First Name *
Last Name *
Business Email: *
Job Function * -- Please Select -- Administrative/Human Resources Administrator Billing/Coding Board Member/Director/Trustee Cardiology Care Management/Population Health Claims & Denials Consulting Dentistry EDI EHR Implementation/Management Engineering/Technical Staff Enrollment Executive Finance/Accounting General Management Information Systems/Technology Laboratory Legal/Regulatory/Compliance Medical Auditing Medical Practice Management Member Engagement Nurse/Nursing Executive Office Manager Operations Patient Access Patient Financial Services Pharmacy Physician Physician Practice Management Procurement/Purchasing/Supply Project Management Radiology Revenue Cycle Management Sales/Business Development/Marketing Training/Education Vendor Relationships Other
Job Level * -- Please Select -- Analyst/Administrator Chief Compliance Officer Chief Executive Officer Chief Financial Officer Chief Information Officer Chief Medical Information Officer Chief Medical Officer Chief Operating Officer Chief Quality Officer Chief Technology Officer C-Level Department Chair Director Doctor Individual Contributor Manager President Senior Vice President Vice President Other
Solution of Interest * -- Please Select -- Clinical Network Clinical Review Consulting Consumer Payments & Communications Data & Analytics Decision Support/InterQual Dental EDI Network Eligibility & Enrollment Extended Care Workflow and Productivity Imaging Medical EDI Network Medical Network MedRx Network Member Engagement Patient Access & Eligibility Patient Experience Payment Accuracy Payment Management Pharmacy Benefits & Third Party Administration Pharmacy Solutions Provider Network Optimization Provider Payments Quality Analytics Revenue Improvement Risk Adjustment Analytics Transparency & Provider Search Value-Based Care Enablement Value-Based Payments
Solution Type -- Please Select -- Services Technology Unsure
Claims Volume
Company *
Company Type * -- Please Select -- Billing Service Dental Emergency Medical Service Government Agency Healthcare Information Exchange Home Health Agency Hospital Employed Practice Hospital/Health System Imaging Center Independent Practice Affiliated with Hospital Independent Practice Not Affiliated with Hospital Laboratory Partner/Reseller Payer Software Vendor Trust Other
Bed Size -- Please Select -- 1-199 200+
Practice Specialty -- Please Select -- Anesthesia Cardiology Emergency Medicine Pathology Radiology Other
Number of Covered Lives
Practice Management Software Vendor
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