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Name
City
State
Zip
Phone
Email
How many patients do you see each day?
How many claims do you file per month?
What is the average dollar amount per claim?
What is your claim rejection percentage?
What percentage of your practice is Medicare/Medicaid?
What percentage of your practice is private insurance?
What percentage of your practice is cash?
Do you currently outsource your billing?
Yes
No
How much do you pay to outsource billing each month?
If you don’t outsource billing, how many employees handle billing?
How much do you pay your billing staff each month?
How much do you pay in employee benefits each month?