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• »?..?, <br /> <br /> <br />MUNICIPALITY may decide billing frequency and content of private pay invoices. <br />Private Pav Notices available: <br />Initial Invoice (Required) <br />*Itemized billing showing all charges, payment, adjustments, and balance. <br />Statement (Optional) <br />*Balance forward billing showing total outstanding balance for entire account. <br />Final Notice (Optional) <br />*Final notification to patient that billing should be paid prior to sending to collection. <br />Custom-Created Letters (Optional) <br />*Patient Notifications with customer-defined narrative. <br />Normal billing procedures would include an Initial Invoice, a Statement 30 days later, and a Final <br />Notice 30 days after Statement. <br />MUNICIPALITY chooses the following options: (Please check each one applicable) <br />Initial Invoice (will automatically occur if no insurance coverage, or immediately <br />after payment/denial from insurance. <br />Statement days after Invoice. <br />Final Notice days after Statement <br />Custom-Created Letters (Defined by provider) <br />9 <br />? . ,,. h,?? ? ?? ? ?«?? ..? ?5 ?, • _ ? r. ?,,? ??. ? ?,???? ?.? = _ ?