Empowered Practice Academy — Practice Qualification
Practice IdentityPatient CareReadiness
Before we talk, I want to make sure we're the right fit for each other.
I've spent 30 years in dentistry and I've learned that the practices who get the most out of this work are the ones who were already thinking about their patients differently.
Answer these questions honestly — there are no wrong answers if they're true. This form takes about 4 minutes.
Section 1 of 3
Practice Identity
Who you are and how you practice
How is your practice structured?
How many new patient exams does your practice complete in a typical month?
When a new patient asks what makes your practice different, what does your team typically say?
Which of the following imaging and diagnostic tools does your practice currently use?
Select all that apply
How would you describe your approach to specialist referrals?
Please answer all questions before continuing.
Section 1 of 3
Section 2 of 3
Patient Care
What you actually do in the room
Walk me through what a comprehensive new patient exam typically includes at your practice.
When you take a patient health history, how far does that conversation typically go?
Think of a patient you wished you could have helped but couldn't because of cost or insurance limitations. What happened?
How does your team talk to patients about the connection between their oral health and their overall health?
When a patient presents with a condition that may have a medical necessity component — sleep apnea, TMJ disorder, periodontal disease alongside a systemic illness — what is your current approach?
Please answer all questions before continuing.
Section 2 of 3
Section 3 of 3
Readiness
What you're willing to do to implement this properly
What got you interested in medical billing for dental procedures right now?
Medical billing for dental procedures requires thorough clinical documentation of medical necessity — not just dental charting. How does your practice currently approach documentation?
Implementing medical billing properly requires workflow changes — from documentation to how cases are flagged and coded. How would you describe your team's readiness for that?
If medical billing implementation goes well, what does success look like for you? Choose the answer that is most honest.
Are you currently working with anyone on medical billing for dental procedures?
Please answer all questions before continuing.
Section 3 of 3
Almost Done
Where should we send your results?
We'll review your answers and be in touch within one business day.
Your information is used only to follow up on your qualification results. We do not share your data.
Please enter your name and a valid email address.
Final Step
✦
Based on what you shared, it sounds like we may be a strong fit.
The way you practice — and the reason you reached out — is exactly what this work is built for. I'm looking forward to talking with you.
You'll receive a pre-call email with a few things to have ready.
Whatever the next step looks like for you, I'm glad you're here. — Danielle Brown, My Smile Insured, LLC
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You're thinking about this the right way — and you're closer than you might think.
The interest and the mindset are there. Let's make sure you have the right foundation before we talk — then we can hit the ground running on the call.
Start here — free
Download the free practice guide: Are You Leaving Money on the Table? — covers which procedures qualify, what documentation you need, and the business case for implementing.
Ready now? Book the call. I'll send a pre-call resource to review beforehand.
Whatever the next step looks like for you, I'm glad you're here. — Danielle Brown, My Smile Insured, LLC
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Thank you for taking the time.
Based on what you shared, the work I do requires a specific foundation that may not be fully in place yet — and I want to be straight with you about that. That doesn't mean never. Here's where to start.
Build toward readiness
Empowered Practice Academy ($1,997) — the 8-module course that gives your team the skills to document, code, and bill correctly. Start here.
Practice Patient Toolkit ($449) — give your patients the tools to advocate for their own coverage right now, before your practice is billing medically. Unlimited use.