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* 1. Please Provide your Name

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* 2. Please Provide Your Location Name

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* 3. How familiar are you with ABS 2 features to support skilled billing?

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* 4. How many of your customers are you billing using UB04 bills? (This is a billing format specified by CMS and is also known as the CMS 1450. It is often used by the Veterans Administration)

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* 5. How many of your customers are you billing using CMS1500 format bills? (This is a format specified by Center for Medicare and Medicaid Services and is also known as the HCFA 1500)

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* 6. Would you be interested in participating in a sandbox pilot of ABS 2 integrated UB04 and CMS1500 features that are targetted for the next ABS 2 release?

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* 7. Do any of your customers require a CMS 485 Home Health Certification form?

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* 8. Do you currently use software besides ABS to submit these types of claims?

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* 9. If you answered yes to the above, please provide the vendor and software package name....

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* 10. Do you currently use a claims management company or clearing house to help you manage these types of claims?

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* 11. If you answered yes above, which company do you use to provide this service?

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* 12. Do you have any additional comments you would like to share on the topic of Medical Billing?

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