Billing / Assignment of Benefits Agreement Sample Contracts

BILLING / ASSIGNMENT OF BENEFITS AGREEMENT
Billing / Assignment of Benefits Agreement • August 16th, 2016

Thank you for choosing to be treated at National Pain Institute. Our office is happy to file all insurance, as we are members of numerous medical plans. Our billing service will provide monthly statements with updated account status. A balance may exist if:

Sample 1
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BILLING / ASSIGNMENT OF BENEFITS AGREEMENT
Billing / Assignment of Benefits Agreement • August 16th, 2016

Thank you for choosing to be treated at The Pain Management Center. Our office is happy to file all insurance, as we are members of numerous medical plans. Our billing service will provide monthly statements with updated account status. A balance may exist if:

Sample 1
BILLING / ASSIGNMENT OF BENEFITS AGREEMENT
Billing / Assignment of Benefits Agreement • June 2nd, 2016

Thank you for choosing to be treated at Advanced Interventional Pain Clinic. Our office is happy to file all insurance, as we are members of numerous medical plans. Our billing service will provide monthly statements with updated account status. A balance may exist if:

Sample 1
BILLING / ASSIGNMENT OF BENEFITS AGREEMENT
Billing / Assignment of Benefits Agreement • May 18th, 2017

Thank you for choosing to be treated at Florida Pain and Rehabilitation Center. Our office is happy to file all insurance, as we are members of numerous medical plans. Our billing service will provide monthly statements with updated account status. A balance may exist if:

Sample 1
Contract
Billing / Assignment of Benefits Agreement • November 7th, 2019
Sample 1
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