Forms
Pristine Medical Billing has collected everything you need in one place, from insurance fee schedule guides to SOAP notes and diagnostic questionnaires. Contact us today for help with setting up your dental sleep medicine practice.
Medical Insurance Fee Schedule Guide – Sleep Apnea
Medical Insurance Fee Schedule Guide – TMD
Workflow – Pristine EMR
Pristine CBCT Workflow
SOAP Note – Implants & Bone Grafting
SOAP Note – Sleep Apnea
SOAP Note – Third Molar Extraction
SOAP Note – TMD
SOAP Note – Trauma Related Oral Surgery
SOAP Template – Frenectomy
Sample Chart Note – Consultation
Sample Chart Note – Delivery
Sample Chart Note – Follow Up
Commonly Used Acronyms
Statement of Therapy
Oral Surgery Medical Diagnosis Codes
Super Bill – Oral Surgery
Super Bill – TMD
Super Bill – Sleep Apnea
PCP Referral Request – Sleep Apnea/TMD
Provider Information Sheet
W-9 Form
Proof of Delivery Form
Patient Intake Form
PDF Fillable Patient Intake Form
PDF Fillable Proof of Delivery
PDF Fillable TMD Super Bill
PDF Fillable Oral Surgery Super Bill
PDF Fillable Sleep Super Bill
Advanced Beneficiary Notice of Non-Coverage (ABN)
Contact Us
Get in touch with Pristine Medical Billing today if you need advice about founding a dental sleep medicine practice.
Schedule a consultation to help your practice grow with strength, stability, and independence.
