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Provider Advocate Training Request Form

Provider Advocate Training Request Form

Please complete this form to request training for your practice. If you have a question that is not related to specific claims or patients, please complete the Provider Education Contact Form.
 
Practice Address
What topics do you want covered in your training session? Check the box(es) that apply.
Who will be attending this training? Check the box(es) that apply.
The questions below are not required, however, the information you provide may be beneficial to your Provider Advocate during your requested training. 
 
Name of clearinghouse:
Name of medical records management vendor:
Name of EMR/EHR vendor: