 min
5 🔵 ☐ Trojan configures connection Vendor 30 min
6 ☐ Test read operations (patient demographics, insurance info) IT 20 min
7 ☐ Test write operations (fee schedule updates, eligibility flags) Billing 30 min
8 ☐ Validate real-time eligibility check workflow Billing 30 min

Test Environment Setup

🟣 ☐ Decision: Centralized test environment vs. per-location testing

Recommendation: Centralized test environment for initial integration validation, then per-location verification with production data subset.

Test Environment Checklist

Item Action Owner Complete
☐ Provision test database (copy of production, anonymized) IT
☐ Configure Trojan test instance (separate from production) Vendor 🔵
☐ Create test user accounts for QA team Project Lead
☐ Load sample fee schedules Billing
☐ Load sample patient/insurance data (minimum 100 patients) IT
☐ Document test cases for each workflow Project Lead
☐ Execute test cases, document results QA Team
☐ Resolve test failures before production go-live All

Validation Checklist

Test Case Expected Result Pass/Fail
Patient lookup by name Patient record retrieved with demographics
Patient lookup by DOB Patient record retrieved correctly
Insurance eligibility check Real-time eligibility response within 15 seconds
Fee schedule recommendation Optimal fee displays for selected procedure
Benefits breakdown Deductible, annual max, coverage % display accurately
Claims status sync Claim status updates reflected in PMS
User access by role Appropriate access restrictions enforced
Audit log generation All PHI access logged

Data Migration / Historical Data Ingestion

Step Action Owner Time Notes
1 ☐ Determine scope: How much historical claims data to import Project Lead 30 min 🟣 Recommend: 12 months
2 ☐ Export historical claims from clearinghouse Billing Director 2 hours
3 🔵 ☐ Format data per Trojan import spec Vendor + Billing 2-4 hours
4 🔵 ☐ Vendor imports historical data Vendor 4-8 hours
5 ☐ Validate import: spot-check 25 claims for accuracy Billing 1 hour
6 ☐ Confirm denial patterns and payer trends populate analytics Project Lead 30 min

Configuration Standards

Standardized Configuration Template (Identical Across Locations)

Setting Standard Value Rationale
Eligibility check timing 48 hours before appointment Balance between freshness and efficiency
Auto-verification threshold 95% confidence Below this, require manual review
Fee schedule update frequency Monthly Align with UCR update cycles
Denial alert threshold Flag claims >$500 denied Focus attention on high-value denials
User session timeout 30 minutes HIPAA compliance
Report generation time 6:00 AM local Complete before office opens
Data retention 7 years Standard compliance requirement

Location-Specific Configuration (May Vary)

Setting Why It Varies Who Decides
Provider-specific fee schedule tiers Specialty mix differs CDO + Office Manager
Payer priority ranking Regional payer mix varies Regional Manager
Appointment reminder integration Some locations use different reminder systems Office Manager
Report distribution list Local leadership varies Office Manager
Alert notification preferences Staff availability differs Office Manager

Enterprise HIPAA Compliance Checklist

Requirement Verification Owner Status
☐ BAA executed with Trojan Signed document on file Legal
☐ Data encryption at rest Vendor attestation, SOC 2 Type II IT Security 🔵
☐ Data encryption in transit TLS 1.2+ verified IT Security
☐ Access controls documented Role-based access matrix approved Compliance
☐ Audit logging enabled Sample logs reviewed IT Security
☐ Breach notification process Documented in BAA Legal
☐ Minimum necessary access Verified during UAT Compliance
☐ Workforce training Privacy training completed HR
☐ Data disposal procedures Documented and agreed Legal + Vendor 🔵
☐ Subcontractor BAAs Vendor provides list Legal 🔵

6. Team Training Plan

Train-the-Trainer Model

Champion Selection Criteria

Each location needs one certified champion. Ideal candidates:

Criterion Weight Notes
Billing/insurance experience High Must understand current workflow deeply
Peer influence High Respected by colleagues
Tech comfort Medium Willing to learn, doesn't need to be expert
Communication skills High Will train others
Availability Medium Needs protected time during rollout
Tenure Medium Minimum 1 year at location preferred

Red flags: Candidate is overwhelmed with current duties; candidate is skeptical of technology; candidate is planning to leave.

Champion Responsibilities

Phase Responsibility Time Commitment
Pre-Go-Live Complete certification training 4-6 hours
Pre-Go-Live Customize training materials for local team 2 hours
Pre-Go-Live Schedule and deliver staff training 3-4 hours
Go-Live Week Serve as first point of contact for questions 2-3 hours/day
Post-Go-Live Conduct weekly office hours for first month 1 hour/week
Ongoing Train new hires, deliver refresher training 1-2 hours/month

Champion Certification Requirements

🔵 ☐ Complete vendor-provided champion training (4 hours) — delivered by Trojan ☐ Pass certification assessment (80% minimum) ☐ Shadow one go-live at pilot location (Wave 2+ champions) ☐ Deliver practice training session with feedback from regional manager ☐ Certification recorded in central tracker

Standardized Training Materials (Created Centrally)

Material Format Owner Distribution
Role-specific training decks PowerPoint Central Training Team Shared drive
Workflow videos (5-7 min each) MP4/LMS Central Training Team LMS or shared drive
Quick reference guides PDF, laminated Central Training Team Print for each location
FAQ document Google Doc/Wiki Central Training Team Updated continuously
Assessment questions Form/Quiz Central Training Team LMS or paper

Role-Specific Training Outlines

Billing/Insurance Staff Training

Duration: 3 hours (delivered by champion)

Format: 1.5 hours live demo + 1 hour hands-on + 30 min Q&A

Content:

Module Duration Key Points
System Overview 20 min What Trojan does, why we're implementing, expected benefits
Login and Navigation 15 min SSO access, dashboard layout, menu structure
Insurance Verification Workflow 45 min Step-by-step: initiating verification, interpreting results, handling exceptions
Fee Schedule Management 30 min Viewing recommendations, updating PMS, override process
Claims Status and Denial Management 30 min Tracking claims, understanding denial codes, appeal workflow
Reporting 20 min Accessing daily/weekly reports, key metrics to monitor
Troubleshooting 20 min Common issues, when to escalate, support contact info

Common Resistance Points:

  • "This is more clicks than what I do now" → Show time savings data from pilot locations
  • "I don't trust the system's recommendations" → Explain AI confidence scores, show override option
  • "What happens to my job?" → Emphasize tool enhances their work, doesn't replace it

Front Desk / Office Manager Training

Duration: 1.5 hours (delivered by champion)

Format: 45 min demo + 30 min hands-on + 15 min Q&A

Content:

Module Duration Key Points
Why We're Changing 15 min Business rationale, expected patient benefits
Eligibility Check in Patient Flow 30 min When verification happens, what to communicate to patients
Interpreting Benefits for Patients 20 min Reading benefits breakdown, explaining coverage
Handling Verification Failures 15 min What to do when eligibility can't be confirmed
Escalation Procedures 10 min When to involve billing team

Common Resistance Points:

  • "This slows down check-in" → Show how real-time verification prevents downstream problems
  • "Patients get confused by new information" → Provide patient communication scripts

Provider Training

Duration: 45 minutes (can be delivered during team huddle or lunch)

Format: 20 min overview + 15 min clinical impact + 10 min Q&A

Content:

Module Duration Key Points
Overview 10 min What Trojan does, why it matters for case acceptance
What You'll See 10 min Benefits breakdown visible in PMS, fee schedule info
Treatment Presentation Impact 15 min Using accurate cost estimates to improve case acceptance
Workflow Changes 5 min Minimal impact — billing handles most interactions
Questions 5 min

Common Resistance Points:

  • "I don't have time for another system" → Emphasize minimal provider interaction required
  • "This doesn't help me clinically" → Connect to case acceptance and reduced patient complaints about surprise costs

Hygienist Training

Duration: 30 minutes (incorporated into team training)

Format: Brief overview + awareness

Content:

  • What Trojan does (5 min)
  • What hygienists might see (verification status on patient record) (10 min)
  • When to flag issues to front desk (eligibility questions from patients) (10 min)
  • Questions (5 min)

Day 1 Cheat Sheets

Billing Staff Cheat Sheet (Single Page)

┌─────────────────────────────────────────────────────────────────┐
│            TROJAN QUICK REFERENCE - BILLING STAFF              │
├─────────────────────────────────────────────────────────────────┤
│ LOGIN: [SSO portal URL] or [direct URL]                        │
│ USERNAME: Your network login                                   │
├─────────────────────────────────────────────────────────────────┤
│ VERIFY ELIGIBILITY:                                            │
│ 1. Search patient by name or DOB                               │
│ 2. Click "Verify" button                                       │
│ 3. Review results (green = verified, yellow = partial, red = fail) │
│ 4. If red: check patient insurance card, contact payer         │
├─────────────────────────────────────────────────────────────────┤
│ FEE SCHEDULE:                                                  │
│ 1. Click "Fee Analysis" tab                                    │
│ 2. Select payer and procedure                                  │
│ 3. View recommendation vs. current fee                         │
│ 4

AI-generated implementation guide based on public vendor information. Verify specifics directly with Trojan Professional Services.