The Payer Info Pool -powered by- UpDoc
This is a 100% ANONYMOUS, public contribution. No user data is shared, ever. The purpose of this form is to help create an open source data pool for clinical entities to be able to better understand & navigate the healthcare marketplace of payers.
Welcome to the Payer Info Pool Survey!
UPDATED CONSIDERATIONS: For this edition of the Payer Info Pool, we are encouraging contributors to submit for this survey data for a Primary Professions and Clinical Setting.
IF YOU OPERATE IN MULTIPLE PROFESSIONS AND/OR SETTINGS: Please consider contributing separate data sets for each profession and setting you represent. THANK YOU!
Created by Ben Fung, DPT, MBA, COO/CoFounder
Please identify the PRIMARY Profession you wish to add to the info pool.
Primary Care | Physician, Nurse Practitioner, CMS Provider
Complimentary and Alternative Medicine
Please select the PRIMARY clinical setting.
SNF / LTAC
Acute Rehab / Neuro Rehab / Inpatient Rehab
Outpatient Surgery and Procedures
Inpatient Surgery and Procedures
Please describe your market mix.
Please check ALL APPLICABLE boxes below to help identify the context of your info pool data point.
Out of Network
Direct Pay / Prompt Pay / Cash
IF MORE DETAIL IS REQUIRED: Please expand on your operations, offerings, clientele, etc.
As a whole, the business entity is:
Outpatient: Less than 20 Locations
Outpatient: Greater than or equal to 20 Locations
Hospital/Health System Based Practice
Work Sharing or Micro Practice
Staffing, Subcontracting, Registry, or Clinician Dispatch
Inpatient: Less than 20 Locations
Inpatient: Greater than or equal to 20 Locations
Which state is this company/entity located?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service