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Easy
as 1, 2, 3.
*
Indicates a required field
(If
an item does not apply please enter zero)
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Step 1: Please Enter Your Key
Information (preferred
but not required) |
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Name of Your Organization
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Email
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Your First And Last Name
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Phone #
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Step 2: Please Enter Your Key Data
Click here to email for help with this form |
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Average Gross Revenue per Inpatient Admission |
$ |
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Market Share in Primary Service Area |
% |
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Average Gross Revenue per Outpatient Visit |
$ |
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Managed Care Discounts and Bad Debt |
% |
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Average Gross Revenue per ER Visit |
$ |
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Variable Cost per Case or Discharge |
% |
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% of ER Patients Admitted as Inpatients |
% |
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Contact Center Direct Operating Cost |
$ |
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Direct Revenue Generated or Revenue
Recovered |
$ |
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Step 3: Please Enter Your Contact
Volume: |
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Total Number of Inbound and Outbound Phone Calls |
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Total Number of Class Registrations,
Physician Referrals via the Web Annually |
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For your estimated
financial benefit |
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