Insurance Information. We understand that your health insurance information may change from time to time, however, it is your responsibility to contact our office immediately should any changes occur. Should you fail to provide us with the most accurate information in a timely manner you will be responsible and billed for all charges that result in non-payment or denial by your insurance company. An invoice will be sent to you and payment is expected within 30 days of receipt.
Appears in 6 contracts
Samples: Patient Responsibility Agreement, Patient Responsibility Agreement, Patient Responsibility Agreement
Insurance Information. We understand that your health insurance information may change from time to time, however, it is your responsibility to contact our office immediately should any changes occur. Should you fail to provide us with the most accurate information in a timely manner promptly you will be responsible and billed for all charges that result in non-payment or denial by your insurance company. An invoice will be sent to you and payment is expected within 30 days of receipt.
Appears in 1 contract
Samples: Patient Responsibility Agreement
