Common Contracts
1 similar Billing Agreement contracts
WORKERS COMPENSATION INFORMATION & BILLING AGREEMENTBilling Agreement • February 8th, 2016
As a courtesy, Glover Physical Therapy & Pain Rehabilitation agrees to bill the above Worker’s C insurance carrier on my behalf. However, I understand that I am financially responsible for all physical therapy charges incurred. Furthermore, I understand that I am financially responsible for any collection / attorney fees that may be assessed to my account due to non-payment of these charges.
