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FREE Needs Analysis

We are happy to provide you with a FREE initial analysis of your medical practice billing needs.

Please fill out the form as completely as possible, click submit and a Billing Specialist will respond within 24 hours. Your information will be kept confidential and will not be shared with a third party.

First Name:  
Last Name:  
Title/Specialty:  
Organization:  
Street Address:  
Address (cont.):  
City:  
State, Zip/Postal Code:  
Country:  
Work Phone:  
Fax:  
E-mail:  
URL:  
What type of services are you looking for?
How many providers are in your office?
What percentage of claims are Medicare?
What percentage of claims are Blue Cross/Blue Shield?
How would you like us to contact you?
Phone    E-mail    Fax    Mail   
Contact Name:
Best time to contact you?:
How are you filing claims now?
How many claims are you filing per month?
What is your average receivables per visit?
Additional Comments:

   

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