Conference Call or Quote Request for Dental Claims Cleanup, LLC or Results! Dental Collections, LLC

Conference Call or Quote Request for Dental Claims Cleanup, LLC or Results! Dental Collections, LLC

Thank you for contacting us. We would like to setup a conference call to discuss your dental billing, debt collection, and other financial support services. To make the most of the call and for us to be able to provide you with a quote for service, please provide us with the information requested.

average number of claims submitted per month
total claims aging over 30 days
# of claims on the report
total accounts receivable (patient and insurance) over 30 days
# of patient balances on the report

Thank you again. We are looking forward to our call and to help your practice.

"Consumer information is not shared with third parties for marketing purposes."

Always on Your Side,

Dr. Dorothy Kassab

800-652-3431

or email dkassab@kassabenterpriseteam.com

Tell Us About You

what type of dental office do you have?

Date*

Your First Name*

Your Last Name*

Office Phone Number

Office or Your Email

Position at the office*

Select or enter value

Doctor's First Name*

Doctor's Last Name*

Doctor's Email*

Doctor's Cell Number

Practice Name*

Dental Office Street Address*

Practice Website*

Newsletter Sign-up Request

Select or enter value

How did you hear about us?*

Select

Date you are available for a conference call MON-FRI: DATE*

What TIME would you like us to reach you?*

Select

TIME ZONE

Tell Us More About Your Practice

What Dental Software do you use?*

How many days is your practice open?*

# Monthly Claims

How many claims does your office submit per month on average?

$ Insurance AR*

DO you know what your current total over 30 days insurance aging is?

$ Balances AR*

WHat is your current patient balances accounts receivable?

outstanding A/R*

Total outstanging AR

Current collection company name?*

Do you currently use a collection agency? Which one?

Which of our services are you Interested in?*

We provide ongoing dental billing services through Dental Claims Cleanup AND seamless submission to our debt collection through our Results! Dental Collection Services. Are you interested in one of these or both?

In addition we can support your practice with

Medical Billing

Verification

Credentialing

Select

Service Interest*

What services are you interested in?

Select

What are your current struggles?*

What are the current struggles in your practice. Please tell us what you are noticing. Sometimes, the owner Dentist does not really know what the problem is but they do see the indicators of a problem. What are those signs?

Please feel free to share with us your reports if you want us to obtain the numbers.

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