A service level agreement, or SLA, is the document that defines what your IT provider is actually accountable for. It specifies response times, uptime commitments, support hours, escalation paths, and what happens when the provider does not meet its obligations.
For a DSO, the SLA is more important than it is for a single practice because the stakes are higher. A slow response at one location affects patient care at that office. A slow response to an organization-wide incident can affect every location simultaneously.
The Gap in Most Dental IT Contracts
Most dental IT contracts include response time commitments. Fewer specify what constitutes a response versus a resolution.
A provider that acknowledges a ticket within four hours has met a response time commitment. If the problem is not resolved for three days, the SLA was technically satisfied. DSOs need to negotiate resolution time commitments, not just response time commitments.
What most SLAs promise
Acknowledge your ticket within 4 hours
What DSOs should negotiate
Resolve critical issues within a defined window — not just acknowledge them
Need a DSO-ready SLA with defined response times across every location? Find out in 15 minutes if we are the right fit.
Standard managed IT agreements leave out several protections that matter at DSO scale. Negotiate for these in every DSO IT agreement. Click each item to see what the standard contract says versus what you should be asking for.
Negotiate for these in every DSO IT agreement
Standard SLA
DSO SLA Should Include
One response time for all tickets regardless of severity
Defined tiers: critical (server down, location outage), high, and normal, each with its own response and resolution window
Critical issues like a server down or a complete location outage should have both a response time commitment and a resolution time commitment. Non-critical issues can have longer windows. Define the tiers clearly in the contract language.
Standard SLA
DSO SLA Should Include
SLA applies to named locations at contract signing. New locations added later may not be explicitly covered.
Explicit coverage for all current and future locations with a defined onboarding process for new acquisitions built into the agreement
Ask whether remote support carries different response time commitments than on-site support. Ask whether locations in different geographies have different windows. These distinctions need to be in writing, not assumed.
Standard SLA
DSO SLA Should Include
Single support channel with no documented process for escalating unresolved issues
Named escalation contacts at each level with defined response time commitments for each escalation tier
The SLA should name specific escalation contacts and the response time commitments at each escalation level. When a location is down and the first contact has not resolved it, the DSO needs to know exactly who to call next and what response to expect.
What Is Typically Missing from Standard IT SLAs
Most standard managed IT agreements are written for single-location businesses. When a DSO signs a standard agreement, several multi-location realities are usually not addressed.
Check off each gap that is addressed in your current IT agreement. Unchecked items are unprotected exposures in your SLA.
Gaps addressed in your current IT agreement0 / 4
Your current SLA addresses all four multi-location gaps.
Your agreement covers the protections most standard IT SLAs omit for DSOs. The next step is confirming that the commitments in the SLA are actually being met -- request a reporting summary from your provider if you do not already receive one on a regular cadence.
Some multi-location gaps remain in your current SLA.
The unchecked items are unprotected exposures. At DSO scale, gaps in proactive monitoring and organizational reporting are the most likely to result in a problem going undetected across multiple locations. These should be negotiated at your next contract renewal or added as an amendment.
Most multi-location protections are missing from your current SLA.
Your IT agreement is likely a standard single-location contract applied to a DSO. The protections that matter at multi-location scale -- organizational reporting, proactive monitoring, new location onboarding, and incident tiering -- are not in place. This is worth addressing before the next incident makes the gap visible.
Volume is your leverage. A DSO committing multiple locations to a single provider has negotiating power that a single practice does not. Use it to negotiate resolution time commitments alongside response time commitments, proactive monitoring across all locations, monthly reporting on every location's IT health, and a defined onboarding process for new locations at no additional setup cost.
Negotiate for these specifically
Resolution time commitmentsProactive monitoring across all locationsMonthly per-location IT health reportingNew location onboarding at no setup costNamed escalation contactsOrganization-wide incident definition
The Question That Reveals DSO Readiness
Ask the provider to walk through their incident response process for a scenario where all locations lose access to the practice management database simultaneously.
How they answer tells you more about their DSO readiness than any document they hand you. A provider built for single-location dental practices will not have a clear answer. A provider with real DSO experience will describe a specific process, name the people involved, and tell you exactly what you should expect within the first 30 minutes of that call.
Frequently Asked Questions
For critical issues including server down, complete location outage, or active ransomware: 30 to 60 minutes response, two to four hours resolution target. For high-priority issues affecting multiple users: two to four hours response. For standard requests: four to eight hours response. These are reasonable minimums for a DSO, not industry maximums.
The agreement should specify remedies for SLA failures. Common remedies include service credits applied to the next billing period or the right to terminate without penalty after repeated failures. An SLA without defined remedies is a statement of intent, not an enforceable commitment.
No. A single organizational SLA that covers all current and future locations under consistent terms is the goal. Location-specific agreements create the same management problem as location-specific IT providers: no leverage, no consistency, and no single point of accountability.
Annually at minimum, and whenever the DSO adds locations, changes platforms, or has a significant incident that revealed gaps in the provider's response. The SLA should evolve with the organization, not remain static from the day it was signed.
Does your DSO's IT agreement actually define what your provider is accountable for when something goes wrong across multiple locations?
Ekim IT Solutions works exclusively with dental practices. We serve New England and New York with on-site support and dental practices nationwide with remote support. We provide DSOs with clear SLAs that define response times, escalation paths, and uptime commitments at both the location and organizational level so you always know what to expect and what recourse you have.
A vague IT agreement is not a safety net. Find out if your DSO's SLA actually holds your provider accountable.
Ezra Angelo
