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Assignment of HealthCareInsurance Receivables for Minor Patient (This is the first page of a two-page form)1. My name is:. This agreement is a legally enforceable agreement, called an assignment.2.
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Assignment of health-care-insurance receivables is the transfer of the right to receive payment from an insurance company to another party, such as a medical provider or healthcare facility.
Medical providers and healthcare facilities are typically required to file assignment of health-care-insurance receivables.
Assignment of health-care-insurance receivables can be filled out by providing relevant information about the parties involved, details of the insurance claim, and signatures of both parties.
The purpose of assignment of health-care-insurance receivables is to ensure that medical providers receive payment directly from the insurance company for the services provided to patients.
The assignment of health-care-insurance receivables must include details such as the patient's name, insurance policy number, date of service, and the amount being assigned.
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