PATIENT MEMBER ACKNOWLEDGEMENTS Sample Clauses

PATIENT MEMBER ACKNOWLEDGEMENTS. Please read each line carefully. By entering into this Agreement, You acknowledge the following in addition to what is set forth in the other sections of this Agreement. • You acknowledge that Carah Medical Arts has advised You to maintain health insurance for coverage of all Services not specifically provided for in this Agreement. You further acknowledge that this Agreement is not a contract that provides health insurance. • You acknowledge that You do not expect Carah Medical Arts or the Healthcare Practitioners or Therapists to file or issue any third party insurance claims on Your behalf. • You acknowledge that, if the Patient Member is a Medicare beneficiary or eligible for Medicare Benefits, You have reviewed and are entering into the enclosed Private Contracts with the Primary Care Physicians and, if applicable, other Healthcare Practitioners and Therapists also. You acknowledge that You will not bill Medicare or attempt Medicare reimbursement for services provided to You or fees paid under this Agreement. • You agree to immediately inform Xxxxx Medical Arts if the Patient Member becomes a Medicare Beneficiary or eligible for Medicare benefits. • You acknowledge that You will not bill Medicaid/Medical Assistance or attempt Medicaid/Medical Assistance reimbursement for services provided to You or fees paid under this Agreement. • You acknowledge that You have received or were offered a copy of the Patient Notice of Privacy Practices. • Unless you object in writing, You authorize Carah Medical Arts and the Healthcare Practitioners and Therapists to communicate with You using electronic mail, facsimile, video chat, instant messaging, and phone. You acknowledge that such communications by their nature cannot be guaranteed to be secure or confidential and that they may include unencrypted Protected Health Information. Unless You object in writing, You agree to be included in our mailing list and receive membership communications from Carah Medical Arts. Please see section 6 for details. • By signing this Agreement, You authorize Carah Medical Arts to charge you the applicable fees under this Agreement via the payment method provided by You on the Payment Authorization form and to sign You up on and enter your payment information into the Patient Member Management system provided by Hint Health, Inc. if You have not done so Yourself already. • In the event of a true medical emergency, You agree to call 911 first. This Agreement constitutes the valid and ...
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Related to PATIENT MEMBER ACKNOWLEDGEMENTS

  • Customer Acknowledgements The Customer acknowledges and agrees that:

  • Customer Acknowledgement Customer acknowledges and agrees that Viasat is not extending credit and that the unreturned Equipment fees are not interest, a credit service fee or a finance charge. If your Equipment is stolen or otherwise removed from your premises without your authorization, you must notify our Customer Care department by telephone or in writing immediately, but in any event not more than three business days after such removal to avoid liability for payment for unauthorized use of your Equipment. You will not be liable for unauthorized use that occurs after we have received your notification. EasyCare Plan Addendum This EasyCare Plan Addendum is between you and Viasat and is separate and different from any other commitment you may have made with Viasat and is fully enforceable under these terms. If you have purchased your Equipment from Viasat's predecessor-in-interest, WildBlue Communications, Inc., or are otherwise not subject to the Lease Addendum, Viasat’s EasyCare Plan (“EasyCare Plan”) is not available to you, and these terms do not apply to you. The EasyCare Plan is not available to residents of Alaska and Hawaii.

  • Your Acknowledgements You acknowledge and agree that:

  • Dissemination of Research Findings and Acknowledgement of Controlled-Access Datasets Subject to the NIH GDS Policy It is NIH’s intent to promote the dissemination of research findings from use of controlled-access dataset(s) subject to the NIH GDS Policy as widely as possible through scientific publication or other appropriate public dissemination mechanisms. Approved Users are strongly encouraged to publish their results in peer-reviewed journals and to present research findings at scientific meetings.

  • CHILD SUPPORT ACKNOWLEDGMENTS The Couple declares the following with regard to their agreement regarding Child Support:

  • Risk Acknowledgement The Sub-Adviser makes no representation or warranty, express or implied, that any level of performance or investment results will be achieved by the Fund, whether on a relative or absolute basis. The Adviser understands that investment decisions made for the Fund by the Sub-Adviser are subject to various market, currency, economic, political, business and structure risks and that those investment decisions will not always be profitable.

  • STUDENT ACKNOWLEDGMENTS 1. I hereby acknowledge receipt of the school’s catalog, which contains information describing programs offered, and equipment or supplies provided. The school catalog is included as part of this enrollment agreement and I acknowledge that I have received a copy of this catalog. Student Initials

  • Seller Acknowledgments Seller represents, warrants, and guarantees that the Seller has complete authority to sell the Property and convey title. Seller has personally reviewed this Agreement, including any Property Disclosure Statement and any other addendums, exhibits, or attachments relating to the description and physical condition of the Property were provided by the Seller and are accurate and complete to the best of the Seller’s knowledge.

  • AUTHORIZATION AND ACKNOWLEDGEMENT I authorize Xxxxx Management to obtain reports from any consumer or criminal record reporting agencies before, during, and after tenancy on matters relating to my Application and Lease with Xxxxx Management and to verify, by all available means, the information in this Application, including criminal background information, income and housing history, and other information reported by any state or federal agency (ex: Social Security Administration). I understand that this authorization cannot be used to obtain any information about me that is not pertinent to my eligibility and continued participation as a qualified applicant or resident.

  • Resume Acknowledgement Form When submitting a response to an RFQ the Contractor shall submit with its response a completed and signed Resume Acknowledgment Form (Contract Exhibit G) to the Customer for each staff augmentation person included in the RFQ response.

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