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Protection Disclaimer: “A statement of benefits or authorizations that may not confirm the installment or guarantee eligibility.

The inclusion of benefits is responsible for all terms, conditions, restrictions, and avoidance of the partial agreement.
period of administration. ”

Payment Protection Protection: Your medical organization will automatically compensate the management you decide to
“rational and important.” All work will be done by this office to have all the management and strategies
pre-approved by your healthcare organization, if applicable. In case your health organization decides
that certain services are unreasonable and important, or that certain services are not included in this program,
your backup plan will reject the installment of that service. We recommend to all patients to touch their protection
ensure that these management systems are covered.

Under this plan, you are responsible for paying your co-pay, any unpaid portions, and any
deductions still do not appear to cover it. In addition, if your insurance agency does not pay our administration, you agree
to pay for services provided on our site.

Recipient Agreement: I understand that my health care organization may reject a management plan
separated above, for the reasons given. Considering that my medical organization denies the installment, I agree that it should be so
in addition you are liable to pay the installment. I also find that when I think that my healthcare organization is making a statement
administrative, I will be liable for any joint installment, deduction, or applicable insurance.

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