Common Contracts

1 similar Financial Agreement and Assignment of Benefits contracts

FINANCIAL AGREEMENT AND ASSIGNMENT OF BENEFITS
Financial Agreement and Assignment of Benefits • March 31st, 2022

Southwest Florida Eye Care, LLC. (SFEC) are privately-owned medical facilities that provide medical services on a fee-for-service basis. SFEC relies solely on insurance reimbursement and patient payment(s) for services rendered in good faith. SFEC receives no federal, state or other third-party funding; as such, SFEC does not have provision for providing on-going indigent care. The following Financial Agreement is developed in accordance with Office of Inspector General (OIG) guidelines as well as all applicable State and Federal reimbursement guidelines.