Dental Billing Virtual Assistant – a dental office billing specialist with a headset at a computer reviewing dental insurance claims and an x-ray attachment on screen

Dental Billing Virtual Assistant: Hire a Remote Dental Billing VA for Claims, Attachments and Insurance Follow-Up

The last patient leaves, and the billing starts. Every procedure on the day sheet needs a claim, some of those claims need an X-ray or a narrative, the secondary plans wait for the primary to pay, and the claims nobody chased last month are still sitting in the aging report. In a busy dental office that work can get done after hours, or not at all.

A dental billing virtual assistant takes it over: a remote billing specialist who sends your claims, gathers the attachments, follows up with dental plans and bills patients for what insurance leaves. This page covers the role and its limits, what the ADA says about CDT codes, how attachments and secondary claims work, the price, and how to hire and onboard the VA.

Quick Answer

A dental billing virtual assistant handles your insurance billing from a remote desk: the VA builds and sends your dental claims with the codes your dentist charted, attaches X-rays and perio charts, drafts narratives for the dentist to approve, posts payments, bills secondary plans, follows up on unpaid claims and sends patient statements. The VA never chooses or changes procedure codes and makes no clinical decisions. With VA MASTERS a dental billing VA costs $7.50–$14/hr, about $1,200–$2,240 a month full-time. It costs nothing to start, and first candidates typically arrive in about 2 business days once the role is agreed.

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What Is a Dental Billing Virtual Assistant?

A dental billing virtual assistant (also called a dental billing VA, a virtual dental billing assistant or a remote dental billing specialist) works in your practice management software from another location and owns the insurance side of the money: from the moment a procedure is completed until the claim is paid, appealed or moved to the patient’s balance. The VA works in your systems, under your rules, with their own logins.

The role is narrower than a general dental VA. For phones, scheduling, recall and checking benefits before visits, see the dental virtual assistant page; for eligibility and benefits checks as a role of its own, the insurance verification virtual assistant page. Billing for medical practices is on the medical billing virtual assistant page, and dental labs (rather than practices) have a dental lab virtual assistant page. For denial and AR work across medical payers, see the revenue cycle management virtual assistant page.

Dental billing has its own rules. Procedures are reported with CDT codes, the ADA’s code set, rather than the CPT codes on medical claims; dental plans can ask for X-rays, periodontal charting and narratives before they pay; and Medicare.gov says that in most cases Medicare doesn’t cover dental services like routine cleanings or fillings, so the VA confirms which plan covers each patient before billing. A VA with US dental billing experience already knows that ground.

Who Decides What: the VA, the Dentist, the Office Manager

Settle this split before the VA’s first login. The VA moves fast on paperwork; the codes, the clinical content and the money decisions stay with your team:

StepDental billing VADentist or office manager
Procedure codesEnters the CDT codes, tooth numbers and surfaces exactly as the dentist recorded them; flags a code that doesn’t match the chart noteThe dentist picks every code; the VA never chooses or changes one
NarrativesDrafts the narrative from the chart notes, measurements and findings already in the recordThe dentist reviews and approves it; nothing clinical is added by the VA
AttachmentsPulls the X-rays, perio charting or photos the payer asks for from the imaging and PM systems and attaches themDecide which images belong with which procedure when it is unclear
Payer calls and portalsChecks claim status, asks why a claim is held, logs the reference number—
DenialsLogs the reason, prepares the corrected claim or appeal letter and tracks the deadlineDecide whether to appeal; sign where the payer requires it
Write-offs and adjustmentsFlags old balances that may not be collectible, with the account notesSign off on write-offs and adjustments above the limit you set
Patient balancesSends statements and reminders with your scripts once insurance has paidApprove payment plans and anything unusual

One rule covers most cases: if the answer is already in the chart, the ledger or the payer’s file, the VA can act on it inside your written rules. If it would alter a billed procedure or calls for clinical judgment, it goes to the dentist or the office manager with the facts and the deadline.

Dental Billing Tasks You Can Hand Over

The billing tasks a VA can own, one by one:

TaskWhat the VA doesWhat you get
Claim creationBuilds the claim from completed procedures on the day sheet, using the codes the dentist chartedClaims can go out the next business day
Claim checksChecks tooth numbers, surfaces, quadrants, dates of service, subscriber and payer IDs before sendingFewer rejections from missing data
AttachmentsAttaches the X-rays, perio charts, photos or reports the payer requires for that procedureFewer claims held for a missing attachment
NarrativesDrafts narratives from the chart notes for the dentist to approveThe dentist reviews a draft instead of a blank page
Electronic submissionSends claims through your clearinghouse and works the rejection reportRejections fixed while they are fresh
Pre-treatment estimatesSends predeterminations the dentist wants for larger treatment and tracks the replyPatients see an estimate of their share before they agree
Payment postingPosts insurance payments from ERAs and EOBs and matches them to each procedureEach payment posted to the right procedure, ready to reconcile with your bank statement
Secondary claimsBills the secondary plan with the primary’s EOB before anything goes to the patientPatients billed only for their real share
Claim follow-upWorks unpaid claims by age and amount through portals and payer phone linesA shorter insurance aging report
Denials and appealsLogs each denial with its reason, corrects and resubmits or prepares the appeal for sign-offEvery denial has a next step and a date
Patient statementsSends statements and payment reminders with your scripts and logs patient repliesPatient balances followed up, politely
ReportingUpdates a weekly summary: claims sent, rejections, unpaid claims by payer, denials by reasonOne page each Monday

From Day Sheet to Paid Claim

  1. Close the day. The dentist’s completed procedures and codes are in the PM system; the VA reads the day sheet the next morning.
  2. Build the claims. One claim per patient and payer, with tooth numbers, surfaces and dates exactly as charted.
  3. Add what the payer needs. X-rays, perio charts, photos and the approved narrative for procedures that call for them.
  4. Check and send. Subscriber, payer ID and provider details checked; claims sent through the clearinghouse.
  5. Clear rejections. The clearinghouse report is worked the same day, and corrected claims are resent.
  6. Post the payment. ERAs and EOBs posted line by line; anything paid short or denied goes to the denial log.
  7. Bill the secondary plan. If the patient has one, the secondary claim goes out with the primary’s EOB.
  8. Bill the patient. Only what is left after both plans goes on a statement, with your wording.

CDT Codes: What the VA Needs to Know

The CDT code is published by the American Dental Association. Here is what the ADA’s own pages (its dental codes FAQ, Code Maintenance Committee and claim form pages) and CMS say, and what each point means in daily billing (checked November 2026):

ItemWhat the ADA or CMS saysWhat it means for the VA
The code setCMS: the CDT (Code on Dental Procedures and Nomenclature) is the code set for dental proceduresEvery procedure line on a dental claim carries a CDT code
Who decidesADA: “A dentist’s clinical decisions determine what services (procedures) are delivered to a patient.” and “Codes should not be chosen based on what will gain the most reimbursement.”The VA enters the dentist’s codes and asks when something looks off; never picks a code to get paid
Which versionADA: the code must come from the CDT version in effect on the date of service; updated yearlyA December visit billed in January uses the old year’s codes
When it changesADA: each version takes effect January 1 (CDT 2027: January 1 to December 31, 2027)In December the VA checks with your office manager and PM vendor that the new version is loaded
ICD codesADA: CDT and ICD codes both apply to electronic dental claims; ICD codes are used on dental claims when neededThe VA enters the ICD code the dentist recorded when a plan asks for one
Claim formatsCMS: X12 837 (version 5010) for electronic dental claims; ADA: the 2024 ADA Dental Claim Form is the current paper formElectronic through the clearinghouse; paper only for payers that still require it

Put the codes your office bills each month on a one-page sheet with each payer’s attachment and frequency rules, as your office manager confirms them. The VA works from it, adds what each EOB teaches, and brings questions instead of guesses.

Attachments and Narratives

A claim held for a missing X-ray is a claim that pays weeks late. The VA can gather and attach what a payer asks for, from systems you already use:

What the payer may ask forWhere the VA gets itCheck before sending
X-rays (radiographs)Your imaging softwareRight patient, right tooth, the date taken, readable
Periodontal chartingThe perio chart in your PM systemPocket depths present for the teeth on the claim
Intraoral photosYour imaging software or camera folderShows the tooth or area the procedure covers
NarrativeDrafted from the chart note, approved by the dentistSays only what the chart says; the dentist has approved it
Primary payer’s EOBThe posted payment in your PM systemAttached to every secondary claim

On narratives the line is firm: the VA turns the dentist’s chart note into the plain, short wording payers read, and the dentist approves every one before it goes. If the chart doesn’t say it, the narrative doesn’t either.

Secondary Insurance and Patient Balances

When a patient has two dental plans, the order matters. The VA bills the primary plan first, posts its payment, then sends the secondary claim with the primary’s EOB attached. Only what is still unpaid after the secondary plan has paid goes to the patient balance, followed by a statement. Each plan’s coordination of benefits rules decide which plan is primary; when it isn’t clear, the VA confirms with the plans before billing.

The X12 claim adjustment group codes (CO Contractual Obligation, OA Other Adjustment, PI Payor Initiated Reduction, PR Patient Responsibility, per X12’s own code page) tell the VA who owns each adjusted amount on an electronic remittance. A CO amount is written off under your contract with the plan or a regulatory requirement, not billed to the patient. A PR amount goes to the secondary plan first if there is one, and to the patient’s statement only after that.

Watch: A Skills Test, and the Path a Candidate Takes

A Real Admin Skills Test: Written Procedure and Client Email

A candidate works through an actual admin assessment: a step-by-step procedure and a professional client email. In a dental billing search the test, used where the role needs it, is built from mock claims, a mock EOB and a short narrative from mock chart notes.

Inside the Recruitment Process, From Job Post to Client Interview

A walk through the stages every candidate goes through, from the job post and screening to the skills test and the client interview. For billing roles the same stages look for steady accuracy and clear written notes.

Following Up on Unpaid Dental Claims

Unpaid claims are worked by age, the largest amounts first:

Age of the claimWhat the VA doesWatch for
0–30 daysConfirms the clearinghouse and the payer accepted the claimRejections and claims with no acknowledgment
31–60 daysChecks status in the payer portal; calls when there is no status or the payer wants more informationRequests for X-rays or narratives that nobody answered
61–90 daysPhones the plan, notes the call reference, resends the claim or the attachmentsClaims the payer says it never received
90+ daysWorks the highest amounts first and brings the office manager the full historyThe payer’s filing and appeal deadlines

Every call or portal check ends with an account note: the date, who the VA spoke with, the reference number, what the payer said and the next step. When a denial is worth fighting, the VA prepares the appeal with the plan’s form and the records, your office manager decides and signs where needed, and the plan’s own deadline goes on the tracker. Each dental plan sets its own filing and appeal limits in its provider manual and your contract, so the VA keeps them per plan rather than from memory.

Dental Software, Clearinghouses and Portals

The VA works in the systems you already have, with their own logins:

Where the VA worksFor exampleBilling work there
Dental practice management systemDentrix, Eaglesoft, Open Dental, Curve Dental, Denticon (whichever your practice runs)Day sheet, claims, ledgers, payment posting, patient statements, account notes
Imaging softwareThe software your X-rays and photos live inPulling the images a claim needs
ClearinghouseYour clearinghouse’s portalClaim submission, rejection reports, electronic attachments, ERAs
Dental plan portalsEach dental plan’s provider portal (read the portal’s terms on access from outside the US)Claim status, predeterminations, appeals, EOBs
TrackingYour PM reports, or a spreadsheet on an account your practice has cleared for patient dataUnpaid claims, denials, appeal dates, weekly summary

Share your PM software, clearinghouse and biggest plans while the role is being scoped: experience with them is something we can recruit for. The first few weeks still belong to your payers, fee schedules and rules.

Who Hires a Dental Billing VA

  • Single-location practices where the front desk does billing between patients and claims go out late.
  • Practices with an aging insurance report that nobody has had time to work.
  • Specialty practices (periodontics, endodontics, oral surgery) where claims can need more attachments and narratives. Some oral surgery and sleep-appliance procedures are billed to the patient’s medical plan; the dentist picks those codes too.
  • Multi-location groups that want one person on claims and posting across offices.
  • Practices leaving a billing company that want billing back in their own hands from the first month.
  • Dental billing companies adding hands for their clients’ claims and follow-up.

Half-Time or Full-Time Billing?

Send us your monthly claim count, the number of providers and how far behind follow-up is today, and we’ll tell you which fits before any search starts.

Get in Touch →

What Does a Dental Billing Virtual Assistant Cost?

A dental billing VA costs $7.50–$14/hr, our Finance & Accounting range. Half-time (80 hours) is $600–$1,120 a month; full-time (160 hours) is $1,200–$2,240. Your rate within the range depends on the candidate’s experience and the scope of the role. That hourly rate already includes the search, the VA’s pay and the account management we provide after the hire; the pricing page shows the breakdown.

$7.50 – $14/hr
Dental billing VA — Finance & Accounting
No upfront fees. No setup fees. It costs nothing to start.

How that compares:

OptionPriceBasis
US billing and posting clerk (employee)median about $23.32/hr; 160 hours cost about $3,731 in wages before benefits, employer taxes and a deskMedian wage from the US Bureau of Labor Statistics (Occupational Outlook Handbook, Financial Clerks, May 2025), converted to an hourly figure at 2,080 hours a year; checked November 2026
Dental billing companyPer claim, per provider, a share of collections or hourly; it varies by companyAsk how the fee is calculated, what it includes, and how you get your data back if you leave
Dental billing VA through VA MASTERS, half-time$600–$1,120 a month for 80 hours ($7.50–$14/hr)Dental billing sits in our Finance & Accounting band; it costs nothing to start
Dental billing VA through VA MASTERS, full-time$1,200–$2,240 a month for 160 hours ($7.50–$14/hr)Same Finance & Accounting range

Paying a US billing and posting clerk the median of about $23.32/hr for 160 hours costs about $3,731 in wages alone. Add benefits, employer taxes and a desk, and a dental billing VA saves up to 80%. In fairness to the other option: a dental billing company suits a practice that wants someone else to run the whole process and answer for the results; a VA fits when billing should stay in your office and your own software. If 80 hours is more than your claim volume needs, roles of about 40 hours a month are possible too (see the pricing page).

Where Software Stops and the VA Starts

Clearinghouse edits catch missing fields, electronic attachment tools send images, and AI tools can read EOBs and suggest narrative wording. They don’t phone a dental plan that has had an X-ray for six weeks, notice that one plan keeps reducing the same procedure, or know which patient asked to be called rather than sent a statement. Let the software check and send; let the VA own the follow-up, the exceptions and the notes; keep the codes and the decisions with the dentist and the office manager.

How to Hire a Dental Billing VA

Step 1: Count the Work

Pull a month of claims and today’s aging report: claims per day, plans you bill most, claims held for attachments, insurance AR over 60 days, secondary claims waiting. From those numbers you can see if the role is half-time or full-time, and where the VA should start.

Step 2: Write Your Billing Rules

The split table above, your code and attachment sheet, one page per large plan (portal, phone line, appeal form, limits) and your patient statement wording. A VA with written rules asks fewer questions in week one.

Step 3: Scope the Role With Us

On the call we talk through the role, the hours and your tools; once the role is agreed, we start the search: custom-built for your role, powered by our database of 400,000+ pre-assessed applicants.

Our 6-stage process is selective: about 1 in 508 applicants is placed (166,350 applications, January 2025 to July 2026; see the statistics report). We can recruit for US dental billing or dental insurance experience, your PM software and clearinghouse, and Spanish if your patients need it. We search for these where you ask, without promising each one in every search; the work is billing administration.

Detailed Job Posting

Our job post is built around your practice: general or specialty dentistry, your PM and imaging software, your clearinghouse, claim volume and office hours.

Candidate Collection

Every search is custom-built for the role, powered by our database of 400,000+ pre-assessed Filipino applicants; for this role we look for US dental billing or insurance work.

Initial Screening

Applicants pass AI-assisted screening first; recruiters then review those who pass it for written English, dental claim and EOB experience, care with numbers and a reliable internet setup.

Custom Skills Test

Where your search needs a test, candidates build mock claims from a mock day sheet, read a mock EOB and draft a narrative from mock chart notes.

In-Depth Interview

Recruiters ask how a candidate handles a code that doesn’t match the chart, a secondary claim, and a payer that asks for X-rays twice.

Client Interview

We present candidates, with first candidates in about 2 business days once the role is agreed. You interview them and pick who handles your claims.

You can see the gap in the data, but in practice the real filtering is human. People read the test results, recognize who actually understands the task at depth rather than just answering correctly, and decide who moves forward.— Alon Pearl, Founder & CEO, VA MASTERS (Why Candidates Don’t Get Hired report, September 2026)

Step 4: Interview With Mock Claims (No Real Patient Data)

Hand every candidate a mock day sheet and a mock EOB (no real patient data) and have them explain their reading: which claims need attachments, what the EOB says about the patient’s share, what goes to a secondary plan, and the note they would leave on the account. The choice of who handles your claims is yours.

Step 5: Set Up Logins, Rules and a Tracker

Before day one, create the VA’s own PM, imaging, clearinghouse and portal accounts and hand over the rules and the tracker. Review their work line by line for the first two weeks; the four-week plan below sets the pace.

Dental billing VA job description template

  • Role: Dental Billing VA (remote billing administration), 80 or 160 hours a month
  • Hours: we recruit for your hours: your office’s schedule and time zone
  • Practice: your type of dentistry, number of providers and locations, the dental plans you see most, monthly claim volume
  • Duties: claims from the day sheet with the dentist’s codes, claim checks, attachments, narrative drafts for approval, clearinghouse submission and rejections, predeterminations, ERA and EOB posting, secondary claims, unpaid-claim follow-up, denials and appeal packets for sign-off, patient statements, weekly summary
  • Not in scope: choosing or changing procedure codes, adding clinical content to narratives, write-offs or adjustments without approval
  • Systems: your PM software (e.g. Dentrix or Open Dental), imaging software, clearinghouse, dental plan portals
  • Must-haves: US dental billing or dental insurance experience, reads EOBs and ERAs, knows tooth numbering and CDT code structure, clear written English, notes every action in the account
  • Measured by: days from visit to claim, rejections, insurance AR over 60 days, secondary claims sent the day the primary pays

Skills-Test Ideas for Dental Billing Candidates

  • From a mock day sheet, build three claims and say which need an attachment and which one.
  • Read a mock EOB (no real patient data): what did the plan pay, what is the patient’s share, and is there a secondary claim to send?
  • Turn a mock chart note into a three-sentence narrative for the dentist to approve, adding nothing that isn’t in the note.
  • From a mock aging report, choose the first ten claims to work and explain the order.

The First Four Weeks

WeekFocusDone when
Week 1Access and shadowingThe VA has their own PM, imaging, clearinghouse and portal logins with role-based permissions; builds the day’s claims and your office manager checks each one before it goes
Week 2Claims and postingThe VA sends the day’s claims and posts ERAs; you check a sample; the rejection report is cleared daily
Week 3Follow-upUnpaid claims over 30 days worked by amount, every call logged with a reference number, secondary claims sent the day the primary pays
Week 4Denials and reportingAppeals prepared for sign-off, patient statements on schedule, the first weekly summary sent; checks move from every claim to a sample

Six Numbers to Watch

Take a baseline in the first month, then look at these once a week:

NumberWhat it tells youWhat to do with it
Days from visit to claim sentWhether claims leave the office promptlyAim for the next business day
Rejections per weekData problems at the front desk or in the PM setupFix the cause: a missing subscriber ID, a wrong payer ID
Claims held for attachments or narrativesWhether the payer gets what it needs the first timeAdd the requirement to the VA’s payer checklist
Insurance AR over 60 daysHow much insurance money is getting oldThe VA works it first, largest amounts first
Denials by payer and reasonWhich plans deny whatFix it upstream: verification, frequency limits, documentation
Days from primary payment to secondary claimWhether secondary plans are billed promptlyAim for the same day the primary pays

Logins and Patient Data

  • If your practice is a HIPAA covered entity, ask your counsel which agreements and safeguards you need before anyone outside your practice works in patient records.
  • Set up a separate user for the VA in the PM and imaging software, with permissions set by role, plus their own clearinghouse and plan portal accounts. The office manager’s login stays the office manager’s.
  • Read each plan portal’s terms, and your payer contracts, for any limits on access from outside the US before requesting accounts.
  • Keep patient data inside the PM system, the portals and the tools your practice has approved; none of it in personal email, SMS or messaging apps.
  • Use two-factor authentication on every account, and write the offboarding list (PM, imaging, clearinghouse, portals, shared folders) on the first day.
  • Our security page sets out how VA MASTERS, clients and VAs keep information confidential.

Five Dental Billing Mistakes

Mistake #1: Asking the VA to Pick Codes

Codes come from the dentist’s clinical decisions. A VA who “fixes” codes to get a claim paid creates a risk you don’t want. The VA flags; the dentist decides.

Mistake #2: Sending Claims Without the Attachments

A claim that goes out without the X-ray the plan requires can come back as a request, weeks later. Keep each plan’s attachment rules on the VA’s sheet.

Mistake #3: Billing the Patient Before the Secondary Plan

A patient billed for an amount their second plan would have paid can end up calling the front desk, and a refund can follow. The secondary claim goes first.

Mistake #4: Letting the Aging Report Grow Quietly

Claims nobody checks for 90 days can run into filing and appeal limits. Work the old, large claims every week.

Mistake #5: Sharing One Login

A shared login hides who changed what and makes offboarding hard. Every person gets their own account.

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See every healthcare role we recruit for on the healthcare virtual assistant services page.

Frequently Asked Questions

What does a dental billing virtual assistant do?

A dental billing virtual assistant handles your insurance paperwork remotely: builds claims from the day sheet with the codes the dentist charted, attaches X-rays and perio charts, drafts narratives for the dentist to approve, sends claims through the clearinghouse, posts payments, bills secondary plans, follows up on unpaid claims, prepares appeals and sends patient statements. The VA never chooses or changes procedure codes and makes no clinical decisions.

How much does a dental billing virtual assistant cost?

A dental billing virtual assistant costs $7.50–$14/hr through VA MASTERS. Half-time (80 hours) comes to about $600–$1,120 a month; full-time (160 hours) to about $1,200–$2,240. It costs nothing to start. For comparison, the US median wage for billing and posting clerks works out to about $23.32/hr (US Bureau of Labor Statistics, May 2025), before benefits and overhead.

Can a virtual assistant do dental billing and CDT coding?

A VA can do the billing and enter CDT codes, but the codes come from the dentist. The ADA says a dentist’s clinical decisions determine the procedures delivered and that codes should not be chosen based on what will gain the most reimbursement. The VA enters the codes the dentist charted, uses the CDT version in effect on the date of service, and flags anything that doesn’t match the chart note; the VA never chooses or changes procedure codes.

What is the difference between dental billing and medical billing?

Dental claims use CDT procedure codes and the ADA claim format (or the X12 837 for dental electronically), and dental plans can ask for X-rays, perio charts and narratives. Medical claims use CPT codes on medical claim formats. Medicare.gov says that in most cases Medicare doesn’t cover dental services like routine cleanings or fillings. For medical claims, see the medical billing virtual assistant page.

Can a dental billing VA send claim attachments and narratives?

Yes. The VA pulls the X-rays, periodontal charting or photos a payer asks for from your imaging and PM systems and attaches them through the clearinghouse or portal. Narratives are drafted from what the chart already says and go out only after the dentist approves them.

How does a dental billing VA handle secondary insurance?

Once the primary plan pays, the VA posts the payment, sends the secondary claim with the primary’s EOB attached, and waits for the secondary payment before moving any remaining amount to the patient balance and sending a statement. Each plan’s coordination of benefits rules decide which plan is primary; the VA confirms that with the plans.

How quickly can I hire a dental billing virtual assistant?

First candidates typically arrive in about 2 business days once your role is agreed; you interview them and choose. About 1 in 508 applicants is placed (166,350 applications, January 2025 to July 2026). The VA needs roughly four weeks to get to know your plans, your software and your rules (the first-month plan on this page shows the steps).

Are there any upfront fees?

No. There are no upfront fees, no setup fees and no recruitment fees: it costs nothing to start. You sign the agreement and we run the search at no cost. If you’re not satisfied with your VA, you get a replacement, free of charge.

Hire a Dental Billing VA, From $7.50/hr

Claims that can go out the next business day with the right attachments, secondary plans billed before the patient, unpaid insurance followed up by date, and the codes and approvals kept with the dentist. VA MASTERS recruits and supports the dental billing VA who does the paperwork.

  • It costs nothing to start: no upfront fees, no setup fees
  • First candidates in about 2 business days once the role is agreed
  • A skills test with mock claims where the role needs it
  • If you’re not satisfied with your VA, you get a free replacement, and your account manager stays with you after the hire
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