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Welcome to Dental Unscripted, a podcast brand that meets doctors wherever they are at in their professional journey. We talk about starting a practice, buying a practice, and running a practice. We cover a lot of ground on this channel!

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Dental Unscripted

The Chart Audit Question That Actually Decides If You Should Buy This Practice

Fifteen hundred active patients on the broker's report turned into roughly a thousand once we went in and ran the real numbers. That gap shows up in almost every acquisition, and it rarely means the seller is misleading everyone. The real risk that slides under the radar on a deal is not the wrong patient counts... It's whether or not you can actually perform the dentistry the seller built this practice on. This breakdown comes from a Dental Unscripted conversation between Michael Dinsio and Paula Quinn on chart audit due diligence. We have highlighted some of the big ones below! But watch/listen to the entire episode as it was jammed packed with some killer information when going into a practice acquisition transaction. 

1. Active Patient Counts and the Eighteen Month Window Most PM Softwares Gets Wrong

Most practice management software counts a patient as active for eighteen to twenty four months, even ones who moved, switched insurance, or came in once for an emergency exam and never came back. Brokers pull that number straight from the software and post it on the prospectus, and that is the extent of their liability. It is not misrepresentation. It is a report nobody cleaned up first. On a recent deal we reviewed, a reported count of fifteen hundred active patients held up closer to a thousand once hygiene visits were checked against that eighteen month window. That difference changes what the goodwill you are paying for is actually worth.

2. Procedure Mix by Count and by Dollars Reveals What You Are Actually Buying

The real purpose of a chart audit is not confirming the broker's collections figure. It is determining whether you can clinically handle the case mix already walking through the door. Pull procedures by count and by dollar value before you assume this is a standard restorative practice.

• Look for code clusters instead of single codes, since an all-on-four case bills as a group of related procedures, not one implant line item

• Check lab expenses and referred-out treatment for a pattern of outsourced surgical or prosthetic work

• Compare the procedure percentages on the prospectus against what the charts actually show on audit day

3. Ortho, Implants, and the Capability Gap That Surfaces After Closing

A practice built around two hundred thousand dollars a year in clear aligner cases can look like a normal restorative practice on paper. It is not. Roughly fifteen percent of that production depends on a skill most dentists never mastered in dental school. A buyer evaluating a similarly ortho heavy practice once said they had never done a case but figured they could learn it. That is the moment a chart audit should stop the conversation instead of moving it forward. The same test applies to implant surgery, third molar extractions, and upper molar endo, procedures a seller often built years of reputation around before you ever walked in. This is exactly the ortho gap our clear aligner training program is built to close.

4. The Decision You Make Before You Sign, Not After

Talk to the seller about which cases they love, which ones they pass on, and what their ortho or implant protocols actually look like. Do this before you close, not after the keys change hands. A full schedule does not tell you whether you can execute the dentistry already on the books. It tells you what you inherit. Knowing the difference before you sign is the entire point of a chart audit. That is the kind of chart-level review we walk buyers through as part of our buyer representation program. If you are evaluating a practice purchase, connect with the NLC team before your due diligence period runs out.