This digital download cash practice kit from Herman & Wallace is designed for Clinicians who receive referrals from urology, gynecology and colorectal practices.  This kit contains a selection of forms developed specifically for Clinicians looking to start or transition to a fee for service program rather than insurance based private practice.

The digital kit will provide you with the basic tools you will need when collecting fees at the time of service.  Some of the documents include sample letters, templates for insurance companies, as well as referral sources that describe your financial policy.

The Following Forms are Included in this Clinic Management Toolkit

1. Insurance Change Sample Letter
2. New Patient Intake Form
3. Informed Consent and Conditions
4. Insurance Benefit Worksheet
5. Patient Information and Financial Policy
6. Genitourinary Referral Pad
7. Confidential Fax Cover Sheet
8. E-mail and Fax Confidentiality Statement
9. Reimbursement/Billing Form
10. Administrative Billing Form
11. Daily Ledger
12. Daily Notes
13. MD Marketing Sample Letter

Note: This product is emailed in Microsoft Word format so that you can instantly access these files and distribute them to patients with your own clinic’s logo.

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