List of Required Documents
- Business Tax Returns (3 Years)
- Tax Asset Summary (from the most recent tax return)
- Income Statement (3 Years, also referred to as a Statement of Profit and Loss) plus a trailing 12 month P&L. Meaning a P&L from the most recent 12 months. Example July 1,2020 – June 30, 2021
- Balance Sheet (3 Years though not as critical as the Income Statements)
- Procedure by Provider Report – Two Years plus YTD. Plus a procedure by Provider report to cover the same period in the TTM period above in #3. Please include the number of new starts in an Ortho practice. Please include the total value of any open contracts in an Ortho Practice
- Salary Report broken out by staff member – One year
- Staff member name, hire date, hours, rate of pay, and position
- Copy of the current lease
- Fixed Asset Description (this maybe on the tax return)
- Current Fee Schedule
- List of all payors you are in network with especially if you are a Delta Premier provider. If Delta Premier please provide the number of Premier patients and revenue generated by those patients one year plus YTD.
- Practice analysis report from the software.
- Production/collection/adjustment report for the most recent 12 months covering the trailing P&L from #3 above.
- Payroll reports for the last full year, YTD current year, and the TTM period please.