Proposals

New Proposal

draft

Client

Practice name (shown on proposal)

Legal entity name (as it appears on the agreement)

Entity type

Organized under laws of

Contact name

Contact title

Phone

Address

Services

Credentialing Medical Billing

Credentialing

Entity setup & contracting (Tax ID / Type 2 NPI)

Entity ($)

Onboarding ($/provider)

Panels ($ each)

Fees: leave blank for standard pricing, or enter 0 to waive. The amounts flow into the proposal, the agreement and the setup invoice.

Medical Billing

Rendering providers

Collection rate (%)

Setup fee ($)

Additional provider fee ($ each)

Agreement template

Monthly Minimum Fee ($)

Waive monthly minimum

Min. months 3–5 ($/provider)

Min. month 6+ ($/provider)

Waived once fee ≥ ($/month)

…for consecutive months

Patient Statement Service ($2.00 per statement)

Custom contract terms (this proposal only)

Only for terms negotiated with this client and approved by your attorney. Pick the section, then edit its text; the heading stays. Every other proposal keeps the standard agreement.

Proposal

Valid through

Message to client (optional, shown on proposal)

Internal notes (never shown to client)