President and CEO of Active Management. A Practice Management...
"The New York State Podiatric Medical Association, Queens Division"
April 28, 2012
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Active Management extends its warmest welcome to you and your staff and look forward to servicing your practice providing the highest level of quality services in the industry.
Our employees are committed to assist you and your staff in complying with the complex billing requirements, associated with the submission of insurance claims and patient billing.
Accordingly, your feedback and comments are invaluable in evaluating our customer satisfaction goals and taking corrective action when needed.
To better serve you, Active Management needs to have basic information. Please take a moment to fill out the attached forms:
Access Administrative Forms
View As Web Page
Financial Information Form
Current Practice’s Billing Policy
Doctor Profile (Please Fill out one per/provider)
In Addition we need the following documents:
CV for Each Provider
Copy of License for Each Provider
Copy of DEA # for Each Provider
Copy of 147C letter for the Corporation
Sample of practice’s Letter Head
The registration process will be initiated after the above requested documents are received by Active Management and upon signed contractual agreement.
Feel free to contact us with questions or to request an in-service
Thank you for your patronage.
for Health Care
Lower Extremity Review
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