Header
Tell Us About You

       Thank you for your interest in CSOA Solutions, Inc.  If you would like to receive further        information, including a price quote, please complete all of the information below and a  CSOA representative will contact you within 24 hours.

Company Information:
Name
Address
City
State
Zip Code
Contact Person:
Name
Title
Phone
E-mail

Type of Service Needed  

(please check all that apply):

Provider/Group Credentialing
Application Prep and Submission to
Health Plans, Medicare, etc.
Primary Source Verifications
Practitioner Credentialing and/or
Recredentialing (NCQA, AAAHC, The
Joint Commission, etc.)
Facility Credentialing
SNF, Home Health Agencies, Hospitals,
Free Standing Centers
Updating of Expiring Elements
Including License, DEA, Malpractice
Insurance, Board Certification, etc.
On-Going Monitoring of Sanctions
State License and Medicare Sanctions
Consulting
Type of Organization            (please check all that apply): HMO
PPO
Hospital/Surgery Center
Medical Group/IPA
MSO
Workers Compensation Network
Specialty Network

Number of  Providers      

(please  select one):

 

Special Comments or

Deadlines to meet:

How did you hear about us? Google Web Search
Yahoo Web Search
Referral
Mailer
Other
  


 

CSOA Solutions, Inc.
   

     

Ph: 832-328-2230  

                               


www.csoamerica.com
sales@csoamerica.com