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South Texas Cardiovascular Consultants Patient Financial Agreement  Form

South Texas Cardiovascular Consultants Patient Financial Agreement Form

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Attorney Other please specify. I request payment of authorized benefits to be made on my behalf to South Texas Cardiovascular Consultants by the Medicare or Medicaid program. Consent to Telephone Calls for Financial Communications. I understand South Texas Cardiovascular Consultants has the right to refuse or accept assignment of such benefits. Assignment of Benefits. I hereby assign to South Texas Cardiovascular Consultants any insurance or other thirdparty benefits available for health care...
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