Common Contracts
1 similar Medicare Private Contract contracts
MEDICARE PRIVATE CONTRACTMedicare Private Contract • February 26th, 2024
This contract is entered into by and between Tom Sloan, M.D. (hereinafter called “physician”), whose principal medical office is located at 1120 Medical Plaza Dr, Suite 100, The Woodlands, TX 77380 and [insert name of Medicare beneficiary] (hereinafter called “beneficiary”), who resides at , and shall become effective on this day of , 20 and shall expire on the 1st day of January, 2015 (the “opt out period”), unless otherwise renewed in accordance with the 42 U.S.C. 1395a; 42 C.F.R. 405, Subpart D.
