Carestream Dental Short Questionnaire Question Title * 1. Contact Name OK Question Title * 2. Practice Name OK Question Title * 3. What is your role in the practice? Owner Management Financial staff IT Provider Hygienist Assistant Front desk staff Other (please specify) OK Question Title * 4. How many locations does your practice / organization have? OK Question Title * 5. How many doctors are in your practice / organization? OK Question Title * 6. How many hygienists are in your practice / organization? OK Question Title * 7. What is the age range of your oldest doctor? less than 39 40-49 50-59 60+ less than 39 40-49 50-59 60+ OK Question Title * 8. What is the age range of your youngest doctor less than 39 40-49 50-59 60+ less than 39 40-49 50-59 60+ OK Question Title * 9. How do you pay your providers? Salary with bonuses Based on Collections Based on Production OK Question Title * 10. How would you classify the care specialty of your practice? General Dental Periodontics Pedodontics Endodontics Oral Surgery Orthodontics Multi-Specialty OK Question Title * 11. What Practice Management software are you using today? PracticeWorks SoftDent OrthoTrac WinOMS Ascend Dentrix Fuse Eaglesoft Other (please specify) OK Question Title * 12. Would you consider changing your practice management software to something newer, quick to learn and easier to use? Yes No OK Question Title * 13. Do you track clinical info (or chart) on paper or in software? Paper Software OK Question Title * 14. Do you use digital imaging, or do you capture x-rays on film? Film Digital OK Question Title * 15. Do you file insurance claims on behalf of your patients? Yes No OK Question Title * 16. Do you submit medical claims for reimbursement? Yes No OK Question Title * 17. What electronic services are you using today? Credit Card Payments Electronic Statements Electronic Claims, eClaims (ECS) Claims Status & Eligibility Claims Payments (ERA) Appointment Reminders Online Patient Registration Other (please specify) OK Question Title * 18. Thank you for your participation! OK DONE