Common use of For Payment Clause in Contracts

For Payment. We may use and disclose PHI so that we can receive payment for the treatment services provided to you. This will only be done with your authorization. Examples of payment-related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services, we will only disclose the minimum amount of PHI necessary for purposes of collection.

Appears in 5 contracts

Sources: Therapist Client Agreement, Client Financial Responsibility Agreement, Medicare Opt Out Contract Agreement

For Payment. We may use and or disclose PHI so that we can receive payment for the treatment services provided to you. This will only be done with your authorization. Examples of payment-related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services, we will only disclose the minimum amount of PHI necessary for purposes of collection.

Appears in 2 contracts

Sources: Treatment Agreement, Professional Services

For Payment. We may use and disclose PHI so that we can receive payment for the treatment services provided to you. This will only be done with your authorization. , Examples of payment-related activities are: making a determination of eligibility or of coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical medical. necessity, or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services, we will only disclose the minimum amount of PHI necessary for purposes of collection.

Appears in 1 contract

Sources: Confidential Fee Agreement