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Physician's Name
Address:
City:
State: Zip Code:
Phone #
Do you experience rejected claims?
What percentage of all claims are rejected (Medicare, Medicaid, Commercial)
How does your office process claims?
If electronic; Are you processing:  
Medicare
Commercial Carriers
What percentage of claims are Medicare?
If you are processing claims manually:  
Do you use a computer to generate forms?
Do you fill in claims manually?
Do you use an outside service to process claims?
Are you satisfied with this service?
Do you find filing insurance claims time consuming?
Would you like to reduce the turn around time on insurance payments?
Would you consider an outside service for processing claims electronically?
Is your software compliant to HIPAA standards?
Would you be interested in software for your practice?