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Financial Agreement Thank you for choosing Catalyst Physical Therapy and Wellness for your rehabilitation needs. Please review the following policy regarding financial responsibility for your care. Patient
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cptw financial agreement2doc is a document used to record financial agreements between parties.
Any parties involved in a financial agreement are required to file cptw financial agreement2doc.
To fill out cptw financial agreement2doc, parties must provide all relevant financial information and sign the document.
The purpose of cptw financial agreement2doc is to document financial agreements and ensure parties are held accountable.
Information such as the parties involved, financial terms, and signatures must be reported on cptw financial agreement2doc.
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HMO PHYSICANS PPO coinsurance REFERAL copays eg allowable DOB submits guarantor authorizes Soc cancellations Wellness Subscriber Camino certify REFERRAL varies balances payable Catalyst Deductible unpaid PT provider rehabilitation

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