AdeoHS Enhancement Request Form
In case of an emergency, please contact us at (214) 302-7380 or enhancement.request@adeohs.com 
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Requestor Name  *
Date Submitted *
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Enhancement Request Name/Title *
Example: "Add a 'Print Receipt' button to Insure."
Enhancement Description *
Please describe your request and include as much detail as possible. 
Example: "It would be helpful to have a Print Receipt button in the Patient Responsibility section of Insure. I'd like the receipt to include all of the patient's demographic info, the procedure info (along with the CPT and ICD_10 codes), all of the insurance benefit info, and the amount paid by the patient and by insurance and any adjustments."
What Problem Will This Enhancement Solve? 
Please include benefits of the request and impacts if this request is not approved.
 *
Please help us (and your management) understand why you're asking for this. 
Example: "Having a printable receipt will help the patient understand and remember their responsibilities. It also lets us clearly convey that the receipt is an estimate, not a bill. It's also a very common patient request; they ask for printable receipts a lot. Having a printable receipt will save us a lot of time – we currently have to manually make one any time a guest requests one."
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