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Healthcare Billing Services


	With Healthcare Billing Services, our service is your solution. Allow us to show you in black and white how we can save you money while increasing your profitability.
Healthcare Billing Services, Inc.

Healthcare Billing Services has a wide range of experience for specialties such as Anesthesiology, Cardiac/Thoracic Surgery, General Surgery, Neurology, Orthopedic Surgery, Pulmonology and more.

Practice/Physician Name
Primary Office Contact
Position
Business Address
Address2
City,
State		Zip
Phone			Ext
Fax
E-Mail Address
Do you currently process billing “In-House”	Yes No
How many employees do you employ to do billing?
What is the name of your current Medical software?
Do you submit claims electronically?	Yes No
Approx. how many Patient Statements do you send out each month?
**What are your average Monthly Charges?
**What are your average Monthly Collections?
What is your current outstanding Accounts Receivable?
**This information will allow us to give you a more accurate Quote, but is not necessary to obtain an estimated Quote.
Average number of Patients
Daily
Weekly
Monthly
Average number of NEW Patients seen weekly?
monthly?
Do you have balances that are over 60 days, and have not been followed up on?	Yes No
What percentage of you’re A/R would you say is over 90 days?
What is the worst problem that you experience in your practice with regards to billing?
Is there something specific that your practice does with billing that you are pleased with, and would not want to change?


	Healthcare Billing Services, Inc. 4419 Hwy 58, Suite 4 Chattanooga, TN 37416 Toll Free - (866)893-1985	All content © 2007 Healthcare Billing Services, Inc