MEDICARE ADVANTAGE PROVIDER AGREEMENT NON-HOSPITAL FACILITY ATTACHMENTMedicare Advantage Provider Agreement • December 4th, 2021
This Blue Cross Blue Shield of Michigan Medicare Advantage Non-Hospital Facility Attachment (“Attachment”) is entered into by Blue Cross Blue Shield of Michigan (“BCBSM”) and the facility (“Provider”) listed on the signature document.
BLUE CROSS BLUE SHIELD OF MICHIGAN MEDICARE ADVANTAGE PROVIDER AGREEMENTMedicare Advantage Provider Agreement • October 28th, 2020
This Blue Cross Blue Shield of Michigan Medicare Advantage Practitioner Attachment (“Attachment”) is entered into by Blue Cross Blue Shield of Michigan (“BCBSM”) and the undersigned Practitioner (“Practitioner”), and is attached to and made a part of the BCBSM Medicare Advantage Provider Agreement (“Agreement”) entered into by the parties hereto.
MEDICARE ADVANTAGE PROVIDER AGREEMENT FEDERALLY QUALIFIED HEALTH CENTER PARTICIPATION SIGNATURE DOCUMENTMedicare Advantage Provider Agreement • November 24th, 2022
IN WITNESS WHEREOF, the Provider wishing to be bound by the terms and conditions of the BCBSM Medicare Advantage Provider Agreement (WP 10380 NOV 15) (Agreement) and the Medicare Advantage Provider Agreement Federally Qualified Health Center Facility Attachment (WP 10646 NOV 15) has affixed its signature to this Signature Document which is incorporated by reference in the Agreement.
MEDICARE ADVANTAGE PROVIDER AGREEMENT NON‐HOSPITAL FACILITY PARTICIPATION SIGNATURE DOCUMENTMedicare Advantage Provider Agreement • January 31st, 2022
IN WITHNESS WHEREOF, the Provider wishing to be bound by the terms and conditions of BCBSM Medicare Advantage Provider Agreement (WP 10380 NOV 15) (Agreement) and the Non-Hospital Facility Attachment (CF 10444 NOV 15) has affixed its signature to this Signature Document which is incorporated by reference in the Agreement.
PPO PROVIDER AGREEMENTMedicare Advantage Provider Agreement • September 12th, 2018 • Michigan
This Medicare Advantage (“MA”) PPO Provider Agreement (“Agreement”) is entered into by Blue Cross Blue Shield of Michigan, a Michigan nonprofit mutual health insurance issuer (“BCBSM”) and the undersigned Provider who is fully licensed or legally authorized to practice in the state of Michigan (“Provider”).
MEDICARE ADVANTAGE PROVIDER AGREEMENT FEDERALLY QUALIFIED HEALTH CENTER FACILITY ATTACHMENTMedicare Advantage Provider Agreement • July 7th, 2022
This Blue Cross Blue Shield of Michigan Medicare Advantage PPO Federally Qualified Health Center Facility Attachment (“Attachment”) is entered into by Blue Cross Blue Shield of Michigan (“BCBSM”) and the Federally Qualified Health Center (“Provider”) listed on the signature document to the Agreement.
MEDICARE ADVANTAGE PROVIDER AGREEMENT RURAL HEALTH CENTERMedicare Advantage Provider Agreement • October 10th, 2021
IN WITNESS WHEREOF, the Provider wishing to be bound by the terms and conditions of the BCBSM Medicare Advantage Provider Agreement (WP 10380 NOV 15) (Agreement) and the Medicare Advantage Provider Agreement Rural Health Center Attachment (WP 10543 NOV 15) has affixed its signature to this Signature Document which is incorporated by reference in the Agreement.
MEDICARE ADVANTAGE PROVIDER AGREEMENT RURAL HEALTH CLINIC ATTACHMENTMedicare Advantage Provider Agreement • May 31st, 2021
This Blue Cross Blue Shield of Michigan Medicare Advantage Rural Health Clinic Attachment (“Attachment”) is entered into by Blue Cross Blue Shield of Michigan (“BCBSM”) and the clinic (“Provider”) listed on the signature document.
BLUE CROSS BLUE SHIELD OF MICHIGAN MEDICARE ADVANTAGE PFFS PROVIDER AGREEMENTMedicare Advantage Provider Agreement • May 31st, 2021
This Blue Cross Blue Shield of Michigan Medicare Advantage Private Fee For Service (“PFFS”) Practitioner Attachment (“Attachment”) is entered into by Blue Cross Blue Shield of Michigan (“BCBSM”) and the undersigned Practitioner (“Practitioner”), and is attached to and made a part of the BCBSM Medicare Advantage Private Fee For Service Provider Agreement (“Agreement”) entered into by the parties hereto.
Please be informed CHP’s Freedom Health Medicare HMO agreement also includes the Optimum product line of business.Medicare Advantage Provider Agreement • May 2nd, 2019
