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Phone: 1-833-867-4357

Email: Info@TMSstartitup.com

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CONTACT US

1-833-TMS-HELP (867-4357)

Direct: (314) 226-1997

TMS Clinic Start It Up!™ Consulting, Services and Support

SERVICE REQUEST FORM

Please select which TMS or Psychiatry Support Services you are interested in. Upon receipt of your request,

one of our TMS & Psychiatry Support Specialists will reach out to you within 48-hours.

Service Request Form

Full Name:

Email:

Phone:

Title

Clinic or Practice Name

Type I NPI

Type 2 NPI

Tax ID/EIN

Business Address

Business City/State/Zip

TMS Consulting Service

TMS Support Service

Physician Credentialing

Which insurance networks do you wish to be credentialed with?

Anthem/BCBS

Beacon

Cambria Health Solutions

CareSource

Centene Corp

Cigna

Coventry

EmblemHealth

Geisinger

HealthNet

Health Partners

Humana

Kaiser Permanente

Medicare

Medicaid

Oscar Health

Tufts HC

UHC/Optum

WellCare

Anthem/BCBS

Aetna

Beacon

Cambria Health Solutions

CareSource

Centene Corp

Cigna

Coventry

EmblemHealth

Geisinger

Harvard Pilgrim Healthcare

HealthNet

Health Partners

Humana

Kaiser Permanente

Medicare

Anthem/BCBS

Beacon

Cambria Health Solutions

CareSource

Centene Corp

Cigna

Coventry

EmblemHealth

Geisinger

HealthNet

Health Partners

Humana

Kaiser Permanente

Medicare

Medicaid

Tufts HC

UHC/Optum

WellCare

Anthem/BCBS

Aetna

Beacon

Cambria Health Solutions

CareSource

Centene Corp

Cigna

Coventry

EmblemHealth

Geisinger

Harvard Pilgrim Healthcare

Health Partners

Humana

Kaiser Permanente

Medicare

Anthem/BCBS

Beacon

Cambria Health Solutions

CareSource

Centene Corp

Cigna

Coventry

EmblemHealth

Geisinger

HealthNet

Health Partners

Humana

Kaiser Permanente

Medicare

Medicaid

Oscar Health

Tufts HC

UHC/Optum

WellCare

Medicare

Beacon

CareSource

Centene Corp

Other (list below in open field)

Specialty Billing Service (TMS/Spravato)

Psychiatry Billing for Med Mgmt and Therapy

Custom Website Design and Development

Website SEO Services

AssistMD Call Center

TMS Start It Up! Training

TMS Patient Intake & Prior Auth Training

SmartMD Provider Network Management

Patient Intake Services for B/E & Prior Auth

Please list any additional insurances you are interested in?

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Direct: (314) 226-1997
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Request Information: info@TMSstartitup.com.com

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