• 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: