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TMA Revenue Cycle Management Solution

 

To see if your practice qualifies for TMA’s revenue cycle management services, please complete this form.

 

Name of practice:    
Specialty: 

   
Location of practice (city):

 		   
Contact name: 

   
Phone: 

   
E-mail: 

   
How would you prefer to be contacted?
Number of physicians and other providers:



   MDs/DOs
  NPs/PAs
Current billing:



  
Technology: 

   Practice Management System
  EMR 
Current billing concerns:


    

 

 

 

 

 

 

 

 

 

 

                                                                                                                      

Having trouble with the form? Try this version