|
|
| |
|
|
PROVIDER DETAILS |
| 1. How many dictators would utilize this service? |
|
1-3 |
|
3-5 |
|
5-10 |
|
10-15 |
|
More than 15 |
| |
|
|
Please provide the names
|
| |
| 2. Do you have multiple locations or satellite offices? |
|
YES
NO |
|
If Yes, |
|
1-2 |
|
2-4 |
|
4-6 |
|
More than 6 |
| |
| 3. Average number of minutes each dictator dictates every day |
|
5-10 Minutes |
|
10-15 Minutes |
|
15-20 Minutes |
|
More than 20 Minutes |
| |
| 4. What is your preferred dictation method? |
|
|
Hand-held digital recorders |
|
|
Dictation through telephone (toll-free) |
| |
| 5. Do you need STAT support (4-hour-TAT)? |
|
|
Yes |
|
|
No |
| |
|
|
FILE TRANSFER |
| |
| 6. We offer the following modes of secure, HIPAA-compliant file
transfers; please select your preferred mode of file
transfer |
a) |
Pradot Transcription Office Manager (TOM) offers, |
| |
Key features of TOM:
- Upload voice files
- Download transcribed files
- Track dictation
- Review transcriptions online and do online corrections
- Add digital signature
|
b) |
|
Secure FTP site (FTP over SSL/SSH) |
c) |
|
Encrypted e-mail upload |
|
|
Please provide the e-mail ID |
| |
|
|
d) |
|
Transfer to your FTP site, if you have your own FTP site for uploading files back to you. Please provide the FTP details |
|
|
|
e) |
Through RDP (remote desktop protocol) |
| |
|
|
TRANSITION |
| |
| 7. To help us serve you better, we request you to provide us the following |
|
|
Soft copy of all the templates |
|
|
Page setup details |
|
|
Samples of all types of reports |
|
|
A copy of standard review of systems/physical examination, if any exist |
|
|
Macros/normals for review of systems/physical examination/standard phrases,
if any exist |
|
|
If there are any specific formatting guidelines to be followed for any
particular physician, please attach a copy of the same |
|
|
Referring physician database |
|
| Please send all the above to: |
Vial e-mail: support@pradot.com
Via fax: 1-866-614-2379
|
8. Do we need to scan your letterheads to enable plain paper printing? |
| |
Yes |
| |
No |
|
If yes, please mail a hard copy of your letterhead to:
Arun Murali (President – US operations)
5546, Primrose Avenue
Indianapolis, IN 46220
|
|
CONTACT DETAILS
|
Name and contact information of the key person who would coordinate transcription work
|
(Front office coordinator or equivalent) |
|
| |
| (Practice manager or equivalent) |
|
|
| If there is
any additional information you would like to provide us,
please enter it below: |
|
|
|
|
|
|
|
|