InterQual® Alliance Partners

First Name *

Last Name *

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Job Function * -- Please Select -- Administrative/Human Resources Administrator Billing/Coding Board Member/Director/Trustee Cardiology Care Management/Population Health Claims & Denials Consulting Dentistry EDI EHR Implementation/Management Engineering/Technical Staff Enrollment Executive Finance/Accounting General Management Information Systems/Technology Laboratory Legal/Regulatory/Compliance Medical Auditing Medical Practice Management Member Engagement Nurse/Nursing Executive Office Manager Operations Patient Access Patient Financial Services Pharmacy Physician Physician Practice Management Procurement/Purchasing/Supply Project Management Radiology Revenue Cycle Management Sales/Business Development/Marketing Training/Education Vendor Relationships Other

Job Level * -- Please Select -- Analyst/Administrator Chief Compliance Officer Chief Executive Officer Chief Financial Officer Chief Information Officer Chief Medical Information Officer Chief Medical Officer Chief Operating Officer Chief Quality Officer Chief Technology Officer C-Level Department Chair Director Doctor Individual Contributor Manager President Senior Vice President Vice President Other

Solution of Interest * -- Please Select -- Clinical Decision Support Solutions Clinical Interoperability Solutions Consumer Payments & Communications Dental Network Solutions Enterprise Imaging Solutions Healthcare Consulting Services Healthcare Data & Analytics Solutions Medical Network Solutions Medical Record Retrieval & Clinical Review Member Eligibility & Enrollment Solutions Member Engagement Solutions Patient Access & Financial Clearance Solutions Engagement & Experience Patient Experience Solutions Payment Accuracy Solutions Pharmacy Benefit Solutions Pharmacy Solutions Provider Network Optimization Solutions Provider Payment Management Solutions Revenue Cycle Management Solutions Risk Adjustment and Quality Solutions Transparency & Provider Search Value-Based Care Enablement Value-Based Care Solutions

Solution Type -- Please Select -- Services Technology Unsure

Claims Volume

Company *

Company Type * -- Please Select -- Billing Service Dental Emergency Medical Service Government Agency Healthcare Information Exchange Home Health Agency Hospital Employed Practice Hospital/Health System Imaging Center Independent Practice Affiliated with Hospital Independent Practice Not Affiliated with Hospital Laboratory Partner/Reseller Payer Software Vendor Trust Other

Bed Size -- Please Select -- 1-199 200+

Practice Specialty -- Please Select -- Anesthesia Cardiology Emergency Medicine Pathology Radiology Other

Number of Covered Lives

Practice Management Software Vendor

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