End-Stage Renal Disease Facility Network Affiliation Agreement Sample Contracts

BCBSM TRUST END STAGE RENAL DISEASE FACILITY NETWORK AFFILIATION AGREEMENT SIGNATURE DOCUMENT

End Stage Renal Disease Facility Network Affiliation Agreement • November 8th, 2022

• Contract Type
  End Stage Renal Disease Facility Network Affiliation Agreement
• Filed
  November 8th, 2022

IN WITNESS WHEREOF, the Provider wishing to be bound by the terms and conditions of the BCBSM TRUST End Stage Renal Disease Facility Network Affiliation Agreement (WP 12912 NOV 06) (Agreement) has affixed its signature to this Signature Document which is incorporated by reference in the Agreement.

TRUST END-STAGE RENAL DISEASE FACILITY NETWORK AFFILIATION AGREEMENT

End-Stage Renal Disease Facility Network Affiliation Agreement • December 9th, 2022 • Michigan

• Contract Type
  End-Stage Renal Disease Facility Network Affiliation Agreement
• Filed
  December 9th, 2022
• Jurisdiction
  Michigan

This Agreement is made by and between Blue Cross Blue Shield of Michigan (BCBSM) and Facility, an End-Stage Renal Disease (ESRD) facility whose tax name, business name (dba) and address are listed on the accompanying Signature Document.