Revenue Cycle Management Assessment
Help us understand your practice so we can recommend the right RCM services and pricing
Practice Information
Practice Name
*
Specialty
*
Select specialty...
Family Medicine
Internal Medicine
Pediatrics
Cardiology
Orthopedics
Dermatology
Gastroenterology
Neurology
Psychiatry
Urgent Care
Pain Management
Other
Provider Count
*
Select...
1 Provider
2-3 Providers
4-6 Providers
7-10 Providers
11+ Providers
Monthly Patient Volume
*
Select...
Under 500 patients
500-1,000 patients
1,000-2,000 patients
2,000-5,000 patients
5,000+ patients
Annual Revenue
*
Select...
Under $500K
$500K - $1M
$1M - $2M
$2M - $5M
$5M+
Current Billing & Pain Points
Current Billing Setup
*
Select...
In-house billing staff
Outsourced to another company
Hybrid (some in-house, some outsourced)
Physician/owner handles it
No organized system
Current Collection Rate
*
Select...
90%+ (excellent)
80-89% (good)
70-79% (fair)
60-69% (poor)
Under 60% (critical)
Don't know
Average Days in A/R
*
Select...
Under 30 days
30-45 days
45-60 days
60-90 days
90+ days
Don't know
Biggest Billing Challenges
*
High denial rates
Slow collections
Billing staff turnover
Complex coding issues
Too time consuming
No visibility into process
Technology & Systems
EHR/PM System
*
Select...
AdvancedMD
athenahealth
eClinicalWorks
DrChrono
Kareo / Tebra
NextGen
Epic
Cerner
Office Ally
SimplePractice
TherapyNotes
CollaborateMD
Paper-based
Custom system
Please specify your custom EHR/PM system
*
Services & Timeline
Services Needed
*
Claims preparation & review
Insurance verification
Medical coding
Claims management
Denial management
Patient collections
Analytics & reporting
Complete RCM takeover
Urgency
*
Select...
Immediate (within 2 weeks)
Soon (within 30 days)
Planning (within 90 days)
Just exploring options
Budget Range
*
Select...
Under $2,000/month
$2,000-$5,000/month
$5,000-$10,000/month
$10,000+/month
Percentage of collections
Need to discuss
Contact Information
Your Name
*
Your Role
*
Select...
Physician/Owner
Practice Manager
Office Manager
Billing Manager
Administrator
Other
Email
*
Phone
*
Best Time to Contact
*
Select...
Morning (8am-12pm)
Afternoon (12pm-5pm)
Evening (5pm-7pm)
Anytime
Priority Assessment
What would success look like for your practice?
*
Any specific concerns or requirements?
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