Free Medical Financial Letter Template

Medical Financial Letter


[Your Company Name]

[Your Company Address]

[Your Company Email]

April 20, 2051

Malcolm Raynor

Jacksonville, FL 32099

Dear Mr. Raynor,

I hope this letter finds you well. I am writing to provide you with important information regarding your recent medical services and associated billing details.

Outstanding Balance

As of April 20, 2051, your outstanding balance for services received on April 10, 2051, is $500.00. This amount reflects the total charges after insurance adjustments.

Payment Options

To assist you in managing this balance, we offer several payment options:

  • Full Payment: You may pay the outstanding balance in full by May 10, 2051.

  • Payment Plan: If you prefer to set up a payment plan, we can arrange monthly installments of $100.00 over five months. Please contact our office to discuss this option.

Financial Assistance

We understand that medical expenses can be challenging. If you are experiencing financial hardship, you may qualify for our financial assistance program. Please complete the attached application form and return it to our office by May 30, 2051.

If you have any questions regarding your bill or would like to discuss your options further, please do not hesitate to contact me directly at [Your Company Number] or [Your Company Email]. We are here to help.

Thank you for your attention to this matter.

Sincerely,


[Your Name]
Billing Coordinator



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