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2004 Route 17M • Goshen, NY 10924
Toll Free: (866) 977-4367 | Fax: (845) 360-9898
https://www.wrshealth.com/
TELEHEALTH SERVICE WITH PATIENT CHECK-IN MODULE SIGN UP FORM
START USING TELEHEALTH AND THE NEW PATIENT CHECK-IN MODULE RIGHT AWAY

WRS released a new Telehealth Module combined with an updated Patient Check-In Module in March 2020. The service allows a practice to see patients remotely. It is fully integrated in WRS EHR, allowing you a single platform to manage the virtual patient encounter from appointment scheduling through revenue cycle management.

WRS Telehealth combined with Patient Check-In Module will enable a Practice to:

 • Enrich Patient Care by Optimizing Workflows
 • Provide Virtual Exams in a Secure and Effective Manner
 • Ensure Payment by Patients and Insurers
 • To be HIPAA Compliant
 • Easy to Navigate Interface for both Patient and Provider
 • Have Seamless Clinical and RCM Integration with the EHR

MONTHLY COST OF TELEHEALTH AND CHECK-IN MODULE
# OF PROVIDERS TELEHEALTHCHECK-INTELEHEALTH & CHECK-IN
1 $50 $100 $127.50
2 $90$180 $229.50
3 $130$260 $331.50
4 $170$340 $433.50
5 $210$420 $535.50

Please call your sales person for better rates if you have more than 5 providers.

Upfront Implementation Fees:

Telehealth $2,500/practice up to 3 providers

Check-in $2,500/practice up to 3 providers

SIGN UP TODAY

Please use the form below to sign up for either or both Telehealth and Patient Check-In Module today.

PROVIDER ENROLLMENT: Name Of Providers Telehealth
Only
Check-In
Only
Telehealth
& Check-In
1
2
3
4
5

List additional providers on a separate sheet.

Privider 1
Privider 2
Privider 3
Privider 4
Privider 5
Privider 6

Using iPad in Conjunction with Check-In Module:

WRS can provide an iPad for you to check-in patients using the latest Check-in Module. The price is $499 per iPad which includes a new iPad with setup and shipping.

QUESTIONS

If you have any questions, please contact Samantha Musumeci. Email: TELEHEALTH@WRSHEALTH.COM OR (866) 977-4367 Extension: 79281

AGREEMENT TERM AND PAYMENT OPTIONS

The term of this Agreement is for an initial 12-month period and will automatically renew for additional consecutive 12 month periods. The pricing is based on a Per Provider basis. Monthly billing cycle starts 30 days following Agreement execution. All payments are non-refundable. Sales Tax will be charged where applicable.


Please choose whether you prefer your Credit Card or Bank Account on file to be charged (Please Choose One):

Complete the form
Contact Name
Phone
phone
Email
mail
Title/Role
Practice ID
Practice
business

Address
Attn
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Full Name
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Accept on behalf of Customer
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