• Free Practice Analysis

    Before you schedule a demo please tell us about your practice so we can show you appropriate pricing and have a C & C Medical Administration consultant contact you to build a customized solution. This form takes less than 10 minutes.
  • IF OUTSOURCE billing:

  • IF IN HOUSE billing:

  • What is your approximate patient payor base distribution? (all should add up to 100%)

  • Commercial *%     
    Medicare * %
    Medicaid * %
    Self Pay * %
    Worker's comp/PI (if any) * %

  • Patient Eligibility
  • Let’s finish up! Who do we have the pleasure of working with on this Practice Analysis request?

  • Should be Empty:
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