Financial and Office Policies Sample Contracts

Comprehensive OB/GYN Financial and Office Policies
Financial and Office Policies • April 9th, 2020

Self-Pay Patients: All self-pay patients are required to pay at the time the services are rendered unless prior payment arrangements have been made.

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Southwest Cardiothoracic Surgeons Financial and Office Policies‌‌‌‌‌‌‌‌‌‌‌
Financial and Office Policies • September 5th, 2013

Filing Claims: Please be sure you inform us of any updates or changes to your insurance, so we have your current information. If we do not have current information this will delay payment and possibly cause you to have unexpected expenses. You will be asked to completely fill out a new information profile every year. These profiles expire one year after being signed.

Financial and Office Policies
Financial and Office Policies • September 11th, 2021

This is an agreement between Santaella Surgical Services, North Star Texas Surgical/Creditor and the Patient/Debtor named on this form. In this agreement the words “you”, “your”, and “yours” mean the Patient/Debtor. The word “account” means the account that has been established in your name to which charges are made and payments credited. The words “we”, “us” and “our” refer to

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