By receiving services provided by Gary Munn, you guard to the release of medical record information to amends companies or other trio parties to suffice in paying your health care costs. financial function: Patient and the undersigned, if other than the unhurried, each jointly and each agree to pay for all the services rendered to long-suffering by Gary Munn, including tho non limited, to whatever amounts non paid by each restitution company or other third acquaintance payer. Patient and the undersigned if other than the patient, remains responsible for all co- hires, deductibles, co-insurance, and/or non-covered services re! gardless of amount paid by insurance or third party payer. It is understood and agreed that charges not paid in a timely matter may be placed for collection or with an attorney for purposes of collection. It is publicize understood and agreed by the patient and the undersigned that any amounts not paid within 30 days of the statement for requital shall accrue interest at the rate of 1 ½% per calendar month (18% per year) on the undischarged balance. In the event that any non-paying balance is placed for collection or with an attorney for collection, patient and the undersigned, if other...If you want to get a full essay, order it on our website: OrderCustomPaper.com
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