Patient Balance Adjustment Waiver

Providers wishing to adjust or "write-off" patient balances must sign and submit the waiver on a case-by-case basis to your biller. The waiver can be found on the provider page of our website and attached here. Your biller will reach out to you with any questions before processing the request within 2-4 business days.

Please consult with your network contracts and have a hardship waiver on file before submitting the waiver. Thank you!

Patient Balance Write off (2).pdf

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