Welcome to Positive Results, LLP - Request for Information

Please complete the following information. All replies will be held in strict confidence. If you have any questions, please feel free to Contact Us or Call 888-442-4484.

Practice Name:
Practice Type/Specialty:
Number of Billing Clinician(s) and degree:
Average amount billed per month?
How many employees (FTE's) do you have working on claims and accounts receivable?
What is the average hourly wage of your employees?
Do you use an outside service to process claims?	Yes No
Are you satisfied with this service?	Yes No
Name of person completing the above information:
Title:
Phone Number:
Mailing Address:

Request for Information