Self-Pay. All eligible employees who fall below the required hours for Health & Welfare coverage shall be permitted to self-pay up to the time period for extended coverage established by federal legislation provided they do so in accordance with the standards and procedures established by the trustees/federal legislation.
Self-Pay. All eligible Employees, as determined by Section 3 above, who fall below the required hours for Health and Welfare coverage or who terminate their employment shall be permitted to submit to the Fund self-payments for up to the amount of time required under the Comprehensive Omnibus Budget Reconciliation Act of 1986 (“COBRA”).
Self-Pay. Payment in full is due at the time of service if you do not have health insurance, and for items not covered by insurance. We accept cash, money orders, check, Visa, MasterCard, Discover and Care Credit. A $35 fee will be assessed for all bad checks. NON-COVERED SERVICES: Please be aware that some of the services you receive may not be covered or may not be considered reasonable/customary/necessary by Medicare or other insurers. You are responsible for payment for those services. REFERRALS / AUTHORIZATIONS: We do not require a referral t be seen UNLESS required by your insurance plan. If you arrive for an appointment and the necessary referral or authorization is not in place, you will be given the option to reschedule or pay for those services at the time they are given. We will do all that we can to help you get these in place, by ultimately it is your responsibility to understand your plan's referral/authorization requirements. NSFAC may refer patients to other providers, facilities and labs. We are not responsible for these entities. The patient should contact these outside service providers, facilities or labs directly regarding any billing questions.
Self-Pay. If you do not want to use health insurance you may elect to pay directly for psychotherapy and treatment services provided under the Outpatient Services Agreement. Please note that KMC does not offer sliding scale or reduced-fee rates.
Self-Pay. If you wish to waive your insurance coverage and be seen on a Self-Pay basis at SDFC for all services, including but not limited to the New Patient Consultation, please check the box below: I/We acknowledge and agree to waive my insurance for any and all medical services at San Diego Fertility Center. I/We understand I/we will be seen on a Self-Pay basis and will be 100% responsible for any associated charges pertaining to these services. If you do not have insurance coverage and will be seen on a Self-Pay basis at SDFC for all services, including but not limited to the New Patient Consultation, please check the box below: I/We acknowledge and agree to receive medical services at San Diego Fertility Center on a Self-Pay basis. I/We understand I/we will be 100% responsible for any associated charges pertaining to these services.
Self-Pay. I am considered self-pay and understand that I am responsible for providing Community Health all of the paperwork required to determine if/where I fall on the sliding fee scale. I further understand until all fee scale requirements are met, I will be responsible for 100% of all charges.
Self-Pay. I understand that as a self-pay patient, I am responsible for all office visits, lab, x-ray and other ancillary charges that exceed the Minimum Payment Amount assessed at the time of my visit.
Self-Pay. If I do not have insurance, or have an insurance that is not accepted, I will be billed at 110% of the current Medicare rates for Santa Xxxxx County. To receive the most current costs, I may contact BASS Medical Group Billing Services.
Self-Pay. ~ Full payment is required from patient / guarantor at the time of service, if classified as “self- pay”.
Self-Pay. I am prepared to pay full fee for all services provided to me or any of my dependents by FCC at the time of service. I will be charged the self-pay rates as quoted at the time of service. This applies also when we have been told you do not have Medicaid and it comes out later that you do. We are not a Medicaid provider and cannot treat you as a self-pay patient if you have Medicaid.
