Lori W. Allen
Founder, President
Phone: 412-765-2067
 
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Practice Needs Survey

 
  Name
:
       
  Practice Name
:
       
  Address
:
       
  City
:
       
  State
:
Zip :  
  Phone
:
Fax :  
  Email
:
       
  Best time to reach
:
       
What is your average number of patient visits per week? :  
  What is your goal?
:
       
What is your average number of new patients per month? :  
  What is your goal?
:
       
Do you have systems in place for the following:      
  Missed appointments   Yes No        
  Reminder calls?   Yes No        
  Reactivation?   Yes No        
Are you Scheduling? Yes No        
Do you schedule manually? Yes No        
Do you have a written policy and procedural office manual?   Yes No  
Do you have regular staff meetings?   Yes No  
         
  Patient visits?   Yes No        
  Patient visit average?   Yes No        
  Services?   Yes No        
  Collections?   Yes No        
  New patients?   Yes No        
               
Do you conduct healthcare wellness workshops for your patients and their families? Yes No  
Do you have patient education and retention programs? Yes No  
Do you feel that your office is systemized and running efficiently? Yes No  
Are you currently working with or have you worked with a consultant in the past? Yes No  
Is your staff as knowledgeable as they should be regarding insurance regulations? Yes No  
Does your current billing software provide you with all you need and want? Yes No  
Are you experiencing claim denials and you don’t know why? Yes No  
Do your end of the month reports reflect growth? Yes No  
Are you aware of the most commonly made mistakes pertaining to coding? Yes No  
Are you ready to take your practice to the next level? Yes No  
       
Please list the areas of your practice where you would like advice or assistance:    
 
 
               
  Submit to PPS for your free 30 minute initial consultation.  
   
 
 
 
 
 
 
 
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