Our price is based on some of the factors listed below. Please choose one option for each question, fill out the form below and click 'Submit'. You will receive our price for transcription service by e-mail or phone from a member of our sales staff. If you would rather speak to a member of our sales staff now, call us at 1-800-515-0095.

Contact Information Name and Title:* Facility Name:* Street Address: City: State: ZIP: Phone: Fax: Email:*

01) Your facility is a Select Hospital Nursing Home Emergency Practice Clinic Surgery Center Other 02) How are you presently handling your transcription service needs? In-house Home Workers Handwritten Speech Recognition EMR Other (Specify) Outsourced / Contracted out Enter Vendor's name and contract expiration date 03) Do you have any EMR or EHR now? Yes No Whether your current transcriptionist type into that EMR or they just send you reports typed in Microsoft Word? Yes, they type into EMR and SpectraMedi need to do the same or build an interface? No, just type and send the reports in Microsoft Word or other special format. 04) What is your most preferred mode of dictation (audio recording)? Use SpectraMedi’s Phone-in system Digital Recorders   PDA or PC Application Combination   Own phone-in dictation system Specify make, model, version, year etc. Own Digital Recorders/PDAs Specify make, model etc. 05) What is your required turnaround time (TAT) for your transcribed reports (transcription)? Less than a day Specify hours Next Day 1 to 2 Days 1 to 3 Days 06)   a) On an average how many reports your doctors will be dictating?  per  Select Day Week Month Year b) How much do you spend for MT?  per  Select Day Week Month Year 07) How many doctors/providers will be dictating with us? 08) How soon do you plan to change the transcription service? Immediately Within One Month Long Range Within two weeks Within Two To Four Months 09) Besides you who else is involved in making decision to change transcription service? I alone make the decision Other (Specify) 10) Do you consider your transcription need as permanent long term or temporary short term requirement? Permanent long term (1 year or more) Temporary short term (few weeks to few months) 11) How are you currently charged for transcription services and how much? Per ( )-Character Gross Line Per( )-Character Gross Line Per 55-characters Per Word Per Page Per Report Per Hour Per Year Other (Specify) Enter Rate 12) Among Quality, Turnaround Time and Price, what is most important to you? Quality Turnaround Time Price 13) Have you received prices from any other company or whom are we competing with to earn your business? No Yes  (Specify) 14) What price range I have to be at to earn your business? 15) Do you have any means to give us your patient details such as patient names, their account number, date of birth etc. in Microsoft Excel or CSV or HL-7 interface? Yes – can give us in Microsoft Excel or CSV Yes – can give it through HL-7 interface No – print and fax only 16) Comments 17) How did you hear about us? ---------Select--------------- Referred by News/Article Telemarketing Advertisement Google MSN Yahoo Fax Email Direct Mail Other   Name   Explain

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