“DSOs Are Bleeding Value From Their Phone Lines”: Dr. Scott Kalniz on the Call Conversion Crisis in Dentistry

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In the high-stakes world of Dental Support Organizations (DSOs), enterprise value isn’t just built in the operatory—it’s determined well before a patient ever sits in the chair. For Dr. Scott Kalniz, a seasoned operator and thought leader in the DSO space, one blind spot is quietly eroding revenue across the industry: low call conversion rates.

“You can have the best clinical teams, the flashiest branding, and top-tier locations,” Kalniz says, “but if your phones aren’t converting calls to appointments, you’re hemorrhaging value at scale.”

According to industry data, between 27–43% of inbound calls fail to convert into booked appointments. Considering that every new patient adds $1,200–$1,300 on average to yearly production, losing out on the opportunity to convert patients significantly impacts practice productivity. Even more, the implications ripple far beyond lost production—they undercut marketing ROI, damage patient trust, and ultimately chip away at a DSO’s valuation.

Diagnosing the Leak

Dr. Kalniz is no stranger to this problem. He began his career as a solo practitioner, eventually acquiring multiple practices and forming a substantial dental group which was later sold to a DSO, where he served as Director of Development, contributing to its expansion to over 50 locations. He later partnered with a private equity firm to establish a new DSO, serving as CEO and Chief Dental Officer. Under his leadership, the organization grew to encompass more than 110 locations across 12 states within five years. 

After all those years optimizing performance across multi-location groups, Dr. Kalniz views the issue through both an operational and strategic lens.

“DSOs need to stop treating call conversion like a front desk problem. It’s a business problem,” he asserts. “We’re talking about the very top of your revenue funnel.”

He recommends that practices start by measuring four baseline indicators:

• Answer rates
• Missed call follow-up time
• Call conversion rates
• Call scoring for coaching

Top-performing locations typically exhibit answer rates of 91–95% and conversion rates above 85%. But achieving that consistency requires more than coaching—it requires visibility and systems. This realization led Dr.Kalniz to take up an advisory role at VoiceStack, a leading AI-driven digital telephony platform built exclusively for dental offices. At VoiceStack, Dr.Kalniz helps the team focus on the bigger picture and the real problems that matter for DSO operators, bringing invaluable industry expertise to create world class AI solutions for dentistry.

Redefining the Opportunity

One of the simplest—but most powerful—fixes, Kalniz says, is aligning teams on what counts as an “opportunity.”

“You’d be shocked how many practices lump in reschedules and billing questions when calculating new patient conversions. That’s creative math—and it clouds decision-making.”

Here’s a clear classification he shares with his teams:

• Opportunity – A new patient or case calling to book an appointment
• Appointment update – A reschedule or follow-up for an existing patient
• Inquiry – General questions about hours, billing, or directions

This clarity helps DSOs build cleaner data sets—and more targeted coaching plans.

Building the System

Dr. Kalniz believes that for DSOs, if the follow-up systems for calls isn’t centralized, it isn’t scalable. Once the redefinition of opportunity is done, he says that the focus must shift to operationalizing the follow-up process. In his experience, most dental offices still rely on sticky notes, shared spreadsheets, or siloed CRM tools to track unbooked opportunities, which is neither scalable nor sustainable. He strongly recommends the use of a modern technology platform like VoiceStack that brings advanced capabilities like:

• Workflow automation
• Opportunity management pipelines
• AI-generated call summaries and task assignments, and
• Conversion-based scoring for prioritizing callbacks
  

These capabilities are crucial for modern DSOs to bring in efficiencies and improve the follow-up processes in-office. However, to get non-subjective ROI data downstream, your tech should also manage your campaign tracking numbers and integrate with Google Analytics. This is where VoiceStack helps again, by bringing in context awareness of the data flowing from upstream through integrations with a number of analytics and CRM systems that hold this data at the top of the funnel. This helps you collect data on the following:

• Total calls
• Calls converted
• Employee conversion rates
• Acquisition cost per scheduled appointment

This helps DSOs in not just identifying which channels provide immediate conversion, but also helps calculate the downstream Average Revenue Per Patient and the Lifetime Value of Patients from different channels. 

Today, these trends are fragmented across multiple data sources in DSOs. Consolidating these can give more insights and decision support for DSO leaders while optimizing their marketing mix. Again, VoiceStack shines in this area with its end-to-end abilities to track patient value driven by deep integrations with marketing tools like Google Analytics and AdWords at one end, to existing popular practice management systems at the other end.

Call Scoring for Coaching

Once the right data is in place, real coaching can begin. Kalniz focuses his call scoring on five essential behaviors:

1. Greeting
2. Empathy
3. Bonding and rapport
4. Attempt to book
5. Closing

Curious about how to leverage call scoring for your teams? VoiceStack has implemented call scoring in their platform, giving you AI analysis of every single phone call made by every team member in your office. By implementing VoiceStack’s call scoring, together with a transparent feedback and training process, DSOs like Northwest Dental Group in Rochester, MN have managed to improve the call conversion ability of their staff members significantly, resulting in estimated additional revenues of up to $78,000 in 30 days. 

Dr. Kalniz believes that this is a game changer for offices, as it helps improve the confidence of the staff members while boosting productivity, resulting in a happier workplace and a thriving practice. 

“This isn’t just about accountability. It’s about giving team members the visibility and feedback to win.”

When to Layer in AI

The dental industry today is being flooded with AI tools buzzing with promises of AI transformation using data analysis. However, Kalniz cautions against jumping too fast onto these tools without fixing the foundations.

“Everyone wants the shiny AI dashboard. But until you’ve hit 85% conversion, built a reliable follow-up cadence, and standardized team processes, those tools can actually distract from fundamentals.”

Fixing these fundamentals is what VoiceStack does best. By focusing on Call Conversion as a holistic problem, VoiceStack helps DSOs strengthen their call handling process, with AI-driven tools designed to boost patient growth:

• Automated AI Text Responses: With the ability to configure for sending out automated text responses in the event of a missed call, VoiceStack helps to continue the engagement with prospective patients, keeping them ready for a conversation as soon as the next agent is available at the front desk.
• AI Concierge: VoiceStack’s AI Concierge acts as a 24/7 front desk, capturing inbound calls that would typically go to voicemail. It can gather critical information such as treatment type, insurance provider, and patient preferences. When appropriate, it can book the appointment directly or take an appointment request that’s queued for the next available human team member. This ensures that the patient experience doesn’t drop off when the office is closed, and marketing dollars aren’t wasted by sending a motivated patient to voicemail.
• AI Task Management: With 57% of calls to a dental office requiring follow-up, it’s essential to have a system in place that listens and helps manage the resulting tasks. VoiceStack’s AI listens to the context of each call and auto-generates tasks, such as callbacks, insurance verification, or scheduling needs, and assigns them to the right team member. This results in a more responsive and organized team.
• AI-driven Missed Opportunity Analysis: VoiceStack provides instant recommendations for calls that did not convert into an appointment, outlining the issues identified by analyzing the transcript with AI, and recommends re-engagement strategies to quickly call the prospect back and re-convert them into a booked patient.

Final Advice: Don’t Buy the Hype

The AI landscape in dentistry is evolving rapidly, but not all platforms are created equal.

“If the pitch sounds too good to be true, it probably is. So, choose a partner like VoiceStack who sees your entire revenue engine—not just one slice,” Kalniz advises.

As an adviser for their team, Dr.Kalniz has encouraged VoiceStack to take a focused and pragmatic approach towards solving patient conversion processes holistically. With inputs from industry leaders like Dr.Kalniz, VoiceStack has developed a system purpose-built to amplify the impact of existing front office teams. The goal isn’t to replace people, but to equip them with technology that enables more consistent execution, higher output, and better outcomes.

A brief demo of VoiceStack’s platform offers a clear illustration of how the right AI system can move from being a buzzword to becoming a measurable business advantage. You can sign up for a demo HERE.

For DSOs ready to improve call conversion rates, VoiceStack has made its “How to Start a Dental Call Center” playbook available for free to all Group Dentistry Now followers. Even for offices without centralized call centers, much of the playbook’s guidance can be applied at the single-practice level.

 

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