Common use of Billing and Collection Services Clause in Contracts

Billing and Collection Services. OSMI and Provider acknowledge that billing and collection shall be the sole responsibility of OSMI. Billing and collection will be the responsibility of OSMI, such billing and collecting services shall be rendered in a professional manner. The Manager will handle all patient and encounter information of Provider on services. The following information will be required by Provider to process customer charges: • Patient’s name • Patient’s date of birth • Patient’s address • Insurance information (copy of face sheet) • Front and back of insurance card (copy) • Location of service • Referring physician • CPT code(s) • Diagnosis code(s) • Office notes if billing an unlisted procedure or billing a multiple procedure on the same day • Any additional information required by OSMI for billing purposes Based upon the above information received from Provider, OSMI shall provide the following billing and account management services:

Billing and Collection Services. OSMI and Provider acknowledge that billing and collection shall be the sole responsibility of OSMI. Billing The RehabPlus Manager, with assistance from and collection will be the responsibility of OSMIsupervision by Provider, such billing and collecting services shall be rendered in a professional manner. The Manager will handle all patient and encounter information of Provider on servicesservices rendered and enter said information into OSMI’s billing & collection system. The following information will be required by Provider to process customer charges: • Patient’s name • Patient’s date of birth • Patient’s address • Insurance information (copy of face sheet) • Front and back of insurance card (copy) • Location of service • Referring physician • CPT code(s) • Diagnosis code(s) • Office notes if billing an unlisted procedure or billing a multiple procedure on the same day • Any additional information required by OSMI for billing purposes Based upon the above information received from Provider, OSMI shall provide the following billing and account management services: