Complete Devdent's Practice Assessment To Receive Customized Information To See If Medical Billing Can Work In Your Unique Practice Devdent Medical Billing Practice Assesment Assessment How Many Providers In Your Practice? * How Many Locations For Your Practice? * How Many New Patients Does The Practice See A Month? * 0-20 20-40 40-60 60-80 over 80 Which Best Describes Your Practice? * Fee For Service Full Fee - Few PPO Contracts Many PPO Contracts All PPO Contracts Other What Practice Management Software Do You Use? * Dentrix Dentrix Ascend Dentrix Enterprise Eaglesoft Open Dental Other Please Describe Your Practice Please List Practice Managment Software You Use Which Best Describes Your Specialty? (click all that apply) * General Practice Oral Surgeon Orthodontist Periodontist Endodontist Pedodontist Prosthodontist TMD/Sleep Other Which of Following Medically Covered Services Do You Provide? (click all that apply) * Implants Bone Grafting Full Mouth Reconstruction 3rd Molar Extractions I.V. Sedation Sleep/TMD Appliances Trauma/Emergency Care CBCT Laser Treatment Periodontal Treatment Implants Average # Per Month Average Fee (Including PPO Fee's) Average Case Acceptance for This Procedure Bone Grafting Average # Per Month Average Fee (Including PPO Fee's) Average Case Acceptance for This Procedure Full Mouth Reconstruction Average # Per Month Average Fee (Including PPO Fee's) Average Case Acceptance for This Procedure 3rd Molar Extraction Average # Per Month Average Fee (Including PPO Fee's) Average Case Acceptance for This Procedure Sleep/TMD Appliances Average # Per Month Average Fee (Including PPO Fee's) Average Case Acceptance for This Procedure If you are human, leave this field blank. Next Δ What Type of Practice Do You Have? Please Select An Option Single Doctor, Single Location Multiple Doctors, Single Location Single Doctor, Multiple Locations Multiple Doctors, Multiple Locations How Many New Patients Do you See In a Month? Please Select An Option 0-20 20-40 40-60 60-80 over 80 How Many Hygiene Hours Do Your Schedule Each Month? Please Select An Option 0-20 20-40 40-60 60-80 over 80 What's Your Previous Experience With Medical Billing? Please Select An Option Brand New Submitted a Few Cases Bill Regularly What Practice Management Software Do You Use? Please Select An Option Dentrix Dentix Ascend Dentrix Enterprise Eaglesoft Open Dental Other What Is Your Role In The Practice? Please Select An Option Dentist Office Manager Front Desk/Admin Hygienist Dental Assistant Other What State Is Your Practice In? Please Select An Option Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming What Technology Do You Use In Your Practice? CBCT Intraoral scanner Laser therapy CAD/CAM What Services Do You Provide? Implants 3rd Molar Extraction IV Sedation Sleep/TMD Appliances Trauma/Emergency Care Periodontics Which Of The Following Best Describes Your Practice? General Practice Oral Surgeon Orthodontist Periodontist Endodontist Pedodontist Prosthodontist Full Name Practice Name Phone Email What Do You Want to Accomplish By Adding Medical Billing To Your Practice? Submit & Schedule your Assessment Call Devdent Medical Billing Practice Assesment What type of practice do you have? Please Select An Option Single Doctor, Single Location Multiple Doctors, Single Location Single Doctor, Multiple Locations Multiple Doctors, Multiple Locations How many new patients do you see a month? Please Select An Option 0-20 20-40 40-60 60-80 over 80 How many hygiene hours do you schedule per week? Please Select An Option 0-20 20-40 40-60 60-80 over 80 What's your previous experience with medical billing? Please Select An Option Brand New Submitted a Few Cases Bill Regularly What Practice Management Software do you use? Please Select An Option Dentrix Dentix Ascend Dentrix Enterprise Eaglesoft Open Dental Other What role do you fill at the practice? Please Select An Option Dentist Office Manager Front Desk/Admin Hygienist Dental Assistant Other What state is your practice in? Please Select An Option Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming What technology have you adopted into your practice? CBCT Intraoral scanner Laser therapy CAD/CAM What types of services do you provide? Implants 3rd Molar Extraction IV Sedation Sleep/TMD Appliances Trauma/Emergency Care Periodontics Which of the following describes your practice best? General Practice Oral Surgeon Orthodontist Periodontist Endodontist Pedodontist Prosthodontist Full Name Practice Name Email Phone What are you wanting to accomplish by adding Medical Billing to your practice? Submit & Schedule your Assessment Call What type of practice do you have? Please Select An Option Single Doctor Multiple Doctors Single Single Multiple Locations How many new patients do you see a month? Please Select An Option 0-20 20-40 40-60 60-80 over 80 How many hygiene hours do you schedule per week? Please Select An Option 0-20 20-40 40-60 60-80 over 80 What's your previous experience with medical billing? Please Select An Option Brand New Submitted a Few Cases Bill Regularly What Practice Management Software do you use? Please Select An Option Dentrix Dentix Ascend Dentrix Enterprise Eaglesoft Open Dental Other What role do you fill at the practice? Please Select An Option Dentist Office Manager Front Desk/Admin Hygienist Dental Assistant Other What state is your practice in? Please Select An Option Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming What technology have you adopted into your practice? CBCT Intraoral scanner Laser therapy CAD/CAM What types of services do you provide? Implants 3rd Molar Extraction IV Sedation Sleep/TMD Appliances Trauma/Emergency Care Periodontics Which of the following describes your practice best? General Practice Oral Surgeon Orthodontist Periodontist Endodontist Pedodontist Prosthodontist Full Name Practice Name Email Phone What are you wanting to accomplish by adding Medical Billing to your practice? Submit & Schedule your Assessment Call
