€¦ · your insurance company to pay the claims. also understand there will be a billing fee for...

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Page 1: €¦ · your insurance company to pay the claims. also understand there will be a billing fee for any unpàid copays& a 2970 collection fee for unpaid METHOD OF PAYMENT: CASH balances
Page 2: €¦ · your insurance company to pay the claims. also understand there will be a billing fee for any unpàid copays& a 2970 collection fee for unpaid METHOD OF PAYMENT: CASH balances
Page 3: €¦ · your insurance company to pay the claims. also understand there will be a billing fee for any unpàid copays& a 2970 collection fee for unpaid METHOD OF PAYMENT: CASH balances
Page 4: €¦ · your insurance company to pay the claims. also understand there will be a billing fee for any unpàid copays& a 2970 collection fee for unpaid METHOD OF PAYMENT: CASH balances
Page 5: €¦ · your insurance company to pay the claims. also understand there will be a billing fee for any unpàid copays& a 2970 collection fee for unpaid METHOD OF PAYMENT: CASH balances
Page 6: €¦ · your insurance company to pay the claims. also understand there will be a billing fee for any unpàid copays& a 2970 collection fee for unpaid METHOD OF PAYMENT: CASH balances
Page 7: €¦ · your insurance company to pay the claims. also understand there will be a billing fee for any unpàid copays& a 2970 collection fee for unpaid METHOD OF PAYMENT: CASH balances
Page 8: €¦ · your insurance company to pay the claims. also understand there will be a billing fee for any unpàid copays& a 2970 collection fee for unpaid METHOD OF PAYMENT: CASH balances