Common use of Medicare and Medicaid Patients Clause in Contracts

Medicare and Medicaid Patients. All the information I gave when I applied for Medicare/Medicaid payment is correct. I request that payment of authorized Medicare benefits be made on my behalf to the above-named Facility for any services furnished to me by them. I authorize any holder of medical information about me to release to The Centers for Medicare and Medicaid Services (CMS) and its agents any information needed to determine these benefits or the benefits payable for related services.

Medicare and Medicaid Patients. All the information I gave when I applied for Medicare/Medicaid payment is correct. I request that payment of authorized Medicare benefits be made on my behalf to the above-above named Facility for any services furnished to me by them. I authorize any holder of medical information about me to release to The Centers for Medicare and Medicaid Services (CMS) and its agents any information needed to determine these benefits or the benefits payable for related services.

Medicare and Medicaid Patients. All the information I gave when I applied for Medicare/Medicaid payment is correct. I request that payment of authorized Medicare benefits be made on my behalf to the above-above named Facility facility for any services furnished to me by them. I authorize any holder of medical information about me to release to The Centers for Medicare and Medicaid Services (CMS) and its agents any information needed to determine these benefits or the benefits payable for related services.