HealthCare Synergy | Managed Services

Managed Services Inquiry Form

HealthCare Synergy

Managed Services Inquiry Form

View Printable PDF


Contact Information

First and Last Name



Owner (First and Last Name)

Administrator (First and Last Name)

Clinical Director (First and Last Name)

Biller (First and Last Name)

Agency Information

Agency Name

Agency Address

City, State, Zip

Office Phone

Services Provided Home HealthHospiceManaged CareOutpatient/Part B Billing

Monthly Patient Census:

Current Number of Claims in ADR:

Month and Year of Last Medicare Survey:

Please choose the Managed Services you are most interested in below:

Coding OnlyCoding and OASISAnalytics - Clinical/FinancialChart ReviewADR ReviewPre-Claim ReviewPPS BillingRevenue RecoveryBookkeeping and/or Accounting

Additional Information

Thank you for your interest! A HealthCare Synergy representative will get back to you within the next 24 hours.