Obligations of Beneficiary. 1. Beneficiary or his/her legal representative agrees to be fully responsible for payment of all items or services furnished by Psychologist and understand that no reimbursement will be provided under the Medicare program for such items or services.
2. Beneficiary or his/her legal representative acknowledges and understands that no limits under the Medicare program (including the limits under section 1848 (g) of the Social Security Act) apply to amounts that may be charged by Psychologist for such items or services.
3. Beneficiary or his/her legal representative agrees not to submit a claim to Medicare and further agrees not to ask Psychologist to submit a claim to Medicare.
4. Beneficiary or his/her legal representative understands that Medicare payment will not be made for any items or services furnished by Psychologist that would have otherwise been covered by Medicare if there were no private contract and a proper Medicare claim had been submitted.
5. Beneficiary or his/her legal representative enters into this contract with the knowledge and understanding that he/she has the right to obtain Medicare-covered items and services from psychologists and practitioners who have not opted out of Medicare, and that the Beneficiary is not compelled to enter into private contracts that apply to other Medicare-covered services furnished by other psychologists or practitioners who have not opted out of Medicare.
6. Beneficiary or his/her legal representative understands that Medigap plans (under section 1882 of the Social Security Act) do NOT, and other supplemental insurance plans may elect not to, make payments for such items and services not paid for by Medicare.
7. Beneficiary or his/her legal representative acknowledges that the Centers for Medicare and Medicaid Services (CMS) has the right to obtain copies of this contract upon request.
Obligations of Beneficiary. This Agreement constitutes the valid and binding obligations of the beneficiary, enforceable in accordance with its terms.
Obligations of Beneficiary. Beneficiary or his/her legal representative accept full responsibility for payment of all items or services furnished by Xx. Xxxx. Beneficiary or his/her legal representative understands that Medicare limits do not apply to what Xx. Xxxx may charge for items or services furnished. Beneficiary or his/her legal representative agrees not to submit a claim to Medicare or to ask Xx. Xxxx to submit a claim to Medicare. Beneficiary or his/her legal representative understands that Medicare payment will not be made for any items or services furnished by Xx. Xxxx that would have otherwise been covered by Medicare if there was no private contract and a proper Medicare claim had been submitted. Beneficiary or his/her legal representative enters into this contract with the knowledge and understanding that he/she has the right to obtain Medicare-covered items and services from physicians and practitioners who have not opted out of Medicare, and that the Beneficiary is not compelled to enter into private contracts that apply to other Medicare-covered services furnished by other physicians or practitioners who have not opted out of Medicare. Beneficiary or his/her legal representative understands that Medigap plans do not, and other supplemental plans may elect not to, make payments for such items and services not paid for by Medicare. The beneficiary or her/her legal representative will receive or have received a copy (a photocopy is permissible) of this contract, before items or services are furnished under the terms of this contract.
Obligations of Beneficiary. Beneficiary shall have no obligation or incur any liability with respect to the erection or completion of the improvements in which the Premises are located or for completion of the Premises or any improvements for Tenant’s use and occupancy. Anything herein or in the Lease to the contrary notwithstanding, no successor owner of the Property shall have any obligation, or incur any liability, beyond the then existing interest, if any, of the Purchaser in the Property and Tenant shall look exclusively to such interest of the Purchaser, if any, in the Property for the payment and discharge of any obligations imposed upon the Purchaser hereunder or under the Lease, and the Purchaser is hereby released and relieved of any other liability hereunder and under the Lease. As regards the Purchaser, Tenant shall look solely to the estate or interest owned by the Purchaser in the Property and Tenant will not collect or attempt to collect any such judgment out of any other assets of the Purchaser. Nothing contained in this Section impairs, limits or otherwise modifies the obligations of Landlord to Tenant under the Lease.
Obligations of Beneficiary. Beneficiary (or h/her legal representative) agrees to be fully responsible for payment of all items or services furnished by Xx. Xxxxx and understands that no reimbursement will be provided under the Medicare program for such items or services.
Obligations of Beneficiary. Beneficiary or his/her legal representative agrees to be fully responsible for payment of all items or services furnished by Mental Health Provider and understand that no reimbursement will be provided under the Medicare program for such items or services.
Obligations of Beneficiary. Beneficiary or his/her legal representative agrees not to submit a claim for payment to Medicare and further agrees not to ask Mental Health Provider to submit a claim for payment to Medicare.
Obligations of Beneficiary. This section states that you are responsible for payment to me and that Medicare is not responsible for payment. It repeats that you (or your legal representative) will not send my bill to Medicare and that your other insurance company may or may not reimburse you for my services.
Obligations of Beneficiary. Beneficiary or his/her legal representative agrees to be fully responsible for payment of all items or services furnished by Physician and understand that no reimbursement will be provided under the Medicare program for such items or services.
Obligations of Beneficiary. By acceptance hereof, Beneficiary agrees:
a. To notify Business Associate of any restriction, or change in any restriction, to the use or disclosure of Protected Health Information that Beneficiary has agreed to in accordance with 45 C.F.R. § 164.522, to the extent that such restriction may affect Business Associate’s use or disclosure of PHI.
b. To notify Business Associate of any limitation(s) in its notice of privacy practices in accordance with 45 C.F.R. § 164.520, to the extent that such limitation may affect Business Associate’s use or disclosure of PHI.
c. Not to request Business Associate to use or disclose PHI in any manner that would not be permissible under the HIPAA Rules if done by Beneficiary.
