Insurance Management Assessment
Section 1
Tell us about you and your practice
1. What is your role in the practice?
Select an Option
Doctor/Dentist/Owner
Officer/Executive
Office Manager
Receptionist
Insurance Coordinator
Scheduling Coordinator
Other
2. What specialties do you offer in your practice today?
(Check all boxes that apply)
General Dentistry (including aligners)
Orthodontics
Periodontics
Endodontics
Oral Surgery
3. Does your office accept insurance?
Select an Option
Yes, we accept insurance
No, we are a cash only practice that doesn’t accept insurance nor assignment of benefits.
4. Do you accept the release of information & assignment of benefits to your office?
Yes
No
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