New Location or New Department for Existing Practice

Request a new location or department for an existing practice.

Example:

  • A practice opens a new satellite office.  A practice needs a new department at an existing location for billing purposes.

 

To facilitate your request, here is the information we will need:

  • What is the requested go-live date? (we request 30 days advanced notice)
  • What is the practice name, address, phone number, and fax number for each location?
  • What are the provider name(s) and their credentials?
  • Affiliate Technical Contact Information (Information Technology Resource).
  • What is Providers MICR ID?
  • What is the providers Quest ID?
  • Is provider adding any additional devices and/or printers?
  • Providers scheduling template (days, start, end, and lunch times; length of visits, visit types, etc).
  • If adding new staff, please provide name of employee(s), their date of birth, and job function?