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First Name
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Last Name
*
Email Adress
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Phone
*
Provider Name
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Provider Address
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Please check the specific billing service model you are most interested in:
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Full-Service Billing (% of collected revenue model)
Partial Services (Select from the list below)
Please select one or more services below
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Claims Appeals Management
Coding- Review/Audit
Charge Entry
Patient Collections Assistance
Practice Management
Claims Submission
Responsive Customer Service
Patient Statements
Accounts Receivable Follow-up
Value-based Care (MIPS) Assistance
Denial Management
Patient Inquiry
Credentialing
Software Flexibility
Advanced Analytics
Payment Posting
U.S. based Account Management
HIPAA Compliance Assistance
Others - please explain below
Others - Explanation
What EHR/PM software solution are you using?
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What Billing Software are you using?
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What areas do you need help within your billing Department?
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Questions
What areas do you need help within your billing Department? *Please explain
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Why are you considering a change or addition to your current RCM/billing solution? *Please explain
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Why are you considering a change or addition to your current RCM/billing solution? *Please explain
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What is your biggest concern with your current process? *Please explain
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Do you currently bill in house? *If Yes: Please explain your current staffing level and areas of concern.
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