Costs for Dentrix Ascend vs. Server-Based Software | How to run a dental practice

So, how much does Dentrix Ascend cost?

For privately-owned, multi-location dental group practices keeping an eye on cloud-based dental software, one of the major considerations is cost. If you own or manage a dental group practice with several offices, you may be interested in comparing what you’re spending now on servers, backup, virus control, tech support and dental communications software against the fees for Dentrix Ascend.Audit

There are 2 tiers of costs for Dentrix Ascend:

  • One-time setup fees
  • Monthly subscription

The one-time fees include an $995 enrollment fee and then $750 for each database conversion. The monthly subscription runs $500/mo, which includes 10 concurrent users (and you can add another 5 users for another $250/mo).

Cost Comparison for 3 Office Group

Let’s take a 3 location group that is considering making the switch to cloud-based software and wants to compare costs. To make the switch to Dentrix Ascend, that’s $2,250 for 3 database conversions plus an enrollment fee of $995, so the total one-time fee comes up to $3,245. Next, we’re looking at $1,500/mo for the subscription fees.

Looking at the existing expenses for this group, we’re signed up for support for the group and that runs $200/mo. Next, we pay for eclaims – and we’ve found one of the flat rate companies that doesn’t charge per claim, so we’re spending about $100/mo per office – $300/mo for all three locations. For each office, we also spend $300/mo on a subscription to one of the popular communications software programs that we’re only using for text / email reminders/confirmations.

The next round of expenses are more difficult to estimate. These are the ones related to backups, tech support for our servers, security and upgrades. In this group, two of the offices have outdated 2003 servers that we know will cost $10,000 each to replace (plus some downtime to move the data). We also pay IT support throughout the year to maintain our virus control, handle updates and problem-solve – we got a great rate at just $125/hr and to take care of all three offices, it’s easy to spend $5000/year per location as there always seems to be the need for a computer to be replaced or some problem to be handled. Plus labor, we also will spend money on a backup solution, which could mean purchasing terabyte storage for our server or subscribing to an online backup service. As you know, backup fees are based on the size of the databases you have, so this will vary widely depending upon the office size and patient volume. For our comparison, I will estimate $300/mo for backup costs.

For existing fees, all this adds up to $1700/mo for the eclaims, dental software support and backup service, $20,000 in new servers (these should last at least 5 years, so call it $4,000/year pro-rated), $4,500 in server licenses (a one time purchase with your new server so we’ll call that $900/yr) and $15,000/year in IT support. We know IT support will still be required once we switch to a cloud-based solution, but without the server-related work, this expense should drop substantially – let’s just say by half. One other cost to add in is the fee for a remote login service, but most offices I know aren’t paying for these, but using a free version. So, let’s call our final costs as $14,100/year.


For Dentrix Ascend in this group, the total fee will be $21,245 year 1 – and then $18,000/year afterward. Compared to the $14,100/year of server-based costs this comes up a bit short. However, going through this exercise, we can see that we are paying a monthly fee for our traditional server based dental software now. Since we have to pay in full for servers and often for our IT support contracts, it’s easy to skip including these costs.

Comparison of Intangibles

Using our numbers above, we will save about $4,000/ year in measurable costs by sticking with a traditional server based dental software solution. This is  $334/mo for a three office dental group practice. However, what about the intangibles that are not easily measured in dollars?

Here are a few hassles to consider:

Remote logins bump off users

Every time a team member wants to check the schedule or look up patient information for another office location, they must take over a computer at that location. If you purchased an additional computer at each office to set up the remote access without affecting the team members onsite, then we should count the cost of an additional computer in each office. Most groups just try to choose a computer that is infrequently used to install this remote login software, but that still means that your staff bumps each other off the computer from time to time. And, for busy offices, this bumping can occur so frequently it can quickly move from an annoyance to a slowing of patient care to an outright work stopping situation.

More than just the inability to print the health history from office A so the doctor in office B can extract the tooth for the emergency patient, technology issues are the number one cause of frustration between team members. And, for team members who work in different locations in the first place, it already can be a challenge to maintain positive relationships and smooth sailing. With a cloud-based dental software, all this is gone.

Incomplete Clinical Notes

Duplicate or incomplete clinical notes between locations. Let’s say a regular patient seen in office A ends up with a dental emergency on a Thursday, when office A is closed. The patient is offered to come to office B for a same day visit but now that doctor has no history of treatment, no health history, no medication list, etc. The administrative team has to try to get this info and then, once this visit is completed, the original office also should track that the patient went to another office for an emergency. More administrative work that could be eliminated by having one cloud-based database with the three locations.

Billing Manager Inefficiencies

Do you have a billing/insurance manager at each office? Most multi-location groups have just one for the entire group, it’s one of the logical choices for groups to be more efficient. But without easy access to each system, this person ends up wasting time just trying to get connected and then calling over to the offices to be ready for when statements print. I have seen the ease of having a billing/insurance manager easily access and print any necessary data for collections using Ascend, optimizing the time of this highly paid team member.

Lack of Support for Absenteeism

How do you handle absenteeism in one of your offices? With a cloud-based system, its easy to ask a team member in another office to step in and handle confirmations calls or insurance verification tasks, to take the load off the remaining staff.


You get the idea. Working with a cloud-based dental software is an entirely new way for dental practices to increase efficiency. We can optimize staff across the entire organization and save countless hours of interruptions because anyone can see the schedule at any time, for any date!

Let me pause from the cheerleading a moment and say that this is not a perfect solution. Cloud-based depends on solid internet service and our reliance on our dental software vendor for as close to 100% uptime as possible. Neither of these are under our control and that may be too much risk for some to stomach. And, as we talk about costs, if you have to invest $1,000/mo in Google Fiber to achieve the speed and reliability necessary for your large group, maybe the costs still don’t work?

As I am at the beginning of learning more about Dentrix Ascend, it was helpful for me to walk through this cost comparison just to see that it will likely be a slightly more expensive solution than sticking with a traditional approach, but the higher cost may be worth it for the convenience and efficiency it brings. Plus, I know Dentrix is willing to negotiate some of its fees based on the size of the group. As always, bigger gets a better deal. So, I hope this article was helpful for you multi-location dental group practice owners as you keep an eye on this new approach to dental software.

Check out my Free Resources

If you’re managing a dental practice and want organized systems for easier dental staff training, then check out my Collections System and how to Set Up a Recall System. Once these internal systems are in place, you may want to focus on marketing with a system for New Patient Referral Tracking and handling patient complaints.

And, if you’re interested in a comprehensive approach to run your dental practice and train your team, visit Dental Staff Training Levels.

AUTHOR: Jill Nesbitt
  • 1. Why are your servers 10,000 dollars each to replace that is the most absurd price I HAVE EVER HEARD we charge 5400 for domain servers and that includes installation and of course the server OS and will support up to 25 users

    2. 300 dollars a month for backup. Our domain server backup is 1785 per server one time fee.

    It seems like you had to go really far to hyper inflate your hardware costs to try to make Ascend even sound close to reasonable.

    June 16, 2016
  • Furthermore, I have a huge range of customers to draw from, our average customer has 90 percent of their support calls related to the user or user computers. The server mostly just runs so by my much better data I would say you will keep 90 percent of your IT costs.

    Also your IT fees are all wrong.

    Any great dental integrator will supply a full service support contract at 600 a month per office. Which would cover all calls.

    You threw in like 5k per year for computer replacements which doesn’t make any sense because if you have that cost it isn’t related to the servers that we buy with 5 year warranties.

    So it must be 5K for workstation computers. We quote workstations at 850 each so are you having 6 workstations fail a year? Our come with 5 year warranties at 850 each.

    So your IT numbers are just incredibly wrong.

    June 16, 2016
  • Jake S

    Jill Nesbit,

    You have absolutely no sources referenced in your article. Where in the world did you gather your information?

    Are we to assume that the hardware and IT costs are quoted from Henry Schein IT department? You’re numbers are so blown up it’s astonishing that you’d even put your name behind such an assortment of innacurate and false statements.

    Server Replacement:
    You quote $10,000 dollars per server per office plus downtime…… TEN THOUSAND DOLLARS?? This is absurd!

    You must quote sources because this number alone is an uneducated guess at best. Here’s a good reference to begin with

    It’s pretty easy for anyone to checkout and build out a server.

    In the following example I went to in an attempt to build out a $10,000 Small Business server. Keep in mind that anything even close to $10,000 is extreme over kill in a dental practice environment…

    So let’s start with a base tower server: PowerEdge T330 and build it out.

    PowerEdge T330

    Build out cost: $4,395.69

    RAID 5
    Qty 4 2TB Hard Drives Hot Swappable
    Xeon E3-1280 3.7Ghz processor
    16GB RAM
    Server 2012 Operating System
    5 YEARS Pro Support 4 Hour Response Time

    IT Support:
    You quote $7,500 dollars per year per office……

    This is blown up as well. Your example group must have the worst IT company ever handling their hardware and software. When servers and computers are set up properly at the TIME OF INSTALLATION there should be no reason you’re spending anywhere near $7,500 per office per year in IT costs…. unless your IT company simply didn’t set things up correctly to begin with.

    Take for instance a standard monthly support agreement. Your looking at maximum $500 per year so $6,000 per year per office. Likely much less as you should be able to get a discounted rate by signing up multiple offices to your support agreement.

    Even still this set monthly agreement is generally unecessary for offices whose equipment was installed and configured correctly from the beginning. Most of our clients simply pay on a per issue basis saving them tons of money since there are minimum issues once equipment is set up correctly from the beginning.

    Add to this the fact that the server I built out above comes with 5 YEARS of Dell Pro Support with a 4 hour response time and your IT costs are severely cut down since any and all hardward problems are covered under the Dell Warranty.

    I get that your inflating prices to make the product that you’re paid to promote seem more attractive but you’re insulting your readers when you publish such blatant lies.

    June 16, 2016
    • if each server had to support 38 workstations then your dentrix ascend numbers are completely inaccurate.

      if you had 114 workstations as you implied I would assume you had 100 users and since Dentrix Ascend is priced per user that would greatly increase your dentrix ascend number by almost 10 times.

      If on the other hand you mean you have 38 workstations at 3 offices. that is 13 computers per office so there is no reason to have anything more than 5K $ SERVERS


      if you managed a group for 15 years and didn’t know you were spending twice as much as you should per server I assume you never even looked for another quote.

      I’m sending this blog to several integrators who can all comment back on how absurd your prices are.

      June 22, 2016
    • Jill,

      I am familiar with Jake and Shawn, we often communicate on the Dentaltown message boards. Like many IT companies, we usually butt heads on almost every issue…but, to be honest, I could not agree with them more.

      Your figures simply are not realistic. Without trying to be critical, if you truly got those numbers from three different IT companies, then word had gotten around that your practices were willing to grossly overspend…because those quotes really are outrageous. I see quotes from other It companies almost daily, not to mention I’ve worked with close to 3000 practices in 18 years…and have never seen numbers that high.

      I would also mention that it’s a fallacy to assume that cloud-based solutions are cheaper than client-server, it’s just not true. This is based on two main concepts:

      1. You’re paying a huge premium for that subscription over the cost of monthly support for a regular client-server solution.

      2. A cloud-based PMS does NOT eliminate the need for other services and hardware. Unless you get the new cloud-based Dexis to integrate with Ascend (which adds more to the monthly fee), then you will need to use a local image software and store those images locally. Plus, you have far more data than just PMS and images, such as QuickBooks, Invisalign, Office files, etc. In other words, you’re still going to need a server, still need services like backup, still need HIPAA compliance.

      I applaud your efforts to compare the new exciting cloud model to traditional solutions, I just beg to differ with the conclusion. I would be happy to be a resource when you are researching future articles on dental IT.

      June 22, 2016
    • I would have to agree with Shawn and Jake on this one.

      June 23, 2016