$340,000 in Unscheduled Treatment Plans: The Revenue Sitting in Your Practice Management System

I asked a dental practice owner in Brisbane to run a report from her practice management system: all treatment plans diagnosed in the past twelve months that had not been scheduled. She had never run this report before.

The number was $342,000. Three hundred and forty-two thousand dollars in treatment that her providers had diagnosed, documented, and presented to patients — crowns, implants, bridges, fillings, extractions, periodontal therapy — that had never been scheduled.

She stared at the number. “That cannot be right.”

It was right. Her practice had 186 patients with unscheduled treatment plans. The average value was $1,838 per patient. Some were small — a single filling at $220. Some were substantial — a full-mouth rehabilitation at $28,000. But every one of them represented a patient who had sat in the chair, heard the diagnosis, agreed that treatment was needed, and walked out without scheduling.

I asked her what follow-up process the practice used for unscheduled treatment. She said the hygienist usually mentioned it at the next recall visit: “Did you ever schedule that crown we talked about?” That was the entire follow-up system. A verbal question at the next cleaning, six months later.

By that time, 60% of those patients had either forgotten the treatment plan entirely, decided it was not urgent, or moved on to a different practice. The $342,000 was not hypothetical future revenue. It was diagnosed need that the practice had identified, presented, and then failed to follow through on.

The Unscheduled Treatment Problem

The treatment plan acceptance gap is the single largest revenue opportunity in most dental practices. Not marketing. Not new patients. Not insurance negotiations. Simply converting treatment that has already been diagnosed into treatment that is actually performed.

Consider the mathematics: a practice with $1.2 million in annual production and a 40% acceptance rate on diagnosed treatment has effectively left $800,000 in treatment unscheduled. Even converting 10% of that — $80,000 — would represent a 6.7% increase in production without adding a single new patient, without extending hours, and without any additional diagnostic work.

The treatment has been identified. The patient has been informed. The clinical justification exists. The only missing element is follow-up — a systematic process that re-engages the patient and helps them take the next step.

The Timing Window

The single most important variable in treatment plan conversion is timing. The patient’s willingness to schedule declines precipitously after the initial diagnosis:

Days 1-7: Peak conversion window. The patient remembers the diagnosis, understands the need, and is motivated. The clinical experience is fresh. Follow-up during this window converts at 65-70%.

Days 8-30: Declining window. The urgency fades. Other priorities intervene. The patient intends to schedule but has not gotten around to it. Conversion drops to 25-30%.

Days 31-90: Re-engagement window. The patient has effectively forgotten. Follow-up at this stage needs to re-establish the clinical need and address whatever barrier prevented scheduling. Conversion: 10-15%.

Days 91-180: Long-term follow-up. The patient may have moved on emotionally. Clinical conditions may have changed. Follow-up should suggest a re-evaluation rather than assuming the original plan is still appropriate. Conversion: 5-8%.

The implication is clear: the 7-day follow-up is the most valuable contact in the entire sequence. Practices that follow up within a week of diagnosis convert dramatically more treatment than practices that wait for the next recall visit.

Addressing the Four Barriers

Patient research consistently identifies four barriers to scheduling treatment. Effective follow-up addresses each one.

Cost (40% of non-scheduling). The patient wants the treatment but is concerned about the financial commitment. The follow-up should provide clear financial information: insurance coverage estimate, patient out-of-pocket cost, and available payment options. Many patients do not know that payment plans exist, or they overestimate their out-of-pocket cost because the total treatment fee feels overwhelming without insurance context.

Fear (20% of non-scheduling). Dental anxiety is real and widespread. For treatment that patients avoid due to anxiety, the follow-up can mention sedation options, describe pain management approaches, and offer a consultation visit to discuss concerns before committing to treatment.

Perceived urgency (25% of non-scheduling). The patient does not feel pain, so they assume treatment can wait. The follow-up should educate — gently but clearly — about the progression of untreated conditions. “A crown now costs $1,200. If the tooth fractures and requires extraction and an implant, the cost will be $4,500-$6,000.” This is not a scare tactic. It is accurate clinical information that helps the patient make an informed decision.

Logistics (15% of non-scheduling). The patient cannot find a convenient time. The follow-up should offer flexible scheduling options, including early morning, evening, or weekend availability if the practice offers them. Some patients need a direct scheduling link or a phone call rather than being asked to take the initiative themselves.

The Provider Dashboard

Treatment acceptance rates vary significantly by provider. In multi-provider practices, the spread between the highest and lowest acceptance rates can be 20-30 percentage points. This variation reflects differences in case presentation skills, patient communication style, and clinical philosophy — not diagnostic accuracy.

Tracking acceptance rates by provider — without making it punitive — creates awareness and accountability. A provider who discovers their acceptance rate is 35% when the practice average is 52% has a specific, measurable area for improvement. The conversation shifts from “you should present treatment better” to “your data shows that patients are not scheduling 65% of what you diagnose — let’s look at what’s happening in those conversations.”

What Changed at the Brisbane Practice

The practice implemented an automated four-touch follow-up sequence for all unscheduled treatment plans over $200 in patient cost. The first month, the system sent 186 follow-up emails (the entire backlog of unscheduled treatment).

Within 90 days, 31 patients responded and scheduled treatment. Total value of scheduled treatment: $57,200. Of that, $42,800 was completed and collected during the first quarter.

The practice owner was astonished — not by the revenue, but by the patient responses. Several patients replied to the follow-up emails with questions they had been too embarrassed to ask during the appointment. “How much will insurance cover?” “Can I do it in two visits instead of one?” “I’m nervous about the procedure — do you offer sedation?”

These were patients who wanted treatment but had unresolved concerns. They did not raise those concerns in the clinical setting because the appointment felt rushed, or because they did not want to seem uncertain in front of the provider. The follow-up email gave them a low-pressure channel to ask.

The $342,000 in unscheduled treatment did not convert overnight. But within twelve months, the practice converted $148,000 of it — a 43% conversion rate on treatment that would have gone entirely unscheduled without follow-up. The remaining $194,000 included patients who declined treatment, patients who had moved, and treatment plans that needed clinical re-evaluation.

The follow-up system did not generate new patients or new diagnoses. It completed the work the practice had already started. It closed the loop between “you need this treatment” and “let’s schedule it.” That loop is where $200,000-$500,000 sits at the average practice, waiting for someone to follow up.