If you are covered under a health plan by the “Affordable Healthcare Act” and you are in the 90 day grace period for unpaid premiums, you are responsible for all medical costs not covered by your healthcare plan.
The undersigned hereby guarantees payment of all fees and charges incurred by patient for services that may not be covered under the insurance plan of the insured. In the event that the undersigned fails to make payment as provided herein or agree to alternative payment arrangements deemed satisfactory by Frontline Medical & Kidney Care, affirmative collection measures will be initiated.
COMMUNITIES SERVED
PATIENTS CARED FOR
PROFESSIONAL STAFF
YEARS OF EXPERIENCE
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