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Dentists

to SMILE!

A reason for

Free Practice Assessment

Increase Time with Patients

Increase Practice Revenue

Member Only Discounts & Benefits

Network with other Dental Professionals

Take the

FREE PRACTICE ASSESSMENT

to see how your fee schedules might be hurting

your bottom line revenue.

a partner in your success

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Become a Member

Connect with other dental professionals and gain access to your membership benefits.

Become a Member

Take the Assessment

Discover if your practice can benefit from our Preferred Fee Schedule or Contract Alignment.

Free Practice Assessment

Increase Your Revenue

Increase practice revenue through our payer solutions and member discounts.

The Dental Advocacy Group is a member-based dental organization formed to enhance the quality of time and services from dentist to patient by pre-negotiating non-clinical business functions that would otherwise occupy time better utilized for clinical care.

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What is your practice specialty?*
- General Dentist
- Endodontist
- Oral Surgeon
- Orthodontist
- Pediatric Dentist
- Periodontist
- Prosthodontist
Where is your practice located?*
What is your practice zip code?*

How many dentists are in your practice?*
- 1
- 2-4
- 5+
How many locations?*
- 1
- 2
- 3
- 4+

When was your practice UCR last increased:*
- within the last 12 months
- within the last 24 months
- more than 24 months ago

What is the estimated Gross Annual Revenue for your practice?*
- $250k to $499K
- $500k to $749K
- $750k to $1.24M
- $1.25M to $2.9M
- $3M-$5M
- $5M +

What percentage of revenue comes from PPO's?*

The practice holds In-Network PPO contracts with: (check all that apply)*
- None of these
- Aetna
- Anthem
- Ameritas
- Assurant
- Blue Cross
- Cigna
- Companion Life
- Delta Dental
- Guardian
- Humana
- Medicare Advantage Plus
- MetLife
- Principal
- United Concordia
- United Healthcare

The practice holds In-Network Umbrella PPO contracts with: (check all that apply)*
- None of these
- Careington
- Connection Dental / GEHA
- Dentemax
- Diversified
- Maverest / Stratose / Zelis
- Premier

What practice management software do you use?*
- Dentrix
- Eaglesoft
- Open Dental
- Other
Do you offer health insurance to your employees?*
- Yes
- No

Who is your primary vendor for clinical supplies?*
- Atlanta Dental Supply
- Benco
- Goetze Dental
- Henry Schein
- Midwest Dental
- Nashville Dental
- Patterson
- Other

What are your practice goals in the next 12 months (check all that apply)*
- Reduce the amount of PPO write-offs
- Increase the profitablity of the practice
- Fill excess capacity
- Start-up practice intending to grow
- Add an associate dentist
- Add a new location
- Acquire an existing practice
- Begin accepting insurance

Please complete to receive your FREE Practice Analysis.
Practice Name*
NPI Number*
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Role*
- Owner/Dentist
- Associate Dentist
- Office Manager
- Other
Email*
Best Phone*
Best Contact Method*
Best days / times to call
How did you hear about us?*
Referred By:*

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Dental Advocacy Group

Tel: 770-727-5611

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