Amendment to Medical Group Participation AgreementMedical Group Participation Agreement • April 3rd, 2019
Contract Type FiledApril 3rd, 2019This amendment (“Amendment”), effective 7/1/2019, is made to the Medical Group Participation Agreement (“Agreement”) dated _______ between Healthplan, contracting on behalf of itself, _____________________., and the other entities that are _______ (collectively referred to as "______") and _____________, (hereinafter "Medical Group" and or “Provider”).