Financial Policy and Payment Agreement Sample Contracts

FINANCIAL POLICY AND PAYMENT AGREEMENT
Financial Policy and Payment Agreement • November 15th, 2013

Thank you for choosing our practice! First and foremost we are committed to the success of your medical treatment and plan of care. Please understand that payment of your bill is part of this treatment and care. Please read below to help understand our financial payment policy.

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LAKE OSWEGO FAMILY DENTISTRY, LLC FINANCIAL POLICY and PAYMENT AGREEMENT
Financial Policy and Payment Agreement • August 8th, 2023
Financial Policy and Payment Agreement
Financial Policy and Payment Agreement • June 1st, 2012

The best medical care can be provided only on the basis of mutual understanding. We encourage you to contact our billing office with any questions regarding filing of insurance claims and your financial obligation to Concord Otolaryngology and/or Alliance Audiology, LLC. Following are our general financial policies. This this is not an all-inclusive list. You may contact our billing office for special concerns.

Alliance Hearing Aids LLC
Financial Policy and Payment Agreement • August 22nd, 2021
LAKE OSWEGO FAMILY DENTISTRY, LLC FINANCIAL POLICY and PAYMENT AGREEMENT
Financial Policy and Payment Agreement • January 28th, 2014
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