Participation in Insurance. The Practice does not participate with any health plans, HMO panels, or any other third-party payor. As such, we may not submit bills or seek reimbursement from any third-party payors for the Services provided under this Agreement. Medicare/Medicaid. The Patient understands that Xx. Xxxx is opted out of Medicare/Medicaid. As a result, both the Patient and the Practice shall be prohibited by law from seeking reimbursement from Medicare/Medicaid for any Services provided under this Agreement. Accordingly, the Patient agrees not to submit bills or seek reimbursement from Medicare/Medicaid for any such services. Furthermore, if the Patient is eligible or becomes eligible for Medicare/Medicaid during the term of this Agreement, the Patient agrees to immediately inform the Practice and sign the Medicare/Medicaid private contract as provided and required by law. Xx. Xxxx will not be responsible for paperwork relating to coverage of products and services provided outside of the Practice. This Agreement Is Not Health Insurance. The Patient has been advised and understands that this Agreement is not an insurance plan. It does not replace any health coverage that the Patient may have, and it does not fulfill the requirements of any federal health coverage mandate. This Agreement does not include hospital services, emergency room treatment, or any services not personally provided by the Practice or its staff. This Agreement includes only those Services identified in Exhibit A. If a Service is not specifically listed in Appendix A, it is expressly excluded from this Agreement. The Patient acknowledges that We have advised them to obtain health insurance that will cover catastrophic care and other services not included in this Agreement. Patients are always personally responsible for the payment of any medical expenses incurred for services not included under this Agreement.
Participation in Insurance. Patient acknowledges that Physician participates in limited health care coverage plans (Medicare Part B only). Fees paid under this Agreement are not covered by any third-party health plan applicable to the Patient. The Patient shall retain full and complete responsibility for any such determination. If the Patient loses Medicare coverage during the term of this Agreement, membership will automatically be redirected to the Direct Primary Care Agreement upheld by Practice on the effective date of Patient’s Medicare coverage deactivation.
Participation in Insurance. Employer understands and agrees that neither the Practice, nor its Providers participate in with any health insurance plan, HMO plan, or other third-party payors. Accordingly, the Practice shall not bill or seek reimbursement from any of the above or provide individual, fee-for-service invoices for any services included under this Agreement.
Participation in Insurance. Patient acknowledges that Xxxxx Xxx Khan M.D. INC. participates in limited health insurance plans. Fees paid under this Agreement are not covered by your health insurance or other third party payment plans applicable to the Patient. The Patient shall retain full and complete responsibility for any such determination.
Participation in Insurance. Patient acknowledges and agrees that neither Legacy Advanced Health, nor any of its providers participate in any health insurance or HMO plans or panels; however, we have recently applied to become a Medicare provider. This is to notify that we will not accept members into a Direct Patient Care membership plan is they have Medicare. WE DO NOT XXXX MEDICARE IF YOU ARE PAYING A DIRECT PATIENT CARE MEMBERSHIP. Neither Legacy Advanced Health, nor any of its providers, make any representations whatsoever that any fees paid under this Agreement are covered by your health insurance or other third-party payment plans applicable to the Patient and that Patient shall retain full and complete responsibility for making any such determination. If Patient is eligible for Medicare, or, during the term of this Agreement Patient becomes eligible for Medicare, then Patient hereby agrees and acknowledges that Patient shall promptly inform Legacy Advanced Health of such event in writing and promptly sign the acknowledgement attached hereto as whereby Patient acknowledges Patient’s understanding that Legacy Advanced Health WILL PROMPTLY REMOVED MEDICARE PARTICIPANT FROM OUR MEMBERSHIP PLAN AND WE WILL NOT XXXX MEDICARE, and as a result, Medicare cannot be billed for any Services performed by Legacy Advanced Health WHILE LISTED AS A DIRECT PATIENT CARE MEMBERSHIP RECIPIENT. Patient agrees that it shall not xxxx Medicare or attempt Medicare reimbursement for any such Services provided by Legacy Advanced Health PRIOR TO NOTIFYING LEGACY ADVANCED HEALTH IN WRITING OR WHILE PAYING A
Participation in Insurance. Patient acknowledges that Xxxxxxx Total Healthcare. participates in limited health insurance plans. Fees paid under this Agreement are not covered by your health insurance or other third party payment plans applicable to the Patient. The Patient shall retain full and complete responsibility for any such determination.
Participation in Insurance. Patient acknowledges that neither HFM nor the Physician participate in any health insurance or HMO plans or panels and has opted out of Medicare. Neither of the above make any representations whatsoever that any fees paid under this Agreement are covered by your health insurance or other third party payment plans applicable to the Patient. The Patient shall retain full and complete responsibility for any such determination. If the Patient is eligible for Medicare, or during the term of this Agreement becomes eligible for Medicare, then Patient will sign an agreement, attached as Appendix 2, and incorporated by reference. This agreement acknowledges your understanding that the Physician has opted out of Medicare, and as a result, Medicare cannot be billed for any services performed for you by the Physician. You agree not to xxxx Medicare or attempt Medicare reimbursement for any such services. Patient shall renew and sign the agreement in Appendix 2 annually. Insurance or Other Medical Coverage. Patient acknowledges and understands that this Agreement is not an insurance plan, and not a substitute for health insurance or other health plan coverage (such as membership in an HMO). It will not cover hospital services, or any services not personally provided by HFM, or its Physician. Patient acknowledges that HFM has advised that patient obtain or keep in full force such health insurance policy(ies) or plans that will cover Patient for general healthcare costs. Patient acknowledges that this Agreement is not a contract that provides health insurance, and this Agreement is not intended to replace any existing or future health insurance or health plan coverage that Patient may carry.
Participation in Insurance. Patient acknowledges that concierge services may not be billed to health insurance.
Participation in Insurance. An employee drawing Plan benefits, who was a participant in the group life insurance plan at the commencement of his disability, will continue to enjoy group life insurance coverage at no cost to him based on the earnings used to establish the amount of his Modifications to Insurance
Participation in Insurance. Patient acknowledges that OneMed, and the Physician do participate in health insurance panels and has not opted out of Medicare as this is a hybrid concierge practice. In instances where, OneMed, is not paneled by a health insurance carrier, OneMed will proceed to xxxx your health insurance carrier as an out of network provider. Patient agrees that if no out of network benefit exists on health plan, self pay rates will apply to all other services not covered by the membership. Neither of the above make any representations whatsoever that any fees paid under this Agreement are covered by your health insurance or other third party payment plans applicable to the Patient. The Patient shall retain full and complete responsibility for any such determination. The Patient understands that the Services provided under this Agreement are not covered by any insurance, private or public and further agrees that they will not independently attempt to submit any bills for these services to their insurance carriers, public or private. The Patient understands that medical care that is not covered by this Agreement will be billed to their insurance in the usual and customary fashion. The Patient understands that any co-pays, deductibles, etc. will be collected for the services provided under insurance coverage.
