I authorize the release of any medical or other information necessary to process an insurance claim. I understand that CNS will diligently attempt to get accurate information regarding my health insurance benefits. I will not hold CNS liable for insurance nonpayment due to misquoted benefits. I acknowledge that I am responsible to know and understand my benefits plan. If CNS accepts me as a client, then CNS will file my insurance claims if in-network for me as a courtesy. I am ultimately responsible for any co-pay(s) and all charges my insurance company does not pay, except for contracted network provider discounts that may apply. I also request assigned benefits be paid to CNS.