How did you find us?

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Name (*)

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Practice/Clinic Name

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Your Position

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Address

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City

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Zip Code

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Daytime Phone

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Fax

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Email Address (*)

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Best Time to Call

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Medical Speciality

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Average Gross Monthly Charges

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Average Payments/Month

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Currently doing billing in-house?   

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How many days/weeks do you process claims?

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If doing in-house, how many full time dedicated billers?

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Primary reason for making a change

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What is your timeframe to make changes?