The patient is responsible for any amount that is patient responsibility assigned which could be a Co-Pay, Co-Insurance, Deductible, or any non-covered service.
Patient voluntarily consents to wound care treatment by physicians at Wound Care Hawaii and their staff.
Treatment may include debridement, dressing changes, biopsies, skin grafts, off-loading devices, physical examinations, diagnostic procedures, laboratory work, imaging studies, and physician prescribed medications.
Benefits include enhanced wound healing and reduced risks of infection and amputation.
Risks may include infection, pain, bleeding, allergic reactions, delayed healing, scarring, and possible damage to surrounding tissues.
Patient authorizes use and disclosure of protected health information in accordance with HIPAA.