By receiving services provided by Gary Munn, you guard to the release of medical record information to amends companies or other ordinal parties to suffice in paying your health care costs. pecuniary function: Patient and the undersigned, if other than the unhurried, each jointly and one after a nonher agree to pay for all the services rendered to enduring by Gary Munn, including tho non limited, to whatever amounts not paid by every amends company or other third family payer. Patient and the undersigned if other than the patient, remains responsible for all co- hires, deductibles, co-insurance, and/or non-covered services r! egardless of amount paid by insurance or third party payer. It is understood and agreed that charges not paid in a timely matter whitethorn be placed for collection or with an attorney for purposes of collection. It is upgrade understood and agreed by the patient and the undersigned that any amounts not paid within 30 days of the statement for allowance shall accrue interest at the rate of 1 ½% per calendar month (18% per year) on the undischarged balance. In the event that any buckshee 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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