Payer Re-Engagement Process This short questionnaire is designed to gather the information necessary to assess the steps needed for your practice to re-engage with the payer system. Question Title * 1. How many billing-eligible providers (MD, DO, CNP, PA, RD) work in the practice? Question Title * 2. Does the practice have a health coach? Question Title * 3. What is the practice’s current status with: Participating Opted Out Non Participating Medicare Medicare Participating Medicare Opted Out Medicare Non Participating Commercial carriers Commercial carriers Participating Commercial carriers Opted Out Commercial carriers Non Participating Medicaid Medicaid Participating Medicaid Opted Out Medicaid Non Participating Question Title * 4. What EMR software is used in the practice? Cerbo Power to Practice Charm Elation EClinical EPIC None of the above Other (please specify) Question Title * 5. Please indicate your practice model (check all that apply): Membership Cash-based fee for service Insurance-based fee for service Bundled packages Question Title * 6. Do you currently have internal billing personnel on staff? Yes No Question Title * 7. What is the full practice’s average monthly visit volume? Question Title * 8. What are the goals of the practice with re-engagement? Opportunity to re engage Medicare during public health emergency Increase practice revenue Attract more patients Other (please specify) Question Title * 9. Would you be interested in expert assistance with re-engaging the payer system? Yes No Question Title * 10. Contact Information (you'll only be contacted if you answered "yes" to question 9) Name Professional Degree Email Address Phone Number Submit
