Common use of Non-Participation in Insurance Clause in Contracts

Non-Participation in Insurance. You acknowledge that FCIM and its nurse practitioner do not participate in any health insurance or HMO plans or panels and has opted out of Medicare. Nothing herein or verbally discussed is to be construed as a representation that any fees due under this Agreement for anything are covered by your health insurance or other third-party payment plans applicable to you. You shall retain full and complete responsibility for any such determination. If you are eligible for Medicare, or during the term of the Agreement become eligible for Medicare, then you will sign the Agreement attached as Appendix 2 and incorporated by reference. This Agreement acknowledges your understanding that the nurse practitioner at FCIM has opted out of Medicare, and as a result, Medicare cannot be billed for any services performed for you by the NP. You agree not to xxxx Medicare or attempt Medicare reimbursement for any services whatsoever provided hereunder. You will renew and sign the Agreement in Appendix 2 yearly.

Appears in 5 contracts

Samples: Patient Agreement, Patient Agreement, Patient Agreement

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Non-Participation in Insurance. You acknowledge that FCIM and its nurse practitioner do not participate in any health insurance or HMO plans or panels and has opted out of Medicare. Nothing herein or verbally discussed is to be construed as a representation that any fees due under this Agreement for anything are covered by your health insurance or other third-party payment plans applicable to you. You shall retain full and complete responsibility for any such determination. If you are eligible for Medicare, or during the term of the Agreement become eligible for Medicare, then you will sign the Agreement attached as Appendix 2 and incorporated by reference. This Agreement acknowledges your understanding that the nurse practitioner at FCIM has opted out of Medicare, and as a result, Medicare cannot be billed for any services performed for you by the NP. You agree not to xxxx bill Medicare or attempt Medicare reimbursement for any services whatsoever provided hereunder. You will renew and sign the Agreement in Appendix 2 yearly.

Appears in 1 contract

Samples: Patient Agreement

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