Open Dental is one of the most widely used dental practice management solutions in the US.
Known for its affordability, customizations, and robust features, Open Dental is trusted by thousands of practices of all sizes, supporting everything from appointment scheduling to clinical charting.
One of the platform’s key capabilities is its integrated payment processing, which allows dental offices to accept credit cards, debit cards, and ACH payments directly within the software. But having multiple payment processors to choose from and understanding your options can be confusing.
So whether you’re currently using Open Dental or considering it for your practice, this review will help you navigate the payment landscape and what’s happening behind the scenes to ensure you’re not overpaying.
Our Insider Take on Open Dental
We work with dozens of dental practices using Open Dental, and they all leverage the integrated payment processing features. The software itself is solid and does what it’s supposed to, but the credit card processing can be a bit more complex.
Here’s what you need to know:
- Open Dental itself is not a payment processor.
- The integrated payment options are powered by major processors like Global Payments, Worldpay, and Fiserv.
- Some options are being phased out for new users (XCharge).
- Global’s acquisition of Worldpay could reduce competition and drive up rates for Open Dental users.
- Integrated processing doesn’t necessarily mean best pricing (and it’s often the opposite).
Payment processing with Open Dental involves layers of providers and relationships behind the scenes. Once you understand these connections and how everything works, it’s much easier to find the right processor for your practice and negotiate the best possible rate.
Open Dental Software Overview
Unlike other dental practice management solutions on the market, Open Dental is known for its open source foundation (hence the name). This allows for more customization and integrations.
Its customization capabilities paired with such an affordable price are the reasons why Open Dental is so popular.
The software can be deployed in two ways:
- On-premise: Installed on your local servers, giving you full control over data and setup.
- Cloud-hosted: Open Dental hosts your data, and you can access it remotely.
Cloud-hosted deployments from Open Dental are a more recent offering. In terms of simplicity and ease of use in the practice management space, more practices are opting for cloud-based tools industry-wide. But we find that most of our clients using Open Dental have been set up on an on-premise deployment for years and don’t want to switch. And that’s totally fine.
It’s worth noting that the deployment option you choose can affect which payment processing options are available to your practice (which we’ll cover shortly).
The platform includes modules for appointments, billing, charting, treatment planning, reporting, patient communications, and so much more. It’s ultimately designed for dentists who want total control instead of something that’s cookie-cutter and turnkey out-of-the-box.
Open Dental Payment Processing Options Explained
This is where things get interesting (and potentially confusing). But I’m going to simplify everything for you.
First, understanding your payment processing options with Open Dental is so important because it directly impacts your costs and who you’ll be dealing with when you need support or want to negotiate better rates.
The software itself isn’t very expensive. So the bulk of your costs are likely going to come from how you’re processing payments.
Open Dental is not a payment processor. Instead, they integrate with third-party processors that handle all of the actual credit card and ACH transactions on the backend. You have multiple options to choose from, and there’s a lot more happening behind the scenes than you might realize:
Let’s break down each option below so you understand exactly what’s going on with your payments.
Edge Express (Global Payments)
Edge Express is Global Payments Integrated’s current processing solution for Open Dental. It’s the primary processing option for Open Dental Cloud, and it’s also available for on-premise installations.
Global Payments is one of the largest processors in the world, but its size doesn’t translate to fair pricing. In fact, we consistently find global payments using deceptive billing practices—including padding assessment fees, inventing bogus charges, and raising prices on a regular basis.
The technology powering Edge Express is fine, and you can use it for in-person transactions, online transactions, and recurring payment plans.
But you really need to keep a close eye on your statements to ensure Global isn’t trying to take advantage of you. There’s a good chance that you have some bogus fees being charged to your account.
I encourage you to read our Global Payments review for more information, including specific fees to watch out for (like their Settlement Funding Fee and Risk Assessment fee) that could be costing you thousands of dollars in overages every month.
XCharge (OpenEdge)
XCharge is a legacy payment processing solution from OpenEdge (which is also owned by Global Payments). It was the original integrated payment processing option for Open Dental before Edge Express came along.
XCharge is no longer available to new customers. Global discontinued new installations and is pushing all new Open Dental users to Edge Express instead.
If you’re already set up with Open Dental and XCharge, you can continue using it, and your existing integration will keep working. But if you want to migrate your on-premise Open Dental deployment to the cloud, you’ll be forced to switch.
For existing XCharge users, it’s important to understand that Global Payments is processing your transactions. So everything we said about Global’s pricing tactics, their bogus fees, and aggressive rate increases will apply to your XCharge account as well.
PaySimple
PaySimple is another integrated payment option available through Open Dental.
While PaySimple can handle credit and debit card processing, it’s best known for its simple ACH payment capabilities. Practices can accept electronic checks from patients without needing physical checks or card readers, which is really useful for patients who prefer bank transfers on larger transactions (and your practice will pay cheaper processing fees).
PaySimple also supports online patient payments and recurring charges, but it’s only available to practices based in the United States.
One thing that most practices don’t realize is that PaySimple primarily uses Worldpay as its backend processor. This means that Worldpay is actually handling the payments behind the scenes, while PaySimple provides the interface and integration with OpenDental.
Why does this matter? Because Global Payments acquired Worldpay in a massive deal.
While the merger hasn’t officially been completed yet, all signs point to it happening within the next year. Once that happens, the competitive landscape for Open Dental payment processing becomes even more limited.
So if you’re using PaySimple, you’re essentially using a middleman to get Worldpay. And soon, Worldpay will be under the same umbrella as Edge Express and XCharge (all owned by Global Payments). By reducing your options it gives your processor more leverage to keep rates high.
The good news is that Worldpay can offer competitive rates if you know how to negotiate. Check out our Worldpay review to learn more.
PayConnect by DentalXChange
PayConnect’s integrated processing solution for Open Dental is offered by DentalXChange, a company that has been servicing the dental industry for over 25 years.
And while PayConnect is not part of the Global Payments ecosystem (and it’s not being acquired by them, either), there’s more going on behind the scenes than might seem obvious to the average dental practice.
When you take a closer look at DentalXChange’s merchant processing page, you can see that EDI Health Group (DentalXChange’s parent company) is a registered ISO of Wells Fargo Bank. And we know that Wells Fargo resells Fiserv’s payment processing services. which effectively means that Fiserv handles DentalXChange’s processing.
You can confirm this by looking at the hardware PayConnect offers, too. They sell Clover terminals, which is a Fiserv product.
So if you use PayConnect, Fiserv is handling the processing on the backend. I know, it’s a lot to keep pace with:
PayConnect > DentalXChange > EDI Health Group > Wells Fargo > Fiserv
But despite its complexity behind the scenes, this is actually a good thing because it means that you have at least one payment processing option that’s outside of the Global Payments empire.
Fiserv is also a large and well-established processor. And while they’re far from perfect, I’d say they are still better than Global in just about every way.
The challenge is that lots of players may be getting commissions on your processing fees when you’re set up with PayConnect via Open Dental. So your markup fee may be higher than it would be if you were going straight to Fiserv.
Key Features of Open Dental Practice Management Software
Open Dental software is modular, which means you can completely customize which features your specific practice needs. Options include:
- Appointment scheduling
- Clinical charting
- Patient records management (EHR)
- Imaging integrations
- Treatment planning
- Integrated payment processing
- Insurance management with electronic claims submission
- Billing and collections management
- Patient portals for viewing records
- Two-way patient communication
- Electronic prescriptions
- Patient self-scheduling
- Web forms
There’s definitely a bit of a learning curve here.
And while the interface isn’t as modern-looking compared to some newer cloud-based competitors on the market, it’s not too challenging to use once you get the hang of things. Just don’t let yourself get overwhelmed by the options at your disposal.
Open Dental Pricing
Open Dental’s pricing is transparent and significantly more affordable than competing practice management solutions.
Plans start at $179 per month per location for a 12-month contract. After that, rates drop to $129 per month.
There’s a free trial available for dentists who want to try before buying, and the paid plans come with a 90-day money-back guarantee.
Phone and live chat support are included with all plans, but you’re limited to just two questions per interaction. Training starts at $50 per hour.
Payment processing is not included with your base Open Dental rates. This is a completely separate fee that depends on the processor you’re using, where you’ll be charged per transaction and some other miscellaneous processing fees every month.
Other Fees to Look Out For
Beyond Open Dental’s base pricing and your per-transaction costs for payment processing, keep an eye on your monthly merchant statements for other fees that just don’t quite seem right.
Processors do a really good job of making fees sound legitimate when they don’t actually add any value to the service you’re getting. And unfortunately, junk fees are a standard practice industry-wide.
So whether you’re getting processing handled by Global, Worldpay, or Fiserv, there’s a high probability you have extra charges on our statement that could easily be removed. Examples include:
- SafePayments Basic Fee
- Processor Transaction Risk Fee
- Auto Enrollment Fee
- Comm Card IC Savings Adjustment
- Risk Assessment Fee
- Annual Membership Fee
- Bank Deposit Service Fee
- Network Access and Processor Fee
- Settlement Funding Fee
- Analytics Reputation Management Fee
- Network and Compliance Fee
- Global VPN Fee
If you see any of these on your statement, it’s a sign that your processor could be overcharging you and it’s worth further scrutiny to figure out what’s going on.
Again, this has absolutely nothing to do with Open Dental. You’ll need to go straight to your processor to sort out these fees and additional charges.
Final Thoughts on Open Dental
Overall, Open Dental is a really good practice management system for small and large dental practices alike. It’s super affordable compared to other tools, and its modular open-source foundation makes it one of the most customizable solutions on the market.
But Open Dental’s payment processing setup is layered with different players and often misunderstood.
To keep it simple, the only thing you really need to understand is who is actually processing your transactions on the backend. That will help you figure out what fees to look for and how to negotiate the best possible terms.
- Edge Express and XCharge are powered by Global Payments
- PaySimple is powered by Worldpay
- PayConnect uses Fiserv on the backend
That’s all it boils down to.
If you’re using Open Dental and you haven’t audited your processing fees recently, there’s a good chance you’re overpaying. We find savings on every single statement we’ve audited from these providers.
Contact our team here at MCC for a free analysis of your Open Dental processing setup. We’ll show you exactly where you’re losing money and help you get it back—without switching providers or changing any of your Open Dental operations.