Medical Reimbursement Consultants since 1988, serving tens of thousands of physicians

Don Self and Assoc. Inc.
Don Self and Assoc. Inc.
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FREE DOCUMENTS - P

PAIN MANAGEMENT SUPERBILL (doc)Download
PATIENT ASKS TO WAIVE INSURANCE (pdf)Download
PATIENT FINANCIAL RESPONSIBILITY FORM (doc)Download
PATIENT REGISTRATION FORM (doc)Download
PATIENT REGISTRATION FORM2 (doc)Download
PAYMENT PLAN PROMISSORY NOTE (pdf)Download
PEDIATRICS ATTENDING FORM (txt)Download
PEDIATRICS SUPERBILL (pdf)Download
PEDIATRICS SUPERBILL1 (pdf)Download
PERIPHERAL ARTERIAL DISEASE CDC FACT SHEET (pdf)Download
PHYSIATRY SUPERBILL (pdf)Download
PHYSICIAN-SUPERVISION (xlsx)Download
PLASTIC SURGERY SUPERBILL (pdf)Download
PODIATRY FOLLOW UP PROGRESS SHEET (doc)Download
PODIATRY INITIAL PROGRESS SHEET (doc)Download
PODIATRY SUPERBILL -ICD-10 (pdf)Download
Podiatry_Diabetic_Shoes-ICD9 SUPERBILL (pdf)Download
PRACTICE STARTUP CHECKLIST - 2 (doc)Download
PRACTICE STARTUP CHECKLIST (doc)Download
PROMPT PAY LAWS BY AMBA (pdf)Download
PSYCHIATRY SUPERBILL (dot)Download
2023 FEDERAL POVERTY GUIDELINES (jpg)Download

FREE DOCUMENTS - Q

QUICK PAY DISCOUNT POLICY (rtf)Download

FREE DOCUMENTS - R

RECORDS RETENTION REQUIREMENTS (doc)Download
REFUND-LAWS-BY-STATE (pdf)Download
REMARK CODES - MEDICARE (pdf)Download
REVIEW OF SYSTEMS FORM FROM DON (doc)Download
RHCs & CCM (pdf)Download
RVUs - 2018 (pdf)Download

FREE DOCUMENTS - S

SCRIBES ARE OK PER CMS (rtf)Download
Specialty Codes-2018 Medicare (pdf)Download
SUPERBILL WITH ICD-10 (pdf)Download
SURGERY SUPERBILL (pdf)Download
SYMPTOMS SURVEY FORM (doc)Download

FREE DOCUMENTS - T

TAXONOMY CODES (pdf)Download
TEACHING PHYSICIAN RULES (doc)Download
TELEPHONE BILLING DOCUMENT (doc)Download
TEXTING & CMS (pdf)Download
TIMED CODES (pdf)Download
TRY CCM FOR FREE (pdf)Download

FREE DOCUMENTS - U

URGENT CARE SUPERBILL (pdf)Download
UROLOGY PROGRESS NOTE (pdf)Download
UROLOGY SUPERBILL (pdf)Download

FREE DOCUMENTS - W

WAIVER - PATIENT WAIVES INSURANCE (pdf)Download
WAIVING COPAYS ROUTINELY (pdf)Download
WARN YOUR PATIENTS (pdf)Download
WELCOME TO MEDICARE CONSENT (doc)Download
WELCOME TO MEDICARE EXAM SYNAPSIS (doc)Download
WELCOME TO MEDICARE PROGRESS NOTE (doc)Download
WHAT IS A NEW PATIENT (pdf)Download

FREE DOCUMENTS - X

X-MODIFIERS (pdf)Download

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