Please complete the following so we may better serve you...

Name               
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Phone              
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Contact me regarding:

Early-out - active receivable services - early-out, pre-collect, payment monitoring
Insurance - follow-up on claims submitted and unpaid
Billing - insurance claims that must be submitted to the insurance company
Bad Debt - accounts at least 120 days old that have not been paid
Other -

Include any information you feel will assist us in responding to your requests:

     

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