simpleisus.com: Simple Early Intervention Software User Solutions

Request Interest in Specific State

SimpleIsUs currently is specific to Louisiana’s Early Intervention Program.

However, we welcome the opportunity to accommodate other states. Please contact us with your interest in the software. We will be happy to evaluate the development work needed and let you know how long it will take to bring your state on-board. There will be no cost to you.

To assist us in gaining insight into the development work and time frame, please fill in the form below and submit. One of our representatives will get back in touch with you.

Your name *
Your email address *
Daytime telephone # *
Practice Name *
Street *
City *
State *
Zip *
STATE Interested In *
Practice
If you checked "Agency" above:
Number of Providers
Number of Locations
Does your state program require mandated* forms for “Daily Session Notes”?
Does your state program require mandated* forms for “Monthly Progress Reports”?
Does your state program provide free electronic billing via Web/Otherwise?
Does your state Medicaid group/office support Electronic Submission?
Are your Part C claims sent to your state Central Billing Office for payment?
If necessary, could you send us a copy of the current recommended forms for Daily Session Notes and Monthly Progress Reports for your State?
*Mandated meaning the information must be on a SPECIFIC FORM created by your State’s program. Do not consider it mandated if only specific information must be on the report or session note.

Are there any particular items of interest that we should know about your state’s early intervention program? (e.g., billing, documentation, electronic submission, agencies): Or what problems are you looking to solve with the software? Or other comments.
How did you find us?