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2017/2018 Superbill
Merchandise
Member:
$249.00
Non-Member:
$500.00
HIPAA Package
Merchandise
Member:
$549.00
Non-Member:
$1,099.00
Patient Registration Form
Merchandise
Member:
$99.00
Non-Member:
$199.00
HIPAA Security Guidance Document
Merchandise
Member:
$350.00
Non-Member:
$600.00
Hearing Aid Insurance Waiver
Merchandise
Member:
$99.00
Non-Member:
$199.00
Hearing Aid Loaner Agreement
Merchandise
Member:
$49.00
Non-Member:
$99.00
Price Quote Form
Merchandise
Member:
$49.00
Non-Member:
$99.00
Insurance Verification Form
Merchandise
Member:
$49.00
Non-Member:
$99.00
Hearing Aid Orientation & Verification Checklist
Merchandise
Member:
$49.00
Non-Member:
$99.00
Hearing Aid Upgrade Notice
Merchandise
Member:
$99.00
Non-Member:
$199.00
Notice of Non-Coverage
Merchandise
Member:
$99.00
Non-Member:
$199.00
Case History Form
Merchandise
Member:
$49.00
Non-Member:
$99.00
Employee Manual
Merchandise
Member:
$499.00
Non-Member:
$999.00
Hearing Aid Package
Merchandise
Member:
$499.00
Non-Member:
$999.00
Hearing Aid Bill of Sale
Merchandise
Member:
$249.00
Non-Member:
$500.00
Office and Financial Policy
Merchandise
Member:
$99.00
Non-Member:
$199.00
Practice Management Package (includes Registration Form, Case History, Financial Policy, Superbill)
Merchandise
Member:
$349.00
Non-Member:
$700.00
Additional Website Listing
Merchandise
Member:
$25.00
Non-Member:
$25.00