• Email Us: info@healthcaresynergy.com
  • Call Us: 800-479-6374

Software Product Evaluation Form

Please Fill Out the Form Below in its Entirety


To help us better serve you and meet your software needs, please fill out the requested information below. Upon completion and submission of the form your account manager will contact you for verification and schedule an in-depth consultation. Thank you!

    Your Contact Information

    Would you like to be included in our mailing list?


    How did you hear about HealthCare Synergy?

    WebsiteMailer/BrochureEmailPrint/AdvertisementWorkshop/Trade ShowReferralOther

    Agency Information

    Is the agency Medicare Certified?


    Number of software users needed?

    Products and Services you would like to evaluate/more interest on:

    Managed Services

    Coding OnlyCoding and OASISAnalytics - Clinical/FinancialChart ReviewADR ReviewTargeted Probe & EducatePPS BillingRevenue RecoveryBookkeeping and/or Accounting

    Cost Reporting

    Simeone ConsultingManis & Ryan

    CAHPS for Home Health or Hospice



    Home Health GoldStrategic Healthcare Partners

    Other Tools

    OASIS Coding AuditsMedicare Eligibility ChecksAbility

    Additional Information: