Form | TrueNorth RCM Leads

Name *

Practice Name *

Email address *

Phone Number *

How many providers work at your practice *

Less than 3
3 - 5
6 - 10
11 - 25
More than 25

What is your specialty? *

Addiction Treatment Services / Center
Allergy and Immunology
Alternative & Holistic Medicine
Anesthesiology
Applied Behavior Analysis / Autism
Bariatrics / Obesity
Cardiology
Chiropractic
Community Health Center / FQHC
Dentistry
Dermatology
Diagnostic Radiology
Dialysis Clinic
Emergency Medicine
Endocrinology
Family Medicine
Gastroenterology
General Practice
Hospital
IVF / Fertility Clinics
Infectious Disease
Internal Medicine
Medical Genetics
Mental & Behavioral Health
Multi-Specialty
Nephrology
Neurology
Nuclear Medicine
Obstetrics and Gynecology
Occupational Therapy
Oncology / Hematology
Ophthalmology
Optometry
Orthopedics / Sports Medicine
Otolaryngology (ENT)
Pain Management
Pathology
Pediatrics
Physical Medicine & Rehabilitation
Physical Therapy
Plastic & Reconstructive Surgery
Podiatry
Proctology
Psychology
Psychiatry
Pulmonology
Radiation Oncology
Rheumatology
Sleep Medicine / Center
Speech Therapy
Substance Use Recovery
Surgery
Urology
Other Specialty

What Services are you looking for? *

Revenue Cycle Management / Outsourced Medical Billing
Provider Enrollment / Credentialing Services
Revenue Cycle Management with Software

What is your practice’s estimated monthly charges? *

$0 (New Practice)
$1 to $1,000 / Month
$1,001 to $5000 / Month
$5,001 to $10,000 / Month
$10,001 to $20,000 / Month
$20,001 to $50,000 / Month
$50,000 to $100,000 / Month
$100,001 to $250,000 / Month
$250,001 + / Month

What is your expected timeline for selecting a billing partner? *

Immediately
Within 30 Days
1–3 Months
3–6 Months
Just Researching Options

What is your Zip Code *