Common Contracts
1 similar Patient Responsibility Agreement contracts
Patient Responsibility AgreementPatient Responsibility Agreement • October 6th, 2023
If you have both Medicaid and a commercial insurance, the total cost of your treatment will be covered. If you do not have Medicaid, you will be responsible to pay for the cost of your services. If you are insured with a Health Maintenance Organization (HMO), you will need a referral prior to receiving services. If you fail to obtain a referral, you will be charged the full cost of services.
