Non-Participation in Insurance. The Patient understands that the Practice does not participate in any health plans, HMO panels, or other private or governmental third-party payer health plans. Accordingly, both the Practice and the Patient are prohibited from submitting charges to, or seeking reimbursement from, any of the above for the Services that the Practice provides to the Patient, the cost of which are included under this Agreement.
Appears in 3 contracts
Samples: Patient Agreement, Patient Agreement, Patient Agreement
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health plansinsurance programs, HMO panels, or any other private or governmental third-party payer payor health plans. AccordinglyTherefore, both the Practice and the Patient are prohibited may not xxxx or seek reimbursement from submitting charges to, or seeking reimbursement from, third-party payors for any of the above for the Services that the Practice provides to the Patient, the cost of which are included under this AgreementAgreement and/or which are personally provided by the Practice.
Appears in 2 contracts
Samples: Medical Weight Loss Patient Agreement, Medical Weight Loss Patient Agreement
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health plansinsurance programs, HMO panels, or any other private or governmental third-party payer payor health plans. AccordinglyTherefore, both the Practice and the Patient are prohibited may not bill or seek reimbursement from submitting charges to, or seeking reimbursement from, third-party payors for any of the above for the Services that the Practice provides to the Patient, the cost of which are included under this Agreement.
Appears in 2 contracts
Samples: DPC Patient Agreement, Patient Agreement
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health plansinsurance programs, HMO panels, or any other private or governmental third-party payer payor health plans. AccordinglyTherefore, both the Practice and the Patient are prohibited may not xxxx or seek reimbursement from submitting charges to, or seeking reimbursement from, third-party payors for any of the above for the Services that the Practice provides to the Patient, the cost of which are included under this Agreement.
Appears in 2 contracts
Samples: Patient Agreement, DPC Patient Agreement
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any health plansinsurance, HMO panels, or any other private or governmental third-third party payer payor health plans. AccordinglyAs such, both the Practice and the Patient are prohibited may not xxxx or seek reimbursement from submitting charges to, or seeking reimbursement from, any of the above for Services provided under this Agreement by the Services that Practice. Neither can the Practice provides to the Patient, the cost of provide receipts for individual visits or services which are included under this Agreementin the monthly fee. This is because as a DPC practice, We do not charge or in a xxxx fee for service manner.
Appears in 1 contract
Samples: Patient Agreement
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any health plansinsurance, HMO panels, or any other private or governmental third-third party payer payor health plans, and cannot accept Medicare or Medicare-eligible patients as Members in this Direct Pay Practice. Accordingly, both the Practice and the Patient are prohibited from submitting charges to, or seeking reimbursement from, any of the above for the Services that the Practice provides to the Patient, the cost of which are included under this Agreement.As such,
Appears in 1 contract
Samples: Patient Agreement
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any health plans, HMO panels, or any other private or governmental third-third party payer health or government insurance plans. AccordinglyTherefore, both the Practice and the Patient are prohibited we shall neither submit bills nor seek reimbursement from submitting charges to, or seeking reimbursement from, any of the above for the Services that provided by the Practice provides to the Patient, the cost of which are included under this Agreement.
Appears in 1 contract
Samples: Patient Agreement