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Patient Financial Obligations and Billing Information
On behalf of your physician, you are being provided with a heart monitor from Preventice Services.
This test will be billed in two parts:
1. Your medical professional will bill your insurance for the in-oice hook-up and the inal
reading of the test results.
2. Preventice Services will bill your insurance for the use of the monitor along with providing
the physician with monitoring center service and all requested data and reports 24 hours a day,
7 days a week.
Your insurance company will usually send you an Explanation Of Beneits (EOB) describing the
amount paid and the amount you owe Preventice. An EOB is not a bill. Our goal is to help your
physician diagnose your heart condition without delay or concerns about billing. We ofer patient-
friendly payment options, including a discounted rate at the time of service or a reduced rate when
your insurance indicates a large fee payable by you for our services or the physician's services.
All equipment is the sole property of Preventice Services. To avoid inancial liability and to ensure
that you do not receive a bill for the value of the equipment in your possession (up to $750), please
return the equipment immediately after your service ends. Any request for an extension of your
study beyond your prescribed study needs to come from your physician through a new order sent to
Preventice Services. Be aware that the second study may not be covered by all insurance providers
and you may be responsible for those charges.
Our Notice of Privacy Practices is available for your review at www.preventicesolutions.com
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