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Dear Medicare Beneficiary, Dr. Man and other RESTORE practitioners have opted out of Medicare. As you are aware, RESTORE
Center for Integrative Medicine does not bill insurance, including Medicare.
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How to fill out medicare beneficiary private contract
How to fill out medicare beneficiary private contract
01
To fill out a Medicare Beneficiary Private Contract, follow these steps:
02
Obtain the Medicare Beneficiary Private Contract form. This form is typically provided by healthcare providers who offer services that are not covered by Medicare.
03
Read the contract carefully and ensure that you understand all the terms and conditions.
04
Provide your personal information, including your full name, address, phone number, and Medicare number.
05
Specify the services for which you are entering into the contract.
06
Review the payment terms and agree to the charges for the services.
07
Sign and date the contract to indicate your agreement.
08
Keep a copy of the contract for your records.
Who needs medicare beneficiary private contract?
01
Medicare Beneficiary Private Contracts are typically needed by Medicare beneficiaries who wish to receive services that are not covered by traditional Medicare plans.
02
This may include services from healthcare providers such as doctors, specialists, or hospitals that have opted out of Medicare.
03
Patients who prefer to pay out of pocket for certain services or seek alternative treatment options may also need a Medicare Beneficiary Private Contract.
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