Dental Services Organization (DSO)

General Information

Number of locations

Total number of dental providers across all locations

Please share what states your practices are located in

Enrollment & Credentialing

How frequently does your DSO add new providers or locations?

Are the enrollment and credentialing processes centralized for all locations?

Practice and Provider Specifics - Continued

Are all of your locations enrolled in the same insurance networks?

Yes

Do you currently offer a membership plan?

Yes

What practice management (PM) system does each location have?

Insurance Network Participation by Location

Do all locations accept the same range of dental insurance plans? If no, please provide an overview or a breakdown by major differences.

Are there specific locations that have faced challenges in network enrollment or claim reimbursements?

Yes

Feedback & Expectations

What improvements would you like to see in the dental insurance network participation and claim reimbursement process?

How did you hear about our services?

Contact Information

Practice's Name

Practice's Website

Your role

State your practice is located

Contact Information - Continued

First Name

Last Name

Email *

Phone *

Your time zone?

Preferred Time and Method of Contact