Practice Looking to Add an Associate

General Information

Name of Practice

Practice’s Website

Address

City

State

Postal code

Total number of dental providers at your practice

Information about the New Associate

Is the associate: (Choose all that apply)

A new graduate

Worked at another private practice

Worked at a DSO (Dental Service Organization)

When is the associate expected to start seeing patients at your location?

Enrollment & Credentialing

How often do you anticipate adding more associates in the future?

Is the enrollment and credentialing process for the new associate managed internally or outsourced?

Membership & Management Systems

Do you currently offer a membership plan?

Yes

What practice management (PM) system do you utilize?

Feedback & Expectations

What enhancements or considerations would you suggest for integrating a new associate concerning dental insurance participation and claim reimbursement processes?

How did you learn about our services, and what are your anticipations in terms of optimizing claim reimbursements during this phase of adding a new associate?

Contact Information

First Name

Last Name

Your role

Email *

Phone *

Your time zone?

Preferred Time and Method of Contact

State your practice is located