Participating Dentist Agreement with United Concordia Companies, Inc. for the Department of Defense (DoD) ProgramsParticipating Dentist Agreement • December 14th, 2022
Under the applicable laws of the State of _ , I am duly authorized to engage in the practice of dentistry. In consideration for being registered as a participating dentist in the Department of Defense (DoD) Networks (i.e. Active Duty Dental Program (ADDP) Network and/or TRICARE Dental Program (TDP) Network) of United Concordia Companies, Inc. and its affiliates (collectively, “United Concordia”), I (“Dentist”) do hereby agree as follows:
Participating Dentist Agreement with United Concordia Companies, Inc.Participating Dentist Agreement • January 12th, 2012
Under the applicable laws of the State of , I am duly authorized to engage in the practice of dentistry. In consideration for being registered as a participating dentist in the Fee for Service Dental Network (the “Network”) of United Concordia Companies, Inc. and its affiliates (collectively, “United Concordia”), I (“Dentist”) do hereby agree as follows:
PARTICIPATING DENTIST AGREEMENTParticipating Dentist Agreement • September 4th, 2019 • Rhode Island
This Participating Dentist Agreement is made and entered into as of the Effective Date set forth below by and between Delta Dental of Rhode Island (“Delta Dental”) and the following participating dentist (“the Dentist”).
AMENDMENT TO PARTICIPATING DENTIST AGREEMENT – GHP PROGRAMParticipating Dentist Agreement • September 11th, 2018
This document constitutes an amendment to the Participating Dentist Agreement (“Dentist Agreement”) previously entered into by Delta Dental of Puerto Rico, Inc. (“DDPR”) and the participating dentist(s) or dental group whose name(s) appear(s) below (“Participating Dentist” or “Dentist” or “Provider”). This Amendment shall become effective on the date it is signed by Dentist.
Participating Dentist AgreementParticipating Dentist Agreement • May 1st, 2015
This Amended Schedule of Dental Care Service Fees to the Participating Dentist Agreement (also referred to as Exhibit A in the Participating Dentist Agreement) with Plan 200 Series benefits shall be effective as of June 01, 2017. This Amended Schedule supercedes and replaces any and all previous Schedules of Dental Care Service Fees to the Participating Dentist Agreement for Plan 205. Dentist shall charge Members no more than eighty percent (80%) of Dentist’s normal charge for any dental care service. Dentist may require Member to pay for dental care services in accordance with the Agreement at the time service is rendered. Dentist is not obligated to charge Members any specified rates for dental care service performed by Dentist after Member’s membership in the Aon Dental Solutions is terminated.
Participating Dentist AgreementParticipating Dentist Agreement • May 1st, 2015
This Amended Schedule of Dental Care Service Fees to the Participating Dentist Agreement (also referred to as Exhibit A in the Participating Dentist Agreement) with Plan 200 Series benefits shall be effective as of February 1, 2019. This Amended Schedule supercedes and replaces any and all previous Schedules of Dental Care Service Fees to the Participating Dentist Agreement for Plan 205. Dentist shall charge Members no more than eighty percent (80%) of Dentist’s normal charge for any dental care service. Dentist may require Member to pay for dental care services in accordance with the Agreement at the time service is rendered. Dentist is not obligated to charge Members any specified rates for dental care service performed by Dentist after Member’s membership in the Aon Dental Solutions is terminated.
PARTICIPATING DENTIST AGREEMENTParticipating Dentist Agreement • June 15th, 2009
This Agreement (“Agreement”) is entered into, on this day of 2009, between the undersigned dentist (“Participating Dentist or a Participating Group Practice”) and
ANTHEM BLUE CROSS PARTICIPATING DENTIST AGREEMENT – SPECIALISTParticipating Dentist Agreement • March 22nd, 2010 • California
This Anthem Blue Cross Participating Dentist Agreement is between Anthem Blue Cross (hereinafter “Anthem Blue Cross”) and the dentist or dental entity signing this Agreement (hereinafter “Dentist”).
SUPPLEMENT TO THE PARTICIPATING DENTIST AGREEMENTParticipating Dentist Agreement • June 1st, 2022
This Supplement (hereinafter the “Supplement”) to the Participating Dentist Agreement (hereinafter the “Agreement”) is made a part of and supplements the Agreement entered into by provider and Delta Dental of Tennessee, Inc. (“Delta Dental”)1 . Dentist agrees that in addition to the terms and conditions and Program Requirements as defined and set forth in the Agreement with Delta Dental of Tennessee , Dentist will comply with the following regulatory requirements for any Enrollees that are covered under a Delta Dental Medicare Advantage dental plan. Please note, as identified below some additional regulatory requirements may only apply to certain types of dental plans.
