InterGroup Services Corporation

Yes, I would like more information on how InterGroup's Provider Plus tools can save me time and money. Please have an InstaMed representative contact me to set up an online product presentation.

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Name*:
Title:
Practice Name:
Email*:
Phone*: Ext:
The best way to reach me is By Phone By Email	The time and date to reach me is Time and Date:
Do you currently accept these forms of payment? (check all that apply) Credit Cards Visa MasterCard Discover Checks
What is your average monthly credit card volume?
How many of your locations process payments?
What practice management system do you use?
What would be your timeline for implementing InstaMed Online? 0-1 Months 2-5 Months 6+ Months
Who is your current clearinghouse?
Do you print and/or mail your own patient statements? Yes No
Do you verify patient insurance eligibility? Yes No