Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health insurance programs, HMO panels, or any other third-party payor health plans. Therefore, the Practice may not bill or seek reimbursement from third-party payors for any of the Services included under this Agreement.
Appears in 3 contracts
Samples: DPC Patient Agreement, Off Grid Doc, DPC Patient Agreement
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health insurance programsplans, HMO panels, or any other private or governmental third-party payor payer health plans. ThereforeAccordingly, both the Practice may not bill and the Patient are prohibited from submitting charges to, or seek seeking reimbursement from third-party payors for 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: Citadel Health Center, Citadel Health Center, Citadel Health Center
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health insurance programs, HMO panels, or any other third-party payor health plans. Therefore, the Practice may not bill xxxx or seek reimbursement from third-party payors for any of the Services included under this AgreementAgreement and/or which are personally provided by the Practice.
Appears in 2 contracts
Samples: Off Grid Doc, 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 insurance programs, HMO panels, or any other third-party payor health plans. Therefore, the Practice may not bill xxxx or seek reimbursement from third-party payors for any of the Services included under this Agreement.
Appears in 2 contracts
Samples: Off Grid Doc, DPC Patient Agreement
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health insurance programsinsurance, HMO panels, or any other third-third party payor health plans, and cannot accept Medicare or Medicare-eligible patients as Members in this Direct Pay Practice. ThereforeAs such, neither the Patient nor the Practice may not bill xxxx or seek reimbursement from third-party payors for any of the above for the Services included provided by the Practice under this Agreement.
Appears in 1 contract
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health insurance programsplans, HMO panels, or any other third-third party payor health payer or government insurance plans. Therefore, the Practice may not bill or we shall neither submit bills nor seek reimbursement from third-party payors for any of the above for the Services included provided by the Practice under this Agreement.
Appears in 1 contract
Samples: Primary Care
Non-Participation in Insurance. The Patient understands that the Practice does not participate in any government-funded or private health insurance programsinsurance, HMO panels, or any other third-third party payor health plans. ThereforeAs such, the Practice may not bill xxxx or seek reimbursement from third-party payors for any of the Services included provided under this AgreementAgreement by the Practice. Neither can the Practice provide receipts for individual visits or services which are included in 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