What You’ll Learn:
- Why third-party software companies pay to access your data
- The landmark ruling that confirmed doctors own their patient data
- How PMS companies are fighting back against third-party integrators
- What this battle means for your practice and your software choices
Why You’re Paying for Access to Your Own Patient Data
Wanna know something most dentists don’t realize? When a software company wants to integrate with your practice management system to provide you a service, they often have to pay your PMS company for access to your data.
Not pay you. Pay them.
“The data in the practice management system is owned by the doctor. It’s the doctor’s data. It’s not the practice management system’s data,” explained Adrian Lefler, CEO of My Social Practice, on a recent episode of The Authentic Dentist Podcast. “But I am charged $30, $40, $50 a month to get access to your data.”
This arrangement has sparked a growing conflict between PMS companies, third-party software providers, and the dental practices caught in the middle. Understanding what’s happening can help you make smarter decisions about the software you use.
How the System Currently Works
When you use Dentrix, Eaglesoft, Open Dental, or any other practice management system, your patient data lives inside that software. Appointments, treatment history, contact information, insurance details: it’s all there.
Now imagine you want to add an AI receptionist that can schedule appointments, or a reputation management tool that sends review requests, or an insurance verification service. These tools need to read and sometimes write data to your PMS to function properly.
To make that connection, software companies use something called an API integration. The PMS company provides data endpoints that allow outside software to connect. But PMS companies charge software vendors for access to those endpoints.
“I make a connection between Annie and Eaglesoft,” Lefler explained, referring to his company’s AI receptionist product. “The way to make that connection is I have to go to Eaglesoft and pay them a fee to get the API data points to connect to my system. And then I pay an ongoing fee to keep it maintained.”
Those fees get passed along to you, built into the cost of whatever software you’re buying.
The Math That Adds Up Against You
Here’s where it gets interesting. If your practice uses five different software tools that all integrate with your PMS, the PMS company collects integration fees from all five vendors.
“Let’s say that Dr. House has Annie, has Pearl, has the notetaker, has eAssist, and has like five other softwares that all access Eaglesoft,” Lefler said. “Eaglesoft is getting paid 10 times for the same integration. It’s my $30 a month. It’s Pearl paying $30 a month to Eaglesoft. Every single company has their own API integration.”
And ultimately, those costs flow back to you through higher software prices.
How Data Access Fees Flow
| What Happens | Who Pays |
| Software vendor wants to integrate with your PMS | Vendor pays PMS company setup fee ($1,000-$10,000+) |
| Vendor accesses your data each month | Vendor pays PMS company $30-$50/month per practice |
| Vendor builds those fees into their pricing | You pay higher software subscription costs |
| You use 5 different integrated tools | PMS company collects 5x the integration fees |
The Workaround War
Some software companies decided they weren’t going to play by these rules. Companies like NexHealth and others built workarounds that access practice data directly, bypassing the PMS company’s official API endpoints.
Their argument: the data belongs to the doctor, not the PMS company. A landmark court case supported this position, ruling that practice management systems don’t own the patient data stored within them.
“It was found that the data in the practice management system is owned by the doctor,” Lefler confirmed. “They can’t forcibly remove people from accessing the data and force them to go through the practice management systems.”
But PMS companies aren’t giving up their revenue stream without a fight.
The “Hostile Company” Emails
Lefler described receiving communications from PMS companies warning about “hostile” third-party integrators. The language makes these companies sound like they’re doing something nefarious with your data.
“They use adjectives that make it sound like these companies are selling your data on the black market,” Lefler said. “What they’re doing is they’re trying to protect their revenue source and force people to work through their data points and pay them the fee.”
The tactics have escalated. Lefler shared a story where his company was using NexHealth for integrations with a large DSO. When a practice’s Dentrix system went down for a day, causing significant production loss, the PMS company blamed the third-party integration.
After months of investigation, including hiring cybersecurity experts, the actual cause turned out to be an outdated system that hadn’t been updated in years. But the integration got blamed first.
“It’s like trying to get two teenage girls that are fighting over the same boy,” Lefler said of navigating these vendor conflicts. “It was so ridiculous.”
What This Means for Your Practice
This behind-the-scenes battle affects you in several ways:
- Higher software costs. Every integration fee paid by vendors gets passed along to you. The more tools you use, the more you’re indirectly paying in data access fees.
- Potential integration instability. As PMS companies crack down on unofficial integrations, software you rely on could suddenly stop working or require migration to different solutions.
- Confusing vendor communications. When your PMS company warns you about “hostile” third parties, understand the financial motivations behind those warnings.
- Limited choices. Some excellent software tools may not be available if they can’t afford or don’t want to pay PMS integration fees, limiting your options.
Is There a Better Way?
Lefler envisions a different model, an open-source or doctor-controlled PMS where the practice, not the software company, authorizes and potentially benefits from data integrations.
“What needs to be built is a practice management system where the agreement is that you pay that practice management system for your PMS, and then you, the doctor, sign the contract for Annie to come gather it,” he explained. “I am paying you to offer you my service.”
In this model, integration fees would flow to practices instead of PMS companies, lowering software costs across the board. The first PMS company to adopt this approach, Lefler suggested, would attract massive market share from doctors tired of the current system.
Until that happens, the battle continues. And dentists remain caught in the middle.
The Bottom Line
You own your patient data. That’s been legally established. But the software company housing that data has built a business model around charging others for access to it, and those costs ultimately come out of your pocket.
As you evaluate software tools for your practice, understand that integration capability and cost are directly affected by this ongoing battle. Ask vendors about their integration approach, and don’t be surprised if you find yourself caught between competing corporate interests.
My Social Practice’s Annie AI integrates with major practice management systems to provide AI receptionist, webchat, and hygiene reactivation services. We navigate these integration challenges so you don’t have to. Want to learn more about how Annie can work with your existing systems? Let’s talk.
Frequently Asked Questions
What should I do if my PMS company warns me about a "hostile" third-party integration?
Understand that these warnings often have financial motivations. The third-party company may simply be accessing data without paying the PMS company’s fees. That doesn’t necessarily mean they’re doing anything wrong or insecure. Evaluate the actual security practices and reputation of any software you use, but take vendor conflict warnings with appropriate skepticism. Ask specific questions about what makes the integration “hostile” beyond just the payment arrangement.
Do I legally own the patient data in my practice management system?
Yes. Court rulings have established that patient data belongs to the dental practice, not the practice management software company. However, while you own the data, the PMS company controls access to it through their software infrastructure. This gives them leverage to charge third-party vendors for integration access, even though the underlying data is yours.
Why do software companies have to pay to integrate with my PMS?
PMS companies provide API endpoints that allow third-party software to read and write data. They charge vendors for access to these endpoints, both as an initial setup fee and ongoing monthly fees per practice. This has become a significant revenue stream for PMS companies. Some third-party companies have developed workarounds to access data directly, bypassing these fees, which has created ongoing conflicts in the industry.
How do API integration fees affect what I pay for dental software?
Integration fees paid by software vendors get built into their subscription pricing. If a vendor pays $30-$50 per month per practice to your PMS company for data access, that cost is reflected in what they charge you. Practices using multiple integrated tools effectively pay these fees multiple times over through higher software costs across all their vendors. This is one reason dental software can seem expensive relative to other industries.
About the Author: Megan Nielsen is an SEO strategist and the Grand Overlord of copywriting at My Social Practice. My Social Practice is a dental marketing company that offers a full suite of dental marketing services to thousands of dental practices throughout the United States and Canada.
