Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees. 2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form #: BEN‐13580 Form_Revised 03/23/2009 529_0309 3. Physician acknowledges that (s)he will not execute this contract at a time when the patient is facing an emergency or urgent health care situation.
Appears in 11 contracts
Samples: Patient Agreement, Patient Agreement, Medicare Private Contract
Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees.
2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form #: BEN‐13580 Form_Revised 03/23/2009 529_0309.
3. Physician acknowledges that (s)he will not execute this contract at a time when the patient is facing an emergency or urgent health care situation.
Appears in 4 contracts
Samples: Patient Care Agreement, Patient Care Agreement, Patient Agreement
Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees.
2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form #: BEN‐13580 Form_Revised 03/23/2009 529_0309.
3. Physician acknowledges that (s)he will not execute this contract at a time when the patient Patient is facing an emergency or urgent health care situation.
Appears in 3 contracts
Samples: Patient Agreement, Private Contract, Medicare Private Contract
Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees.
2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form #: BEN‐13580 Form_Revised 03/23/2009 529_0309.
3. Physician acknowledges that (s)he will not execute this contract at a time when the patient "Patient" is facing an emergency or urgent health care situation.
Appears in 1 contract
Samples: Patient Agreement
Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees.
2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form of2 Form#: BEN‐13580 BEN-13580 Form_Revised 03/23/2009 529_030903/23/2009
3. Physician acknowledges that (s)he will not execute this contract at a time when the patient is facing an emergency or urgent health care situation.
Appears in 1 contract
Samples: Medicare Private Contract
Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees.
2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form #: BEN‐13580 Form_Revised 03/23/2009 529_0309.
3. Physician acknowledges that (s)he will not execute this contract at a time when the patient is facing an emergency or urgent health care situation.
Appears in 1 contract
Samples: Medicare Private Contract
Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees.
2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form #: BEN‐13580 Form_Revised 03/23/2009 529_0309.
3. Physician acknowledges that (s)he s) he will not execute this contract at a time when the patient Patient is facing an emergency or urgent health care situation.
Appears in 1 contract
Samples: Medicare Private Contract
Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees.
2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form #: BEN‐13580 Form_Revised 03/23/2009 529_0309.
3. Physician acknowledges that (s)he will not execute this contract at a time when the patient "Member" is facing an emergency or urgent health care situation.
Appears in 1 contract
Samples: Member Access Agreement
Obligations of Physician. 1. Physician agrees to provide such treatment as may be mutually agreed upon by the parties and at mutually agreed upon fees.
2. Physician agrees not to submit any claims under the Medicare program for any items or services even if such items or services are otherwise covered by Medicare. National Government Services, Inc. Page: 1 of 2 Form #: BEN‐13580 Form_Revised 03/23/2009 529_0309.
3. Physician acknowledges that (s)he he will not execute this contract at a time when the patient Patient is facing an emergency or urgent health care situation.
Appears in 1 contract
Samples: Direct Primary Care Member Agreement