Welcome

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Practice Name
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Contact Name
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Email
example@example.com
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Primary State of Operation
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What type of support are you looking for right now?* This field is required.
One-time setup or readiness support
Ongoing monthly operational or billing support
Not sure / need guidance
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Will insurance billing be part of your practice?* This field is required.
Yes, currently billing insurance
Yes, planning to accept insurance
No, self-pay only
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Are all providers currently credentialed with the payers you plan to accept?* This field is required.
Yes, fully credentialed
Some providers need credentialing
No, credentialing is needed
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Are you looking for ongoing monthly support after setup?* This field is required.
YESNO
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Practice Type
Solo Practitioner
Group Practice (2–5 providers)
Group Practice (6+ providers)
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Do you currently accept insurance?
Yes
No
Planning to
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Which Practice Operation function(s) are you interested in?* This field is required.Select all that apply
Practice Systems & Workflow Setup
Credentialing & Payer Setup
Revenue Cycle Operations
Performance & Operational Visibility
Compliance & Documentation Controls
Ongoing Practice Operations Support
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Which Practice Management System (PMS) do you use?
SimplePractice
TherapyNotes
Jane
TheraNest
Other
Not set up yet
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How many providers will use the system?This includes any clinician or practitioner who will log in to the practice system to schedule appointments, document sessions, or submit services for billing.
1 provider
2 providers
3 providers
4 providers
5+ providers
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Is this a new setup or a system cleanup?
New setup
Cleanup / reconfiguration
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Do you offer TeleHealth Services?
YESNO
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Providers Needing Credentialing
YESNO
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How many providers need credentialing?
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How many insurance payers per provider (estimate)?This is an estimate of how many insurance companies each provider will be credentialed with.
1–2 Payers
3–5 Payers
6–8 Payers
9+ Payers
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What credentialing support is needed?Select any additional credentialing services that apply to your practice.
CAQH setup / maintenance
Medicare
Medicaid
Multi-state credentialing
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Is this new enrollment or re-credentialing?
New enrollment
Re-credentialing
Both
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Do you currently submit insurance claims?
Yes
No
Starting Soon
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What is your approximate monthly claim volume?
Under 50
50–150
150–300
300+
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How many providers generate claims?
1 provider
2–3 providers
4–6 providers
7–10 providers
11+ providers
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How is billing currently handled?
In-house
Outsourced
Mixed
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How many providers should be included in reporting?
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What is your reporting preference?
Monthly
Quarterly
As needed
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Practice size
Solo
2–5 staff
6+ staff
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Do you accept Medicare or Medicaid?
YESNO
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Level of ongoing support desired
Light support (periodic check-ins)
Active support (regular involvement)
No Support Needed
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Preferred support cadence
Monthly
Bi-weekly
As needed
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Estimated One Time InvestmentThis does not include Credentialing
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Estimated Credentialing Costs
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Estimated Monthly Costs
Should be Empty: