The Multi-Location A/R Framework
Grow Revenue, Not Your Back Office  

Growing a multi-location dental organization creates a specific A/R problem that single-location practices don't face: every new office adds its own billing quirks, its own aging accounts, and its own front-office team learning the same lessons independently. Hosted by Becker's Dental + DSO Review, this session covers the framework DSOs use to grow production without growing their back-office headcount in lockstep — the grow revenue, not your back office premise in the session's title.

The conversation focuses on the specific accounts-receivable failure points that show up as DSOs scale past a handful of locations: inconsistent billing processes between offices, aging A/R that's hard to see across a portfolio instead of one practice, and the staffing math that makes manual billing increasingly expensive as location count grows.

Key takeaways

• Standardization beats heroics. DSOs that keep A/R healthy at scale do it through consistent, repeatable billing processes across every location — not by relying on a strong biller at each office.
• Visibility across locations is the first fix. You can't manage aging A/R you can't see in one place; portfolio-level reporting is a prerequisite for improving it, not a nice-to-have.
• Headcount doesn't have to scale with locations. Automation applied at the ledger level lets billing processes scale across new offices without proportionally scaling billing staff.
• The math compounds. Small per-location inefficiencies in aging A/R and collection rate become large dollar amounts once multiplied across a growing portfolio — which is why multi-location groups tend to see outsized returns from RCM automation relative to single practices.

These are the same dynamics behind results Pearly customers have reported at scale — including a 68-location DSO that cut aging A/R by 47%, and a 100-office DSO that automated patient billing organization-wide.