PAYMENT OF SERVICES definition
Examples of PAYMENT OF SERVICES in a sentence
LIMITATION ON COUNTY’S FINANCIAL RESPONSIBILITY FOR PAYMENT OF SERVICES UNDER TITLE XIX ▇▇▇▇▇-▇▇▇▇▇/MEDI-CAL SERVICES, MEDI-CAL ADMINISTRATIVE ACTIVITIES AND/OR TITLE XXI MEDICAID CHILDREN’S HEALTH INSURANCE PROGRAM 15 M.
LIMITATION ON COUNTY’S FINANCIAL RESPONSIBILITY FOR PAYMENT OF SERVICES UNDER TITLE XIX ▇▇▇▇▇-▇▇▇▇▇/MEDI-CAL SERVICES, AND/OR TITLE XXI MEDICAID CHILDREN’S HEALTH INSURANCE PROGRAM 14 L.
I UNDERSTAND THAT I AM RESPONSIBLE FOR PAYMENT OF SERVICES RENDERED WHICH ARE NOT BENEFITS OF MY INSURANCE AND RESPONSIBLE FOR PAYING ANY CO-PAYMENT AND DEDUCTIBLE AMOUNTS THAT MY (Initial) SUPERVISION (FOR CHILDREN YOUNGER THAN 14 YEARS OLD) I acknowledge that I am responsible for the supervision and safety of my child.
LIMITATION ON COUNTY’S FINANCIAL RESPONSIBILITY FOR PAYMENT OF SERVICES UNDER TITLE XIX ▇▇▇▇▇-▇▇▇▇▇/MEDI-CAL SERVICES, AND/OR TITLE XXI MEDICAID CHILDREN’S HEALTH INSURANCE PROGRAM 16 M.
I UNDERSTAND THAT I AM RESPONSIBLE FOR PAYMENT OF SERVICES RENDERED WHICH ARE NOT BENEFITS OF MY INSURANCE AND RESPONSIBLE FOR PAYING ANY CO-PAYMENT AND DEDUCTIBLE AMOUNTS (Initial) PAYMENT In order to streamline billing and minimize the possibility of financial matters intruding on the therapeutic relationship, I agree to place a currently valid credit card on file with HCP and authorize HCP to make appropriate charges on that card for services rendered on or shortly after the date of service.
YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE RECEIVED THE HIPAA NOTICE, THAT YOU GIVE YOUR PERMISSION TO HAVE INSURANCE CLAIMS SUBMITTED FOR SERVICES RENDERED TO YOU FOR THE PURPOSE OF SEEKING REIMBURSEMENT, AND THAT YOU HAVE READ THE THERAPIST-CLIENT SERVICES AGREEMENT AND CONSENT TO ITS TERMS (INCLUDING RESPONSIBILITY FOR PAYMENT OF SERVICES).
Each Re-Submit will be Charge $10 PAYMENT OF SERVICES: Payment must be made before any ISF filing will be performed by ▇▇▇▇▇▇▇.▇▇▇ / ▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇.
LIMITATION ON COUNTY’S FINANCIAL RESPONSIBILITY FOR PAYMENT OF SERVICES UNDER TITLE XIX ▇▇▇▇▇-▇▇▇▇▇/MEDI-CAL SERVICES, AND/OR TITLE XXI MEDICAID CHILDREN’S HEALTH INSURANCE PROGRAM 15 L.