Common Contracts
1 similar Financial Responsibility Agreement contracts
Patient Financial Responsibility AgreementFinancial Responsibility Agreement • November 4th, 2019
It is in your best interest, as a patient, to know and understand your insurance plan benefits and your responsibility for any deductibles, co-insurance, or co-payment amounts prior to any visit. Not all services are covered in all insurance contracts. In addition, you should be sure that TWC is listed as a participating provider by your insurance company. If your insurance plan does not cover a service or procedure, you are responsible for payment of these charges. If your insurance is not valid, or your coverage is not active at the time the services are rendered; you will be solely responsible for the full amount of your office visit and/or any procedures rendered. In addition, if your insurance plan
