Common Contracts
3 similar Provider Enrollment Agreement contracts
Provider Enrollment AgreementProvider Enrollment Agreement • January 5th, 2017
(hereinafter the “Provider”) wishes to participate in the Connecticut Medical Assistance Program. For purposes of this Provider Enrollment Agreement (hereinafter the “Agreement”), the term “Connecticut Medical Assistance Program” means any and all of the health benefit programs administered by the State of Connecticut Department of Social Services (hereinafter “DSS”). The Provider represents and agrees as follows:
Provider Enrollment AgreementProvider Enrollment Agreement • January 20th, 2012
(hereinafter the “Provider”) wishes to participate in the Connecticut Medical Assistance Program. For purposes of this Provider Enrollment Agreement (hereinafter the “Agreement”), the term “Connecticut Medical Assistance Program” means any and all of the health benefit programs administered by the State of Connecticut Department of Social Services (hereinafter “DSS”). The Provider represents and agrees as follows:
PROVIDER ENROLLMENT AGREEMENTProvider Enrollment Agreement • November 23rd, 2007
(hereinafter “Provider”) wishes to participate in the Connecticut Medical Assistance Program and, therefore, represents and agrees as follows:
