Prior Authorizations; Personal Financial Obligation

Northern Light Health has not obtained any prior authorization or referral that may be required by your health insurance plan for any services identified in this estimate, and Northern Light Health has not contacted your health insurance provider to confirm the costs that will be covered by your insurance plan. You are responsible for getting any prior authorizations and referrals that your health insurance plan requires. You are responsible for contacting your health insurance plan to confirm the costs that will be covered by insurance and any costs for which you will be personally responsible for paying. You will be subject to personal financial obligation for all charges for services performed by Northern Light Health and any other provider whose services are related to or associated with those services. You are responsible for promptly paying any costs not covered by your insurance company.