Medicare Worksheet
- Bulk Pricing:
- Buy in bulk and save
- Buy 4 or above and pay only $20.00 each
- Packages:
- of 50 forms
Bulk discount rates
Below are the available bulk discount rates for each individual item when you purchase a certain amount
Here's a better way to present your first visit fees for non-covered services.
Use this super-simple worksheet to replace your excluded services first visit Medicare ABN. It makes explaining your Medicare fees a snap.
During the financial consultation your staff simply enters the range of your customary fees for non-covered services in the yellow fields, and the patient's first-visit responsibility in the green. Enter the fee for their cost of the adjustment, add them up and presto! You've explained how your first visit Medicare fees are computed.
The simple layout provides a visual explanation that seniors find helpful. Request a signature, make a copy for your files and you're done. Coordinates brilliantly with our Par and Non-Par Medicare brochure.
Avoid confusion and misunderstandings. Bring order to your first-visit Medicare financial consultation the easy way. Not sure? Still have questions? Please read this.
Watch the video that explains how to use it:
Medicare Worksheet
Pkgs of 50
8½" X 11"