Professional Practice Solutions, Inc. will provide anyone a quote if they please complete this form.


 Insurance Companies that you utilize 

# Patients/Day: 

# of BlueCross/Blue Shield claims processed weekly:

# of Medicare claims processed weekly:

# of Medicaid claims processed weekly:

# of other claims processed weekly:

Which insurance companies do you have the most problems with?

                         

Which insurance companies is your practice participating with?

% of Rejected claims/month:

% of claims paid within 30days:

Average timeline to receive payment on submitted claims:

# of Patient statements sent per month:

Will patient statements be prepared by PPSI:  (please select)

 % of patients with secondary insurance:

Do you submit secondary insurance for patient? (please select)  

Do you generally have to resubmit claims? (please select)   

Do you have an outstanding accounts receivable? (please select)

If so, approximate balance:  

Do you have more than one office location? (please circle) 

Is your office computerized? (please circle) 

If so, what system and software are you currently using?  

 

 

 

 

 




 

Professional Practice Solutions, Inc. 4 Triangle Ln Ste 160 - Export, PA 15632