By receiving services provided by Gary Munn, you guard to the release of medical record information to amends companies or other 3rd parties to suffice in paying your health care costs. fiscal function: Patient and the undersigned, if other than the unhurried, each jointly and one at a time agree to pay for all the services rendered to diligent by Gary Munn, including tho non limited, to whatever amounts non paid by either insurance policy company or other third beau monde payer. Patient and the undersigned if other than the patient, remains responsible for all co- hires, de ductibles, co-insurance, and/or non-covered ! services regardless of amount paid by insurance or third party payer. It is understood and agreed that charges non paid in a timely matter may be placed for collection or with an attorney for purposes of collection. It is tell understood and agreed by the patient and the undersigned that any amounts not paid within 30 days of the statement for hire shall accrue interest at the rate of 1 ½% per month (18% per year) on the undischarged balance. In the event that any rent-free 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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