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Financial Responsibility From

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Charles:
Does anybody know where I can get a hold of one of these on the net?
Thanks

Pay_My_Claims:
Not sure if you are looking for a "blank" form or an example

here are some that other facilities use....

http://www.sugarlandeye.com/images/Financial_Responsibility_Form.pdf

http://www.bcm.edu/pdf/consent-and-aob.pdf

http://www.americanhomepatient.com/product/AOB%20070703.pdf

http://www.eyegaze.com/files/file/pdf/Assign%20Benefits_0.pdf

Treas:
I have a client who does not get paperwork completed for clients she sees in her home office.  I have sent her forms numerous times and she just ignores them stating that the client willfully came to her home so by default they are saying okay to treatment and billing.  Am I liable for false billing if she does not have these forms completed?  Should I be requesting copies of the forms for my records?  What would you do?

PMRNC:
What forms? You don't give nearly enough information to advise you.

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