Medical Billing - Cost Analysis

Empire Medical Billing Solutions, Inc.
214-55 Jamaica Avenue
Queens Village, NY 11428

The information you provide will calculate an estimation per month to show cost comparison between utilizing our billing service verses in-house billing. The savings in time and money are substantial!

Practice Name:		Provider Name:
Office Address:		Email Address:
Phone:		Fax:
Average number of claims you file a month?		Your cost to file a claim:
What percentage of claims are rejected?		Number of claims processed per hour?
In-office billing wages?
Average cost for taxes, ins., perks a 401K's etc:
Total billing per month?		Total collections per month?
Average number of patient statements per month?
Total hours to prepare?		Cost per statement?
Average long distance calls per month?		Postage, forms, paper, etc. per month?
Miscellaneous expenses?		Software investment or upgrades?
Direct Modules?		Staff training?
Clearinghouse fees per month?		Provider fees?
Per claim fees?
City		State
Zip code

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