Enriquez Computer Service

Welcome to ECS, your complete medical billing service

Is your office computerized?

Yes No

 

If so, what is the name of the program you are currently using?

 

What is the patient volume (approximate number of patients in your system if computerized or how many total in the practice)?

 

What was your practice dollar volume for the last full calendar year?

 

How much does your practice bill per month?

 

How many patients do you see per week?

 

What type of business or specialty is your practice?

 

What percentage of your claims are Medicare?

 

What percentage of your claims are HMO's, PPO's and POS?

 HMO's

 PPO's

 POS's

 

How many insurance carriers are you participating with?

 

Does your office have an out-source billing service? If so, which one and why did you choose it?

 

Does your office currently file claims electronically?

Yes  No

 

If Yes, does your office file only Medicare claims electronically or do you send electronic claims to all carriers who will accept them?

 

How long does it usually take before you receive payment from insurers?

 

Would your business benefit if you received payments faster and had fewer rejected claims?

Yes  No

 

Do you have an employee assigned to follow up on rejected claims?

Yes  No

 

Would your office run more efficiently if you had someone to concentrate on billing, leaving your staff free to take care of your patients?

Yes  No

 

Name of Practice:

 

Home many doctors work for the practice?

 

Practice Address:

 

Practice Telephone Number:

 

Practice Email: