Common Contracts
1 similar Financial Policy and Patient Agreement contracts
FINANCIAL POLICY AND PATIENT AGREEMENTFinancial Policy and Patient Agreement • February 16th, 2022
Any co-payments specified by your insurance company must be paid at the time of service, as is stated by your insurance company and can not be billed at a later date. Acceptable forms of payment are cash, personal check, money order, credit card, or CareCredit. You will also be responsible for payment of any charges that your insurance company applies towards your deductible and will be billed accordingly. Our office will call your insurance company and attempt to obtain your benefit and eligibility information prior to your appointment; however, we are not always given accurate information.
