Prompt Med Urgent Care Centers CAREER OPPORTUNITY FORM
STEP 3 - CHECK YOUR MATH

RETURN TO CAREERS PAGE

Date: Location Applied For: Position Desired:
Name: Email: Phone:
PLACE YOUR ANSWER IN EACH OF THE 3 EXAMPLES BELOW, THEN SUBMIT THIS FORM
#1  
Deductible $300.00
Deductible Met $300.00
Insurance Pays 80\20
Total of today's visit $100.00
How much does the patient owe?
#2
Deductible
$500.00
Deductible Met
$0
Insurance Pays
80\20
Total of today's visit
$426.00
How much does the patient owe?
#3
Deductible
$250.00
Deductible Met
$200.00
Insurance Pays
50\50
Total of today's visit
$300.00
How much does the patient owe?

REQUIRED CHECKBOX! DO NOT CLICK THE SUBMIT BUTTON BELOW BEFORE CHECKING THIS BOX OR YOU MAY LOOSE ALL YOUR DATA!
By checking this box, I understand and agree with the terms and conditions of this online job application form: