THIS IS A COPY OF THE ALLIANCE HEALTH PROFESSIONAL PROVIDER CONTRACT TEMPLATE. IT IS PROVIDED FOR REVIEW ONLY AND IS NOT FORMATTED FOR SIGNATURES.Medicaid Network Participating Provider Contract • June 7th, 2022 • North Carolina
is made and entered into by and between Alliance Health , a political subdivision of the State of North Carolina and Prepaid Health Plan operating a Tailored Plan (hereinafter referred to as “Alliance” or “Tailored Plan”), and the Provider listed below (hereinafter referred to as “Provider” or “Participating Provider”), also individually referred to as “Party” and collectively as “Parties”, for Provider’s provision of Medicaid Covered health care items and Services to Alliance’s Tailored Plan Enrollees.
