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Dental practice

Harbor Dental Group · Dental practice · Bellingham, WA

Renata Okonkwo runs the front desk at Harbor Dental Group, a six-chair family practice in Bellingham, and she uses this to take each new patient from the first call through forms, a coverage check and a booked first visit.

HealthcareIntakeForms3 tables · 4 views · 1 form · 1 dimension set · 1 dashboard · 1 digest · 1 notification · 1 stage rule set · 1 agent
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Intake board

Patients
Enquiry4
Thandiwe EllingsworthHDG-41382Feb 2, 1988
Ulrich Castellanos-FreyHDG-41389Nov 18, 1980
Valentina OstergaardHDG-41396May 9, 1996
Wendell Hartigan-LundHDG-41403Jul 27, 1973
Forms sent4
Ottilie SkjelbredHDG-41354Oct 13, 1982
Prosper Mbeki-AlvaradoHDG-41361Mar 6, 1977
Rosalind Thackeray-MoonHDG-41368Jun 20, 1993
Silvestre OyamadaHDG-41375Sep 15, 1969
Forms received4
Katarzyna SundqvistHDG-41326Aug 22, 1989
Leopold AmaechiHDG-41333Apr 4, 1971
Marguerite Ostrander-BellHDG-41340Dec 17, 1999
Nikolai HaverfordHDG-41347Jan 29, 1960
Insurance verified4
Genevieve Abarca-LindholmHDG-41298Jul 15, 1976
Horatio Blackwood-NwosuHDG-41305Feb 8, 1994
Isadora WexcombeHDG-41312Nov 11, 1966
Jovan Petrakis-HolmHDG-41319May 30, 1985
First visit booked6
Anneliese Kowalczyk-ReyesHDG-41256Jan 12, 1990
Bastian OkonjoHDG-41263Jun 28, 1981
Cordelia MerriweatherHDG-41270Oct 5, 1963
Dashiell Tran-EriksenHDG-41277Mar 19, 1998
Evangeline PrudhommeHDG-41284Dec 2, 1972
1 more
Active patient8
Corinne Abernathy-VossHDG-41200Feb 17, 1986
Hamid Zahradnik-DunnHDG-41207Sep 3, 1979
Linnea BergstromHDG-41214Nov 26, 1992
Odell Fitzgerald-ParkHDG-41221May 14, 1968
Perpetua KellerhalsHDG-41228Jul 8, 1995
3 more

Tables

Patients

30 sample rows · 19 columns

Every new patient from the first call through forms, coverage check and a booked first visit.

Patient nameChart numberDate of birthMobile phoneEmailMember IDInsurance plan
Thandiwe EllingsworthHDG-41382Feb 2, 1988(360) 555-0136thandiwe.ellingsworth@marrowfieldinbox.net——
Ottilie SkjelbredHDG-41354Oct 13, 1982(360) 555-0132ottilie.skjelbred@marrowfieldinbox.net—Pelican Point Dental Choice
Ulrich Castellanos-FreyHDG-41389Nov 18, 1980(360) 555-0137ulrich.castellanosfrey@kestrelcoastmail.net——
Prosper Mbeki-AlvaradoHDG-41361Mar 6, 1977(360) 555-0133prosper.mbekialvarado@kestrelcoastmail.net—Northwest Trades Union Dental Fund
Valentina OstergaardHDG-41396May 9, 1996(360) 555-0138valentina.ostergaard@quillhavenpost.org——
Katarzyna SundqvistHDG-41326Aug 22, 1989(360) 555-0128katarzyna.sundqvist@marrowfieldinbox.netSV3826398Skagit Valley Employers Dental Trust
Rosalind Thackeray-MoonHDG-41368Jun 20, 1993(360) 555-0134rosalind.thackeraymoon@quillhavenpost.org—Skagit Valley Employers Dental Trust
Wendell Hartigan-LundHDG-41403Jul 27, 1973(360) 555-0139wendell.hartiganlund@tamsinbrookmail.net——
Leopold AmaechiHDG-41333Apr 4, 1971(360) 555-0129leopold.amaechi@kestrelcoastmail.netSP3827309Self-pay
Silvestre OyamadaHDG-41375Sep 15, 1969(360) 555-0135silvestre.oyamada@tamsinbrookmail.net—Kestrel Coast Dental Plan
Genevieve Abarca-LindholmHDG-41298Jul 15, 1976(360) 555-0124genevieve.abarcalindholm@marrowfieldinbox.netBW3822754Brindlewood Dental Network
Marguerite Ostrander-BellHDG-41340Dec 17, 1999(360) 555-0130marguerite.ostranderbell@quillhavenpost.orgKC3828220Kestrel Coast Dental Plan

18 more rows

Insurance plans

6 sample rows · 4 columns

The plans patients bring, with the line the desk calls to check coverage.

PlanPlan typeVerification lineUsual wait to verify
Kestrel Coast Dental PlanPPO(360) 555-01512
Brindlewood Dental NetworkHMO(360) 555-01523
Skagit Valley Employers Dental TrustEmployer plan(360) 555-01534
Pelican Point Dental ChoicePPO(360) 555-01542
Northwest Trades Union Dental FundUnion plan(360) 555-01555
Self-paySelf-pay(360) 555-01561

Forms and booking

New patient form

Form
New patient formWhat a new patient sends from the practice web page, so the chart can be opened ahead of the appointment.
What is your full name, as it is on your insurance card? *
What is your date of birth? *Carriers verify on name and birth date.
Which mobile number should we text reminders to? *
What email should we send your forms to?
Which member number is printed on your plan card?Leave it blank if you are paying yourself.
What brings you in?Cleaning and examToothacheBroken toothWhitening consultSecond opinionBraces consult
How did you hear about us?Neighbor referralOnline searchEmployer benefitsWalked past the officeReferred by a dentistSocial media
Is there anything we should know before you arrive?
Send to Harbor Dental

Dashboards

Intake this month

Patients
Patients by stage
  • Active patient8
  • First visit booked6
  • Insurance verified4
  • Forms received4
  • Forms sent4
  • Enquiry4
Estimated patient portion by plan type$1,408
New enquiries by week
  • Aug 30, 20262
  • Sep 6, 20262
  • Sep 13, 20263
  • Sep 20, 20266
  • Sep 27, 202614
  • Oct 4, 20263

Also included

  • Intake boardStage rules
  • Forms in, coverage not checkedDigest
  • Coverage confirmedNotificationTells the front desk the moment a patient's coverage is confirmed so a visit is offered.

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