Insured Patients Sample Clauses

Insured Patients. All co-pays and deductibles are due at the time of your office visit. As a courtesy, we will bill your primary and secondary insurance for you. However, insurance coverage is an agreement between you and your insurance company for payment of medical services. You are responsible for understanding your coverage benefits. It is your responsibility to call your insurance company before your first appointment with us to verify that Xx. Xxxxxx is an “in-network” provider under your insurance plan, and to verify how much your co-pay or deductible is for a “primary care office visit.” It is also your responsibility to assure that we have your most updated insurance information on file. You are responsible for paying for your co-pay, deductibles, and ANY BALANCE DUE after your insurance has been billed and has paid their part. Please contact our office before your appointment if you need assistance verifying your insurance benefits at 000-000-0000 or xxxx@xxxxxxxxxxxxxxxxxxx.xxx. Initials___________
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Insured Patients. If you are insured you must indicate your insurance details on your Agreement to Pay Form, retaining one copy only for your records. You should note that being insured does not mitigate your liability as an individual to pay for any and all treatment given by the Trust should your insurer, for whatever reason, not agree to reimburse the Trust in respect of any and all charges levied by the Trust for your care. You should check with your insurer that the policy you hold with your insurer covers you for the treatment that you require. Some insurance companies will provide you with an authorisation number for each episode of treatment, which you should indicate on the Agreement to Pay Form. Where you are covered by an insurer, the Trust will expect that you pay any and all charges not covered by your policy and/or which your insurer refuses to pay for within 14 days of the date of the Trust’s invoice. Non-insured Patients If you have elected to pay for the treatment yourself then you must indicate this on the Agreement to Pay Form. Methods of Payment Paying by cheque: Cheques should be made payable to ‘Salisbury NHS Foundation Trust’ and crossed account payee only. You should send your cheque in the envelope with your Agreement to Pay Form. Paying by debit/credit card: Debit/credit card payments should be made to Parkside xxxx by phone or through personal visit. Please ensure that you have your card details available including the card company, card number, card expiry date, security code and the full name and address of the person listed on the card.
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Insured Patients. 4.1.1. Direct Settlement by Insurance Companies You should check with your insurer that you have adequate cover. We will try to help you do this, but only your insurer can confirm that your cover is adequate. The credit/debit card details you have supplied to us under clause 4 will be used for any shortfall and/or outstanding balances as in paragraph 4. If your insurance company operates a direct settlement scheme, we will send your account and claim form to the insurance company for payment on your behalf. So that we can do this, you will need to obtain pre-authorisation in advance for tests and treatment that you are to receive. You will also need to provide us with a valid authorisation code prior to your admission. If your insurance company does not pay the account in full within 30 days from the date you were discharged, any outstanding balances will be notified to you by letter. You will have 10 days from the date of our letter to query this outstanding payment before your credit/debit card is debited with the outstanding balance. A receipt will be provided on request.
Sample 1
Insured Patients. Payment for fees not covered by insurance is due within 10 days after we receive the insurance payment. Your insurance company will first send you an Explanation of Benefits, so you will know what the insurance payment and your portion will be. I authorize the Doctor and staff to perform any and all forms of treatment, medication and therapy that may be indicated in connection with me or my dependents’ treatment. I understand that I may be charged a $30 fee if I fail to cancel an appointment without 24 hour notice. I understand credit bureau reports may be obtained. In the event of default, I agree to pay a 30% collection fee on any outstanding balance; in addition to interest, court costs, and reasonable attorney fees. Please sign below stating you have read the above information and understand the payment options. Print Patient Name Patient Signature (or parent/guardian if patient is a minor) Date: / /
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Insured Patients. We have contractual agreements with many insurance health plans to accept an assignment of benefits. This means that we will bill those plans for which we have an agreement and will require you to pay the authorized co-payment, co-insurance or deductible amount due per your insurance’s Explanation of Benefits. You could be billed for any remaining amount after the services are rendered. If you have insurance coverage with a plan we do not have a contractual agreement with, the charges for your care and treatment are due at the time of service. In the event that your health plan determines a service to be “non-covered” or out-of-network you will be responsible for the negotiated rate for the services performed. If you have an insurance that requires you to select a Primary Care Provider/Manager (PCP or PCM), you will need to contact your insurance prior to your visit to ensure that a TotalCare physician is assigned to your policy. If you do not have a TotalCare physician selected as your PCP/PCM, you will be considered non-insured.
Sample 1
Insured Patients. It is TotalCare’s policy that you must present your insurance card at each visit. We have contractual agreements with many insurance health plans to accept an assignment of benefits. This means that we will bill those plans for which we have an agreement and will only require you to pay the authorized co-payment, coinsurance or deductible amount due per your insurance’s Explanation of Benefits. You could be billed for any remaining amount after the services are rendered. If you have insurance coverage with a plan we do not have a contractual agreement with, the charges for your care and treatment are due at the time of services. In the event that your health plan determines a service to be “non-covered” or out of network you will be responsible for the negotiated rate for the services performed. If you have insurance that requires you to select a Primary Care Provider/Manager (PCP or PCM), you will need to contact your insurance prior to your visit to ensure that a TotalCare physician is assigned to your policy. If you do not have a TotalCare physician selected as your PCP/PCM before your appointment, you will be considered uninsured.
Sample 1
Insured Patients. Patients must authorise Veincentre to submit claims relating to their insurer on their behalf and permit us to send necessary clinical details relating to their assessments and treatment onto them in order to receive appropriate authorisation and payment. Clinical Audit Veincentre is required to audit clinical records for quality assurance reasons, which may include your health records. Your data will be treated strictly in line with National CQC standards and will be subject to confidentiality according to the Data Protection Act.
Sample 1
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Related to Insured Patients

  • Self-insured programs and self-insured retentions Approval. Any self-insurance program, or self-insured retention must be approved separately in writing by the District's Risk Manager and shall protect the District, its Board of Trustees, and their officials, employees, volunteers, and agents in the same manner and to the same extent as they would have been protected had the policy or policies not contained such self-insurance or self- insured retention provisions.

  • Medical Insurance Upon termination of employment, the Executive shall be entitled to all COBRA continuation benefits available under the Company's group health plans to similarly situated employees. To the extent permitted under Code Section 409A, during the applicable Payout Period, the Company shall provide such COBRA continuation benefits to the Executive at the active employee rates similarly situated employees must pay for such benefits. Upon the expiration of such Payout Period, the Executive will be responsible for paying the full COBRA premiums for the remaining COBRA continuation period.

  • Basic Medical Insurance All regular Employees may choose to be covered by the medical plan for which the British Columbia Medical Plan is the licensed carrier. Benefits and premiums shall be in accordance with the existing policy of the plan. The Employer will pay one hundred percent (100%) of the regular premium.

  • Deductibles and Self-Insured Retention Any deductible or self-insured retention that apply to any insurance required by this Agreement must be declared and approved by COUNTY.

  • Deductibles and Self-Insured Retentions Any deductibles or self-insured retentions must be declared to, and approved by CITY's Risk Manager. At the option of CITY, either; the insurer shall reduce or eliminate such deductibles or self-insured retentions as respects CITY, its officer, employees, agents and contractors; or GRANTEE shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses in an amount specified by the CITY's Risk Manager.

  • Self-Insured Retentions Self-insured retentions must be declared to and approved by City. City may require Contractor to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self- insured retention may be satisfied by either the named insured or City.

  • Optical Insurance The Employer shall contribute the full composite premium cost for an optical insurance plan policy premium for each SUCCESS employee deemed eligible (e.g. Vision Service Plan). Participation in the optical insurance benefit is voluntary for each eligible SUCCESS employee. In order to qualify for the Employer’s share of the monthly premium, the SUCCESS employee must qualify under the rules and regulations of the respective carrier and may enroll in one of the following plans:

  • Product Coverage This Agreement shall apply to all manufactured products, - including capital goods, processed agricultural products, and those products failing outside the definition of agricultural products as set out in this Agreement. Agricultural products shall be excluded from the CEPT Scheme.

  • Policy Deductibles and/or Self-Insured Retentions The policies set forth in these requirements may provide coverage that contains deductibles or self- insured retention amounts. Such deductibles or self-insured retention shall not be applicable with respect to the policy limits provided to the City. Consultant shall be solely responsible for any such deductible or self-insured retention amount.

  • Self-Insured Retention/Deductibles Certificates of Insurance must indicate the applicable deductibles/self-insured retentions for each listed policy. Deductibles or self-insured retentions above $100,000.00 are subject to approval from OGS. Such approval shall not be unreasonably withheld, conditioned or delayed. The Contractor shall be solely responsible for all claim expenses and loss payments within the deductibles or self-insured retentions. If the Contractor is providing the required insurance through self-insurance, evidence of the financial capacity to support the self-insurance program along with a description of that program, including, but not limited to, information regarding the use of a third-party administrator shall be provided upon request.

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