The Patient is responsible for any co-payments and deductibles that may be applied by your insurance plan. Our Customer Services Associate will advise you as to which Breast Pump your Plans benefit covers. If you wish a Breast Pump with more features, your Insurance Plan's reimbursement amount can be applied toward the purchase of the upgrade.
NOTICE OF ASSIGNMENT OF INSURANCE BENEFITS AND RELEASE OF INFORMATION: I hereby authorize my public and/or private insurance company or funding resource responsible for paying for my care, if applicable, to pay benefits on my behalf directly to Baird Respiratory, for any products and services furnished to me by Baird Respiratory, I also authorize Baird Respiratory to request, on my behalf, all public and private insurance benefits for products and services provided to me by Baird Respiratory. I hereby authorize Baird Respiratory to release my medical records to any person, organization, company and/or agency which is or may be (1) involved in providing care for me or (2) liable for any portion of the payment of the charges for such products and services.