Public pilot intake

Tell us what a good fit looks like.

This form collects business requirements only. It should take about four minutes, and it never asks for patient information.

Practice name

Your name

Business email

Primary state

Number of clinicians

Primary EHR

Main insurance payers

Current billing setup

Approximate monthly collections

Desired start

Primary need

What needs to improve?Business information only. Patient or clinical information will be rejected and removed.

I confirm this request contains no patient information and authorize BillerFit to share a redacted business summary with compatible pilot vendors under the Pilot Terms and Privacy Notice.

During the public pilot, matching records are used only to evaluate this service and facilitate requested introductions.