My Account Locate a Pharmacy Company Careers Contact Events
Please use the form below to request additional information.
Product --Please Select-- ClaimIQ DecisionPoint DecisionPoint Enterprise DecisionPoint ASP DecisionPoint Service Center CIQ Investigation Module CIQ Liability Module CIQ Negotiation Module CIQ Reporting Module
First Name*
Last Name*
Company Name*
Account Number
Phone* (Example: 123-456-7890)
Fax (Example: 123-456-7890)
Email Address*
Zip Code* (Example: 12345)
How may we help you?
Interest Level --Please Select-- Interested in purchasing Just looking for information Not sure yet Not interested in purchasing
Timeframe --Please Select-- None 1-6 months 7-12 months 13-24 months 25+ months Not changing
2 + 4 ? Just say 6
* Required fields are marked with an asterisk.
If you wish to contact us directly, please call 1.800.424.1132.