Virtual Healthcare Assistants Client Form – MedStar Billing Technology and Resources

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September 2025
October 2023

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Virtual Healthcare Assistants

Client Form

Virtual Healthcare Assistants Client Form

Practice Information

Practice/Clinic Name

Number of Staff / Employees

Practice Address / Location

Type of Practice

Other

Contact Information

Contact Person Name

Email Address

Phone Number

Virtual Assistant Requirement

Virtual Assistant Type

Services Needed

Services Required

Patient Scheduling

Insurance Verification

EHR/EMR Management

Billing Support

Patient Communication

Administrative Reports

Other

Other:

Current Setup

Current Software Used

Consultation Details

Preferred Start Date

Additional Notes / Requests

MedStar Billing Technology & Resources

Impacting the Success of Global Business While Making a Difference in the Lives of Others

Services

Virtual Healthcare Assistants

Medical Billing & Coding Services

Healthcare Training & Education

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info@medstarbtr.com

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