Common use of Private Payment Clause in Contracts

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay rate for room and board is $595.00 per day for a semi-private room and $610.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Margaret Tietz

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Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 570.00 per day for a private room and $545.00 per day for a semi-private room and $610.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 520.00 per day for a semi-private room and $610.00 530.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 550.00 per day for a semi-private room and $610.00 590.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 660.00 per day for a semi-private room and $610.00 670.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Nursing And

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 610.00 per day for a semi-private room and $610.00 620.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Nursing And

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 470.00 per day and $445.00 per day for a semi-private room and $610.00 per day for a private room room. In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay rate for room and board is $595.00 545.00 per day for a semi-private room and $610.00 560.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Margaret Tietz

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 570.00 per day for a semi-private room and $610.00 580.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $620.00 per day for a private room and $595.00 per day for a semi-private room and $610.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay rate for room and board is $595.00 545.00 per day for a semi-private room and $610.00 560.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Margaret Tietz

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 600.00 per day for a semi-private room and $610.00 635.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 545.00 per day for a semi-private room and $610.00 570.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 550.00 per day for a semi-private room and $610.00 590.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

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Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 680.00 per day for a semi-private room and $610.00 690.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay rate for room and board is $595.00 455.00 per day for a semi-private room and $610.00 485.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 610.00 per day for a semi-private room and $610.00 620.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Nursing and Rehabilitation Center

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 570.00 per day for a private room and $545.00 per day for a semi-private room and $610.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay rate for room and board is $595.00 per day for a semi-private room and $610.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Margaret Tietz

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay rate for room and board is $595.00 370.00 per day for a semi-private room and $610.00 410.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 580.00 per day for a semi-private room and $610.00 590.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 630.00 per day for a semi-private room and $610.00 640.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill xxxx by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

Private Payment. If the Resident is paying privately for the cost of his or her care, and part or all of such payment is not covered by a third party payor, the private pay room rate for room and board is $595.00 545.00 per day for a semi-private room and $610.00 570.00 per day for a private room In addition, the Resident will be billed for ancillary services including, but not limited to, urinary care supplies, trach and ostomy supplies, surgical supplies, parenteral and enteral feeding supplies, occupational, speech and physical therapy, physician services, prescription medications, laboratory tests, x-rays and other diagnostic services, ambulance/ambulette services, beauty and xxxxxx services, and newspaper delivery and extraordinary rehabilitative devices according to the Facility’s and/or the service providers’ charge schedules. However, rates of payment to the Facility may differ for individuals with additional sources of payment such as Medicare, Medicaid and third-party insurance. A copy of the Facility charge schedule for ancillary services is attached to this Agreement and included in your admission package. Payment must be made to the Facility upon receipt of the bill by the Resident, Designated Representative and/or Sponsor. The private pay room and board rate and additional services charges are subject to increase upon thirty (30) days written notice to the Resident, Designated Representative and/or Sponsor.

Appears in 1 contract

Samples: Admission Agreement

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