Common Contracts
1 similar Patient Policy Agreement contracts
Still Waters Mental Health Services, LLC Bradley J. Shaw, CRNP, FNP-C, PMHNP-BCPatient Policy Agreement • May 21st, 2020
We bill participating insurance companies as a courtesy to you. Services are provided with the understanding that you (not an insurance company) are ultimately responsible for the cost of the services that you are scheduling. Insurance plans vary and not all services may be covered. You are responsible for knowing what services are covered by your particular plan, please check with your plan by calling the number on the back of your card before your appointment. If you need a prior authorization for services, this must be completed before you are scheduled. If you fail to obtain authorization, any and all charges incurred and not reimbursed, will be your financial responsibility.
