Credentialing Client Discovery Form
(Billing-Only)
This form focuses on gathering information on existing billing operations, transition readiness, A/R, denials, reporting, and ongoing revenue-cycle support.
EHR/PM software, clearinghouse, payer portal access, and active payer enrollments are expected to be already established.
• Complete every applicable field. Select only services currently provided or planned.
• Upload supporting documents through the secure upload fields. Do not email protected or sensitive documents.
• Items marked “if applicable” may not apply to every provider or practice. Upload documentation through the secure portal only.
Thank You!
Your Billing-Only Credentialing Client Discovery Form has been submitted successfully.
Our Billing team will review your information and supporting documentation and contact you if additional information is required.
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