Perio Surcharging — Case Acceptance Impact

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Urgent — California Legal Exposure (surfaced by surcharging research)

3 of the 17 West offices are in California (MCP Monterey Coast Salinas/Carmel, TPD Tsai Perio – Walnut Creek, TPD Diablo Perio – Danville). California SB 478 (effective 7/1/2024) bans mandatory checkout-added fees under the Consumer Legal Remedies Act — credit card surcharging at these offices is effectively in violation. Action: remediate before Q3 independent of the revenue analysis below. Texas offices (7) sit in a contested gray zone; UT/OH/NJ are permissive. See full research brief for legal + behavioral econ detail.

Julia’s Question 1

Did SGA West case acceptance decline after surcharging?

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network change

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Julia’s Question 2

What is current case acceptance for SGA East Perio?

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trailing 12-month average

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★ Verdict

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West Network Trend — Months Relative to Surcharging Go-Live (Patient Case Acceptance %)

Each point is the cross-office average at that many months before/after each office’s own go-live. Month 0 = go-live. Dashed horizontal lines show the before and after averages for each cohort. The ex-Stoner line removes the 3 Ohio Stoner offices (Arlington, Dublin, New Albany — same owner) — they’re operational outliers that don’t represent how surcharging landed at the other 9 offices.

All 12 covered offices Ex-Stoner (9 offices)

Dumbbell Chart — West Office Before vs. After (Patient Case Acceptance %)

Each row is one office. Left dot = 12-mo before go-live. Right dot = post go-live through Mar 2026. Red = declined, green = improved. The three Stoner offices (flagged) cluster at the bottom.

Offices (Covered / Total)

12 / 17

5 without Dental Intel data

Avg Before

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12-mo prior to go-live

Avg After

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Post go-live to Mar 2026

Delta (All 12)

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Delta (Ex-Stoner, n=9)

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with 3 Ohio Stoner offices removed

Offices Declined / Improved

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of 12 covered

Before vs. After Scatter (Patient Case Acceptance %)

Each dot is one office. Above the gray diagonal = improved. Below = declined.

All 17 West Offices — Before / After Detail

Office	Phase	Go-Live	Before	After	Δ pp	DI Location	Note

Offices (Covered / Total)

15 / 21

6 without DI data

Network Avg

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Apr 2025 – Mar 2026

Median

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50th percentile

Top Performer

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Bottom Performer

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Offices ≥ 75%

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strong performers

East Offices — Ranked by Trailing 12-Mo (Patient Case Acceptance %)

Each row is one office, sorted high to low. Bar shows the trailing-12 value for the currently selected metric.

All 21 East Offices — Trailing 12 Month

Trailing 12-month average = Apr 2025 through Mar 2026. 6 offices have no Dental Intel data — flagged in the notes column.

Office	Patient CA%	Dollar CA%	New Pt CA%	DI Location	Note

All West avg All East avg

Methodology

What Is "Surcharging"?

Surcharging = passing the credit card processing fee (typically 3%) along to the patient as a line-item at checkout when they pay by credit card. Patients paying by cash, check, ACH, or debit are not charged the fee. The rationale is to offset the merchant's cost of card acceptance. SGA turned on surcharging at 17 West Perio offices in three phases: Mar 2025, Apr 2025, and May 2025.

Data Source

Dental Intel monthly export (Case acceptance data.csv), covering Mar 2024 – Mar 2026 (25 months).

Metric Definitions

Patient Case Acceptance % — of patients who had treatment presented, the percentage who accepted at least some of that treatment. Counts people, not procedures. Example: 10 patients presented, 7 accepted → 70%. This is the primary headline metric.
Dollar Case Acceptance % — of the total dollar value of treatment presented, the percentage accepted. Weights by plan size, so a single $20K plan moves this more than several $500 plans. Example: $100K presented, $40K accepted → 40%. Most sensitive metric to surcharging friction on large plans.
New Patient Case Acceptance % — same as Patient CA%, but limited to new patients (first visit) only. Captures how well case presentation converts first-time, price-sensitive patients with no prior trust relationship. Where surcharging would be expected to bite hardest if it bites at all.

All three are pulled directly from Dental Intel — no custom derivation. Values are monthly office-level; aggregates are simple means across offices (not weighted).

Crosswalk

SGA canonical office names mapped to Dental Intel location names via SGA Location Mapping.xlsx plus pattern matching on DI location strings.

Companion Brief

See the full research brief for the legal landscape (CA SB 478, TX), behavioral-economics literature (pain-of-paying, price salience), industry guidance (ADA/CDA/DMA), and recommended alternatives (cash discount framing, financing-first workflow, interchange-plus renegotiation).

SGA West — Before / After Windows

Before: 12 months ending the month before go-live (excluding go-live month).
After: the month after go-live through Mar 2026.
Go-live cohorts: Phase 1 = Mar 2025, Phase 3 = Apr 2025, Phase 4 = May 2025.
Paired t-test on 12 matched office pairs: t = −0.91, p = 0.38. Network-level decline is not statistically significant.

SGA East — Trailing 12

Trailing 12-month average: Apr 2025 — Mar 2026.
21 East perio offices — 15 have DI coverage, 6 do not (listed below).

West — 5 Offices Without DI Data

ILP Las Cruces
MCP Monterey Coast Perio — Salinas
MCP Monterey Coast Perio — Carmel
NTP Rockwall
NTP Paris

East — 6 Offices Without DI Data

Columbus Perio — Columbus GA
Golden Triangle Starkville
LowCountry Hardeeville
MS Perio Flowood
Outerbanks — Elizabeth City
Outerbanks — Nagshead

Ambiguous Mappings (Verify With Julia)

CLP Kaysville → Cassity Implants and Periodontics, CLP South Ogden → Legacy — best-guess split of CLP brand.
Golden Triangle Columbus MS uses the single DI "Golden Triangle" row (Starkville has no DI).
LowCountry Hilton Head — DI row may merge Hilton Head + New River.