Patient Advocate Group
Partnering to Maximize Your Healthcare Dollars
Name:
Address:
City, State, Zip Code:
Phone:
Email Address:
Preferred Method of Contact:
email
phone
I need help with:
Medicare
Medicare Benefits
Medicare Prescription Drug Card
FREE Prescriptions
Medicare Claims/Bills
Medigap Bills
Others:
Insurance
File claims
Per Diem Hospital Locator
Claim Denials
Hospital bill negotiation
Claim Rejections
Doctor bill negotiation
FREE Medication Locator
Past Due Medical Bills
Uninsured/Underinsured cost negotiation with doctor/hospital
Any Other Issues, please describe below:
WWW.PATIENTADVOCATEGRP.COM
Tel. 972-390-1101, FAX 972-396-9545
Free Prescriptions | Negotiate Medical Bills | Advocate Hospitals