2146 CHAPMAN ROAD, CHATTANOOGA, TN 37421
8 8 8 - 7 5 8 - 0 5 8 4
I would like to use the following DentalBanc services:
Credit assessment and payment plan recommendations
Fast and informative. Will NOT affect a patient’s credit score.
Payment Plan Management – Pre-Purchased Accounts
We make recurring transactions easy. DentalBanc manages the accounts so you have less to worry about. Your
payments stay up to date (99.4% on time). Patients can see their accounts on-line – 24/7.
I want to accept:
Regular Price: Minimum Purchase – 10
By signing below I authorize DentalBanc, LLC to debit the total package price indicated above from the checking account
“Make-A-Payment” by TeleVox
DentalBanc and TeleVox have teamed up to offer your patients the ability to make on-line payments through your
website designed by TeleVox.
Credit Bureau Reporting / Collections
Level A - Send letter and report collection to all three national Credit Reporting Agencies (CRAs) if not paid.
Level B - Send series of letters and report collection to CRAs if not paid.
Level C – Send series of letters, report collection to CRAs if not paid - Full Collection Services.
Monthly Subscription $30.00 One Year Pre-Purchased Subscription $315.00
Updates and Reports to be emailed to:
Please provide a list of users/staff that need access to the DentalBanc system.