Please be informed that the services provided by the visiting physician are on a cash basis and not covered by insurance. Payment must be made directly to the hospital at the time of service, or a deposit must be paid in advance, in accordance with the hospital’s current policies.
The only exception to this rule is if the patient obtains prior written approval from their insurance provider to cover the cost of the services provided by the visiting physician. It is solely the patient's responsibility to arrange and confirm this pre-approval before receiving any services.
By signing this disclaimer, the patient acknowledges that they are not eligible for reimbursement from their insurance provider after receiving services from the visiting physician. The patient agrees to bear the full cost of these services and understands that reimbursement claims will not be accepted.
