Common Contracts
1 similar Patient Financial Agreement contracts
ContractPatient Financial Agreement • October 17th, 2021
Patient Financial Agreement Thank you for choosing PRIME MD OF NAPLES as your health care provider. We are committed to building a successful physician- patient relationship with you and your family. Your clear understanding of our Patient Financial Policy is important to our professional relationship. Please understand that payment for services is a part of that relationship. Please ask if you have any questions about our fees, our policies, or your responsibilities. It is your responsibility to notify our office of any patient information changes (i.e., address, name, insurance information, etc). Co-pays The patient is expected to present an insurance card at each visit. All co-payments and past due balances are due at time of check-in unless previous arrangements have been made with a billing coordinator. We accept cash, check or credit cards. Absolutely no post- dated checks will be accepted. Insurance Claims Insurance is a contract between you and your insurance company. In mos
