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New Recovery Act HIPAA Requirements
Self-Assessment and Compliance Guide For
Health Care Providers

Thank you for subscribing to the HIPAA Self-Assessment and Compliance Guide. You may register online by completing the form below.  Payment online is by credit card only.  You may also pay by check.  Print the form off below, complete it and send your check payable to Bricker & Eckler LLP to the attention of Karen Smith at the address below.  If you have any questions about payment options, please contact Mary Cummins 614.227.8884 or by email at mcummins@bricker.com.

Mail check and registration form to :

Bricker & Eckler LLP
ATTN:  Karen Smith
100 South Third Street
Columbus, OH  43215

If paying by credit card, complete the online registration form below and click the submit button.  Please remember to print your receipt. You will receive a confirmation email, along with your password, one to two business days after payment has been verified. For any questions regarding your payment, or if you do not receive the confirmation and password within 2 business days, please contact Mary Cummins at 614.227.8884 or mcummins@bricker.com. There are no refunds.

Price: $2500  Single Facility or Provider/Practice Group
$3500  Health Care System (will be used by more than one health care facility)

 

Name of Health Care Provider:  
Type of Provider (e.g. hospital):
Address:
City:
State:
Zip:
Contact First Name:  
Contact Last Name:  
Job Title:
Telephone:    
Email Address:    

Was the Health Provider a subscriber to the previous HIPAA Self-Assessment and Compliance Program offered by Bricker & Eckler LLP through QMCG, which was located at www.hipaacomplyonline.com?  (If yes, a $250 discount applies.) 

TOTAL PRICE:   $ 2500.00
(plus applicable sales tax)

 

 

 

 

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