INSURANCE PAYMENT RIDERInsurance Payment Rider • November 1st, 2020 • California
Contract Type FiledNovember 1st, 2020 JurisdictionThis Insurance Payment Rider is entered into by and between Newport-Mesa Audiology, Inc., (hereinafter referred to as Facility) and you, the Patient (hereinafter referred to as Patient) or Patient’s legal guardian with respect to the following: