Common Contracts

1 similar Patient Financial Policy & Agreement contracts

Contract
Patient Financial Policy & Agreement • November 9th, 2016

Please read and sign this agreement before we agree to accept assignment directly from your insurance company. This avoids any misunderstandings and facilitates the processing of your insurance claims. If you have any questions, please ask us. Hudson Family Dental is in network with: Delta Dental Premier, BlueCross Blue Shield & Cigna.

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