Common questions

Is the report templated, or tailored to us?

Both. The method is fixed: the same five categories, the same definitions, the same derivation on every engagement, because that is what makes the figures comparable across locations and defensible to a counterparty. Everything around the method is built to you: the conversion to EBITDA runs on your own cost stack and underwriting targets, the categories are weighted to the deal in front of you, the executive summary is written for the reader you have to convince, and the recovery roadmap is sequenced to your integration calendar. The five categories, your own underwriting targets, and a summary written for your reader are part of every report. Beyond that, where you want something specific examined in the practice management system, a question put to the other side's operations or office management team, or a particular concern of your board, sponsor, or lender worked into the analysis, we add it to the scope wherever it can be done. Where it cannot, we say so before the engagement starts rather than after.

Why doesn't our QoE firm, broker, or consultant already do this?

A financial QoE works from the books: reported earnings, adjusted for owner compensation, personal expenses, and a replacement associate. Every adjustment moves a figure that was billed and collected. What we measure was never billed, because the patient never came back, the plan never got booked, or the appointment never got filled. It is potential production, sitting in the practice management system, and an accounting system cannot record something that did not happen. The most careful earnings bridge will not find it.

Brokers price a listing from the financial package and the seller's account of the practice, which is the right job for a listing. But rebuilding two years of patient behavior from the practice management system is a separate discipline that takes weeks, and it has not been in anyone's scope.

DRAI does not produce financial QoE work. The two reports draw on different data, answer different questions, and sit in the same data room without duplicating a line of each other.

Why has nobody measured this before?

Pieces of it have been. A retention consultant pulls lapsed patients for a practice that hires them. A dashboard shows recall compliance. What has not existed is a single document that measures all five categories, converts them to EBITDA on the buyer's own numbers, and carries a signature from a party with no stake in the deal. Producing that inside a diligence window takes a fixed method, a data request an office manager can complete, and a way of reading every practice management system the same way. Building that took the better part of a year, and nobody in a live deal has a year.

What is the difference between a Portfolio Review and a Pre-Listing engagement?

Same forensics, different document, different clock. A Portfolio Review runs on the locations you intend to keep operating, at any time and usually every year, with no sale in view. It anchors on recurring annual EBITDA, carries no valuation multiple and no date, and its readers are the CFO, the board, and the lender during the hold. A Pre-Listing engagement runs once, 12 to 24 months before a sale, and is aimed at the listing date: it models the trajectory of trailing EBITDA to that date, sequences the capture so the recovery lands in the twelve months a buyer will price, and carries a section built to survive the buyer's own diligence. If you are years from a sale or not planning one, it is the review. If you have a date, it is pre-listing.

Our analytics platform already shows this. What does the report add?

Three things a dashboard is not built to do, whichever side of the deal you are on.

It sees a practice you do not yet own. On an acquisition, the target's practice management system belongs to the seller until close, and its data is not in your reporting stack. DRAI works from the seller's exports inside the diligence window, which is the only way to see the operational opportunity before you commit the capital. After close, bringing the practice into your stack takes months, during which the integration team is on payroll, credentialing, and keeping staff, and the sponsor has already approved the price.

It turns rates into money the deal can use. A dashboard reports a state: recall compliance is 48 percent, or a hundred accepted plans are unscheduled. It does not tell you what that is worth in production, how much of it a competent operator can realistically capture and by when, what survives write-offs and collection rate to reach cash, what that is in EBITDA on your own cost structure, and what that means at your multiple. Getting from the rate to that number takes the practice's own write-off history, a capture rate the practice has already demonstrated, your cost stack, and a method that reconciles every figure against every other. That number is what the board approves capital on, the lender sizes the loan on, and the price is set against, and no dashboard produces it.

It carries a signature the other side will accept. On the sell side, this is the whole point. Your dashboards can show you the opportunity in your own locations. They cannot show a buyer's diligence team anything, because a seller's own reporting is exactly what a buyer discounts. A document produced by a party with no stake in the outcome, with every figure traced to its source and its method written down, is what survives diligence, anchors an earn-out, or explains a recent uplift in trailing earnings before the buyer decides it is a spike. On a portfolio review with no deal in view, the same signature is what the board, the lender, or the next sponsor reads instead of management's account of itself.

Why not build this in-house?

The group's operations people, the CFO, and the deal lead are the readers, each for their own reason, and the report gives each of them the findings to act on. The CEO who uses it well is the one whose team takes the findings and executes.

Inside a DSO this function does not fit the scope of any role. Corporate development runs the deal, FP&A models it, integration inherits it after close, and business intelligence reports on the business day to day. Each is fully employed doing that, and patient-level forensics is a different discipline from all of them. Building the function means hiring someone who understands both dental operations at the patient level and transaction finance, which is a rare combination, carrying that cost permanently against deal volume that arrives in lumps, and then waiting a year for a method to exist, because the definitions, the data request that works across every practice management system, the conversion, and the benchmarks all have to be built and tested before the first number can be defended. That is the same arithmetic that leads acquirers of every size to commission the financial QoE externally rather than staff a QoE team.

“They're good at building systems and processes at the corporate level. But patient-level or practice-level forensics is foreign territory to them. It's not an indictment of those guys, they're really good at what they do. It's patient and practice-level specifics they didn't come up in, so they don't know.”Co-founder of a 50+ location DSO, regarding his COO and VP of Operations

The other reason is the reader. If your own company does this work, your own team is confirming your own thesis, which carries limited weight with a board and none with the next buyer. A third party with nothing to gain from the answer is what makes the number usable in the room.

“I'm less concerned about the cost of outsourcing it. It lends something, credibility might not be the right word, but something that seems more sewn up about a third party providing this.”CEO of a sponsor-backed DSO, on the cost of commissioning it externally

Will this change what we pay, or slow the deal down?

On the buy side, the report is yours and stays private. The opportunity it identifies is not disclosed to the seller, so you are never put in a position of paying for upside that has not been earned yet. Price justification still runs on current earnings, as it always has. Two things can move: if the report finds production concentrated in a provider who may leave, that is quantified as value at risk at your multiple and you can price it, which standard diligence only flags; and if you choose to use the recoverable figure in the deal structure, an earn-out or a holdback for example, every number behind it is derived and shown, so it holds up. If you choose not to, nothing changes about the price, and the difference shows up after close, when the operating plan starts on day one with the opportunities already quantified, instead of after months spent finding them.

On the sell side, the point is the opposite: the report is what lets you put the opportunity in front of the buyer on your terms, documented, before their diligence finds it and uses it against you. Which side holds the information decides who holds the edge, and it is always the side that commissioned the work.

The process runs inside the existing diligence window the financial QoE already takes, on the access the LOI already grants, so it adds no friction to the critical path.

How can we trust the output, and where does AI come in?

Every figure comes from the target's own practice management data. We gather the exports, standardize them, rebuild the patient base's visit and treatment pattern by cohort, and show the source report and the arithmetic behind every number, with the filter recorded so your own advisors can verify any figure against its source.

AI carries the data-heavy work: reading exports from whichever system produced them, rebuilding the visit and treatment pattern by cohort, and checking every figure against every other so the report reconciles in every section. That is how a multi-location group gets the same depth on every location inside four weeks.

Can we see examples of the report before working together?

Yes. The four sample reports are on this site in full. → Sample reports

What does an engagement ask of our team?

One coordinator on your side, usually the VP of operations, the COO, or a regional manager, completes a short group overview form and passes a short location form to each office manager. Each office manager completes that form and exports a fixed set of standard reports from the practice management system through a secure link we provide. That is the whole of it. If anything material cannot be settled from the data, one batched set of written questions goes to the coordinator. We never contact individual offices directly, and nobody on your side needs to clean or prepare anything before sending it; every practice's exports have gaps and inconsistencies, and reconciling them is our work, not yours.

How long does it take, and does it fit inside the post-LOI window?

Four weeks from complete data. On an acquisition that sits inside the post-LOI window, concurrent with the financial QoE, and is delivered before it closes.

How does a referral or partnership work?

Either through you or direct, with a referral arrangement for the advisors who introduce engagements. The mechanics are under Referrals and introductions on the Engagements page.

Who sees the findings?

The party who commissioned them and nobody else. A buyer's findings stay with the buyer. A seller's findings reach the buyer only when the seller chooses to put them in the data room, and that is exactly what a Going to Market engagement is for. No client, partner, or counterparty is named by us in any public or third-party context without their explicit approval.

Do you offer any guarantees?

Every engagement is tailored to your cost stack, your reader, and your calendar before delivery, so the report arrives built for the room it is going into. If, on delivery, you are not satisfied the document is defensible to the other party in your transaction, one revision to that standard is included at no additional fee. Every figure is sourced and shown so your advisors can use it, and every engagement is revisited at 6, 12, and 24 months, at no cost, so you know whether the number held, and every later engagement with you is calibrated on what your own locations actually recovered.