I am interested in learning more about your services!
Please fill out this form as accurately as possible so that we can thoroughly assess the needs of your business.
Email address *
Name *
Practice Name *
Address (please include city and state) *
Phone *
Fax *
Email *
Additional Locations *
If Yes, or if additional locations are a possibility, where are they located? *
Specialties *
Are you a Group or Solo Practice? *
How many billable providers? *
Please provide name (and NPI, if known) for each billable provider: *
How many clients do you currently serve? *
Are you In-Network with insurance carriers? *
If yes, which companies are you currently contracted with?
What services are you interested in? *
Is your billing currently done in-house or outsourced? *
If your billing is done in-house, how many billing employees do you have?
What is your billers' average hourly salary?
How many hours per week are spent processing claims?
How many claims on average per month do you currently process?
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