04/27/2009

Evan McDaniel PO Box 6095 Peoria, IL 61601 Dear Evan, You have been a patient in our office for a long time. We have had a good relationship and would like to keep that with you. We have been sending monthly billing statements, but have not received a payment. No payments have been made since 11/17/08. If you would please take the time to look over the following payment plans and let me know which one will work for you. We need you to pick one of the plans and the payments to be started within the next 30 days to prevent us from having to take further action. If none of these plans work for you please give us a call to see if we can work something else out. 1.) $17.33 each month for ten months until paid in full 2.) $21.66 each month for eight months until paid in full 3.) $28.88 each month for six months until paid in full 4.) $43.32 each month for four months until paid in full 5.) $86.65 a month for two months until paid in full 6.) Payment in full = $173.29 (We even can take a credit card over the phone.) I would like to set up payment plan # ______. _________________________ (Signature) Thank you,

Pamela Selby Office Manager

6-22-2007

Sieffermans Dear , Your family has been patients in our office for many years. We have a good relationship and would like to keep that with you. We have been sending monthly billing statements with no response. Ive tried to call to set up a payment plan with no response to the message I left. No payments have been made since 7-14-06. If you would please take the time to look over the following payment plans and let me know which one will work for you. We need you to pick one of the plans and the payments to be started within the next 30 days to prevent us from having to take a collection company. If none of these plans work for you please give us a call to see if we can work something else out. 1) 2) 3) 4) 5) 6) $20.00 each month for a year until paid in full $30.00 each month for eight months until paid in full $40.00 each month for six months until paid in full $60.00 each month for four months until paid in full $120.00 a month for two months until paid in full Payment in full = $240.47 (We even can take a credit card over the phone.)

I would like to set up payment plan # ______. _________________________ (Signature) Thank you,

Stephenie Gambetta Office Manager

6-22-2007

Mr. McDonough 116 Hilton Ct. East Peoria, IL 61611 Dear Chuck, You have been a patient in our office for a long time. We have had a good relationship with you and would like to keep it that way. We have been sending monthly billing statements, but have not received a payment. I believe that you know the following balance is from insurance requesting a refund from over payment. No payments have been made since 5-31-06. If you would please take the time to look over the following payment plans and let me know which one will work for you. We need you to pick one of the plans and the payments to be started within the next 30 days to prevent us from having to take further action. If none of these plans work for you please give us a call to see if we can work something else out. 7.) $21.80 each month for six months until paid in full 8.) $32.70 each month for four months until paid in full 9.) $43.60 each month for three months until paid in full 10.) $65.40 a month for two months until paid in full 11.) Payment in full = $130.71 (We even can take a credit card over the phone.) I would like to set up payment plan # ______. _________________________ (Signature) Thank you,

Stephenie Gambetta Office Manager

9-21-09

Veronica Karnes 425 Capri St Pekin, IL 61554 Dear Veronica, We have been sending monthly billing statements, but have not received a payment. If you would please take the time to look over the following payment plans and let me know which one will work for you. We need you to pick one of the plans and the payments to be started within the next 30 days to prevent us from having to take further action. If none of these plans work for you please give us a call to see if we can work something else out. 1.) 2.) 3.) 4.) 5.) $ each month for eight months until paid in full $15.75 each month for six months until paid in full $23.62 each month for four months until paid in full $47.24 a month for two months until paid in full Payment in full = $94.48 (We even can take a credit card over the phone.)

I would like to set up payment plan # ______. _________________________ (Signature) Thank you,

Pam Selby Office Manager

04/27/2009

Robert Marvin 5717 N Rosemead Peoria, IL 61614

Dear Robert,

You have been a patient in our office for a long time. We have had a good relationship with you and would like to keep it that way. With the large collection of promotional materials and billings that most people receive, its easy for an important invoice to be overlooked or misplaced. Were concerned that this may have occurred with your statement. We have been sending monthly billing statements with an amount due of $102.47, but have not received a payment since 06/27/08. We need you to make a payment within the next 30 days to prevent us from having to use a further action.

Thank you,

Pamela Selby Office Manager

09/21/2009

Craig Meller 5829 Mar Vista Dr Peoria, IL 61614 Dear Craig, With the large collection of promotional materials and billings that most people receive, its easy for an important invoice to be overlooked or misplaced. Were concerned that this may have occurred with your statements. We have been sending monthly billing statements, but have not received a payment. If you would please take the time to look over the following payment plans and let me know which one will work for you. We need you to pick one of the plans and the payments to be started within the next 30 days to prevent us from having to take further action. If none of these plans work for you please give us a call to see if we can work something else out. 1.) 2.) 3.) 4.) 5.) $ 25.62 each month for eight months until paid in full $ 34.16 each month for six months until paid in full $ 51.23 each month for four months until paid in full $ 102.48 a month for two months until paid in full Payment in full = $204.95 (We even can take a credit card over the phone.)

I would like to set up payment plan # ______. _________________________ (Signature) Thank you,

Pam Selby Billing Coordinator

12-18-2007

Mr. Eric Dunigan SR 1702 N Peoria Ave. Peoria, IL 61603 Dear Mr. Dunigan, We have sent billing statements to your auto insurance. They have informed us that you have not released payment; therefore there will be no payment from them. Our office policy is to take medical payment. We do not wait for third party insurance to settle. If you dont release payment we will need you to look over the following payment plans and let me know which one will work for you. We need you to pick one of the plans and the payments to be started within the next 30 days to prevent us from having to take further action. If none of these plans work for you please give us a call to see if we can work something else out. Feel free to call us if you have any questions. 1.) 2.) 3.) 4.) $240.25 each month for twelve months until paid in full $480.50 each month for six months until paid in full $1,441.50 a month for two months until paid in full Payment in full = $2883.00 (We even can take a credit card over the phone.)

I would like to set up payment plan # ______. _________________________ (Signature) Thank you,

Stephenie Gambetta Office Manager

12-7-2007

Esther Tudor 1126 W Willcox Peoria, IL 61604 Dear Esther, You have been a patient in our office for a long time. We have had a good relationship with you and would like to keep it that way. We have sent billing statements to your auto insurance. They have informed us that you have not contacted them with the information that they are waiting on. Therefore there will be no payment from them. There is a possibility that they will still cover this auto accident, but you must contact them with insurance information and inform them that they need to make payment to our office. If you dont contact the insurance I need you to look over the following payment plans and let me know which one will work for you. We need you to pick one of the plans and the payments to be started within the next 30 days to prevent us from having to take further action. If none of these plans work for you please give us a call to see if we can work something else out. Feel free to call us if you have any questions. 1.) 2.) 3.) 4.) $137.75 each month for twelve months until paid in full $275.50 each month for six months until paid in full $826.50 a month for two months until paid in full Payment in full = $1653.00 (We even can take a credit card over the phone.)

I would like to set up payment plan # ______. _________________________ (Signature) Thank you,

Stephenie Gambetta Office Manager