Proclaims Medical Billing

Type of Practice Multi-Disciplinary Geriatric Pediatric Internal Medicine Anesthesia APN Community Health Center Cardiology Surgery Pulmonology Podiatry OB/GYN Orthpaedics Nephrology DME Opthalmology Nephrology Dermatology Neonatology Ottolaryngology Other *

Number of Providers 1 2 3-5 6-8 9-15 16-24 24-39 40-99 100+

Practice Management Software

EMR Software Make/Version

Meeting Stage 1 Meaningful Use? Yes No *

AR Balance under 60 Days

AR Balance over 60 Days

Accept Medicaid?

Number of Locations

10% or More Visits Capitation? Yes No

Current Billing Arrangement Office Staff Person Internal Billing Department External Billing Department Outside Billing Company

Need Credentialing Support? Yes No

Contact Person Name

Phone Number

Email

Additional Comments (300 chars left)