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A Time Efficient Screening Tool for the purpose of gathering the most important pertinent information about your Practice to determine if we can assist you in increasing your Monthly Collections!
Email
(Required)
Average # of Patient Visits Per Month?
(Required)
Average Monthly Gross Charges
(Required)
Average Monthly Collections
(Required)
Of your Average Payer Mix what % is Blue Cross?
(Required)
Please enter a number less than or equal to
100
.
Of your Average Payer Mix what % is Medicare (Regular Fee For Service Type)?
(Required)
Please enter a number less than or equal to
100
.
Of your Average Payer Mix what % is Attorney?
(Required)
Please enter a number less than or equal to
100
.
Number of Clinics
(Required)
Number of Licensed Providers
(Required)
Total Number of States (in which your practice operates)
(Required)
Primary State in which your Practice operates?
(Required)
