Common Contracts
1 similar Practitioner Affiliation Agreement contracts
BLUE CROSS COMPLETE OF MICHIGAN PRACTITIONER AFFILIATION AGREEMENT SIGNATURE PAGEPractitioner Affiliation Agreement • July 24th, 2020
IN WITNESS WHEREOF, the parties wishing to be bound by the terms and conditions of the Blue Cross Complete of Michigan Practitioner Affiliation Agreement (NOV2012) have affixed their signature on this Signature Document, which is incorporated by reference in the Blue Cross Complete of Michigan Practitioner Affiliation Agreement appropriate to practitioner’s specialty. The Agreement effective date will be established by Blue Cross Complete of Michigan (BCC) and documented on the original counter- signed Agreement returned to the Provider upon completion of the affiliation process.
