P4 PHARMACY IS A LONG TERM CARE PHARMACY SPECIALIZING IN CARE AND SERVICES FOR
RESIDENTS OF ASSISTED LIVING COMMUNITIES
AND HOME HEALTH/HOSPICE PATIENTS
P4 Pharmacy will bill all appropriate agencies/insurances when possible, but the resident/patient or responsible party is ultimately accountable for any and all non-covered charges and co-payments.
Private Pay: P4 Pharmacy will bill the resident/patient
or responsible party directly.
Insurance: After insurance has been billed, the resident/patient or responsible party will be billed for all non-covered charges.
Hospice: P4 Pharmacy will bill the hospice agency for all related charges. The patient or responsible party will be billed for all non-covered charges.
I agree to allow P4 Pharmacy to use the included credit card, bank account information or other method of payment to pay for pharmacy services as defined above. I understand that this information will be stored securely and that suitable measures will be taken by the pharmacy to protect this information.