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       Thank you for your interest in CSOA services. If you would like to receive further        information, including a price quote, please complete all of the information below and a  CSOA representative will contact you within 24 hours.

     
Company Information:    
Name  
Address  
City  
State  
Zip Code  
     
Contact Person:    
Name  
Title  
Phone  
E-mail  
     

Type of Service Needed  

(please check all that apply):

Provider/Group Credentialing
Application Prep and Submission to
Health Plans, Medicare, etc.
  Primary Source Verifications
Practitioner Credentialing and/or
Recredentialing (NCQA, AAAHC, The
Joint Commission, etc.)
  Facility Credentialing
SNF, Home Health Agencies, Hospitals,
Free Standing Centers
  Updating of Expiring Elements
Including License, DEA, Malpractice
Insurance, Board Certification, etc.
  On-Going Monitoring of Sanctions
State License and Medicare Sanctions
  Consulting
     
Type of Organization            (please check all that apply): HMO
  PPO
  Hospital/Surgery Center
  Medical Group/IPA
  MSO
  Workers Compensation Network
  Specialty Network
     

Number of  Providers      

(please  select one):

   
     

Special Comments or

Deadlines to meet:

 
     
How did you hear about us? Google Web Search
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We Accept All Major Credit Cards. 
 

 

Credentialing Specialist Of America
PO Box 17761
Sugar Land, TX 77496

866-300-6682   Toll Free
713-446-3486   OFFICE
281-313-0559   FAX


www.csoamerica.com
sales@csoamerica.com 


We Accept All Major Credit Cards.