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Based in Irving, Texas, U.S. Oral Surgery Management supports oral and maxillofacial surgeons by managing their back-office operations so they can prioritize patient care, not paperwork.
Anna Crenshaw serves as Director of Accounts Payable and Treasury, where she and her team oversee accounting processes for nearly 200 practices nationwide. These practices make up the client base U.S. Oral Surgery Management serves, and Crenshaw’s team helps transition each one into a centralized, streamlined invoice and payment process using AvidXchange.
A Workflow and Reconciliation Nightmare
When Crenshaw joined U.S. Oral Surgery Management in 2017, one thing became clear: their own accounting process wasn’t built to scale. Their team was using Concur Invoice to automate their invoicing and NetSuite as their ERP; the challenge was that at the time, these two systems required manual intervention to share invoice data with each other.
As a result, manual work ate up to two days’ worth of Crenshaw’s time at the end of every month. Additionally, invoice visibility was limited, and there was no way to route invoices directly to their clients for approval, which created more delays and confusion throughout the month.
Their clients would also pay suppliers (vendors) with company credit cards, rather than unique virtual card numbers for each transaction, leading to complex and time-consuming reconciliations. When using credit cards for payments, Crenshaw stated they would struggle to connect which invoice belonged to which practice, especially when a single supplier could be used across multiple practices.
“It created a reconciliation nightmare. It was almost impossible to tell the invoices apart. Were we double-paying? Were we paying it through both accounting systems? It was all over the place.” – Anna Crenshaw
At the time, only four team members were dedicated to coding and processing invoices. As volume increased, the team had to hire additional entry-level staff just to keep up with the demand. On top of workflow and visibility challenges, Crenshaw and her team faced challenges onboarding their clients into the AP system.
Month-End Processes: from Days to the Click of a Button
By 2020, Crenshaw and her team recognized that their AP processes were no longer sustainable. As the business expanded and the number of practices supported grew, they couldn’t keep up with the manual work involved to share data between their AP solution and ERP . Processing up to 17,000 invoices each month called for more than extra hours; it required a smarter, more streamlined solution.
They needed a platform that could scale with them, support flexible and customizable workflows, and the ability to route invoices to the right approver without delays, and that’s where AvidXchange came in. Greater visibility into invoices was essential, especially with practices operating nationwide to support compliance and help prevent fraud attempts. With AvidXchange, their clients can keep track of who approves, when the invoice is processed, and when suppliers are paid, all at the click of a button, and from any device with internet access.
“What I really like about AvidXchange is you’re able to see the payments like cleared checks or credit cards. Whenever a supplier (vendor) calls, you know exactly when you sent it and if it’s cleared. You can send the status to them versus having to look at the bank or call.” – Anna Crenshaw
Supplier management was another growing challenge. With an average of 50 new suppliers added each month, maintaining accuracy and avoiding duplicate entries in their supplier master file became essential. By onboarding clients through AvidXchange, Crenshaw’s team benefits from shared supplier data as many suppliers exist in the system from other practices, making the setup process faster and more efficient.
Crenshaw’s team implemented a centralized solution that checked every box. AvidXchange integrated seamlessly with their NetSuite ERP, streamlining repetitive tasks and improving overall workflows.
A Scalable, Centralized AP Process Built for Growth
Crenshaw and her team lead the onboarding process for each new practice joining the business, helping them transition from credit card payments to a more efficient, centralized approach. On average, they onboard one to five new practices a month, supported by two dedicated members of their team who help ensure a smooth and consistent experience.
“AvidXchange has really helped us because it’s simple to train someone. It’s great that it’s so easy to train different people every single month with new acquisitions.” – Anna Crenshaw
U.S. Oral Surgery Management has been able to scale their business with confidence, growing from 30 practices in 2020 to 139 in 2025. By having customizable workflows, greater visibility, and accurate approval routing with AvidXchange, the team has transformed their processes, allowing them to pay suppliers faster. According to Crenshaw, tasks that once took days are now done in minutes. “All you do is go in there, click, batch, and upload. There’s no room to mess things up. When you’re working in Excel, there’s a lot of room for error. With AvidXchange, you’re just batching it over and letting it go.”
And because U.S. Oral Surgery Management supports practices across the country, all their clients have access to their AP via an internet-connected device, no matter where they’re located.
AvidXchange has helped free up time for Crenshaw and her team to focus on growth, while ensuring their clients are supported with exceptional service.
“What I really like about AvidXchange is you're able to see the payments like cleared checks or credit cards. Whenever a supplier (vendor) calls, you know exactly when you sent it and if it's cleared. You can send the status to them versus having to look at the bank or call.”
