HealthCare Synergy | Software and Services

Product Evaluation Form

Your Contact Information

First and Last Name


Email Address

Would you like to be included in our mailing list?YesNo

How did you hear about HealthCare Synergy?WebsiteMailer/BrochureEmailPrint/AdvertisementWorkshop/Trade ShowReferralOther

Agency Information

Agency Name

Agency Address

City, State, Zip

Office Phone

Is the agency Medicare Certified?YesNo

Current Patient Census:

Number of software users needed?

Back Office


Products and Services you would like to evaluate/more interest on:

SoftwareSynergy EMRSynergy in the Cloud

Managed ServicesCoding OnlyCoding and OASISAnalytics - Clinical/FinancialChart ReviewADR ReviewTargeted Probe & EducatePPS BillingRevenue RecoveryBookkeeping and/or Accounting

Cost Reporting
Simeone ConsultingManis & Ryan

CAHPS for Home Health or Hospice

Home Health GoldStrategic Healthcare Partners

Other Tools
OASIS Coding AuditsMedicare Eligibility ChecksAbility

Additional Information: