Patient Financial Responsibility Policy

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Patient Financial Responsibility Policy

Insurance: Please bring current insurance information; you’re responsible for non-covered services, deductibles, copays, and coinsurance.
Self-pay: Payment due at time of service unless otherwise arranged.
Billing questions & estimates: Contact 520-420-1966 or [billing@sanovamedical.com].
Missed appointments: [insert no-show/late cancellation policy].
Refunds & credits: [insert process and timeline].
Collections: Accounts past due may be referred to a collection agency after notice.

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Sanova Medical Group – Policy Text (ready to paste)

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Practice Name: Arizona Physician Group, PLLC d/b/a Sanova Medical Group
Address: 5983 E Grant Rd, Ste 101, Tucson, AZ 85712
Phone: 520-420-1966 | Fax: 866-733-1907
Email (Compliance/Privacy): [privacy@sanovamedical.com] (use info@sanovamedical.com if you prefer one inbox)
Effective date: [Month DD, 2025]