Non-Participation in Insurance. You acknowledge the Patient’s understanding that neither the CLINIC, nor its Dentist, participate in any health insurance or HMO plans or panels and can not accept Medicare payments. We make no representations that any fees that You pay under this Agreement is covered by your health insurance or other third party payment plans. It is the Patient's responsibility to determine whether reimbursement is available from a private, non-governmental insurance plan and to submit any required billing on Your own.
Appears in 3 contracts
Samples: Dental Savings Plan Agreement Terms and Conditions, Dental Savings Plan Agreement Terms and Conditions, Dental Savings Plan Agreement Terms and Conditions
Non-Participation in Insurance. You acknowledge acknowledges the Patient’s understanding that neither the CLINIC, nor its Dentist, participate in any health insurance or HMO plans or panels and can can- not accept Medicare payments. We make no representations that any fees that You pay under this Agreement is are covered by your health insurance or other third party payment plans. It is the Patient's Pa- tient’s responsibility to determine whether reimbursement is available from a private, non-governmental gov- ernmental insurance plan and to submit any required billing on Your own.
Appears in 2 contracts
Samples: Dental Retainer Agreement, Dental Retainer Agreement
Non-Participation in Insurance. You acknowledge the Patient’s understanding The Patient understands and agrees that neither the CLINIC, nor its DentistPhysician, participate in any health insurance or HMO plans or panels and can cannot accept Medicare paymentseligible patients. We make no representations that any fees that You pay under this Agreement is are covered by your health insurance or other third party payment plans. It is the Patient's ’s responsibility to determine whether reimbursement is available from a private, non-governmental nongovernmental insurance plan and to submit any required billing on Your ownbilling.
Appears in 2 contracts
Samples: Patient Agreement, Patient Agreement
Non-Participation in Insurance. You acknowledge This acknowledges the Patient’s understanding that neither the CLINIC, nor its DentistProviders, participate in any health insurance or HMO plans or panels and can cannot accept xxxx Medicare payments. for eligible patients.We make no representations that any fees that You pay under this Agreement is are covered by your health insurance or other third party payment plans. It is the Patient's ’s responsibility to determine whether reimbursement is available from a private, non-governmental insurance plan and to submit any required billing on Your ownbilling.
Appears in 1 contract
Samples: static1.squarespace.com
Non-Participation in Insurance. You acknowledge the Patient’s understanding that neither the CLINIC, nor its Dentist, participate in any health insurance or HMO plans or panels and can not accept Medicare payments. We make no representations that any fees that You pay under this Agreement is covered by your health insurance or other third party payment plans. It is the Patient's responsibility to determine whether reimbursement is available from a private, non-governmental gov ernmental insurance plan and to submit any required billing on Your own.
Appears in 1 contract
Samples: Dental Savings Plan Agreement