Primary Care Physician Participation Agreement Sample Contracts

ARKANSAS MEDICAID PRIMARY CARE PHYSICIAN MANAGED CARE PROGRAM PRIMARY CARE PHYSICIAN PARTICIPATION AGREEMENT
Primary Care Physician Participation Agreement • October 8th, 2018

(Please print, stamp or type physician’s name) hereafter called provider, and the Arkansas Division of Medical Services, hereafter called Medicaid.

Sample 1
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PRIMARY CARE PHYSICIAN PARTICIPATION AGREEMENT
Primary Care Physician Participation Agreement • December 4th, 2013

This Addendum to the Primary Care Physician Participation Agreement is entered into by and between Physician (hereinafter “Group”) and Corporation on the day of , 201_ (the “Effective Date”).

Sample 1
PCP PARTICIPATION AGREEMENT
Primary Care Physician Participation Agreement • April 18th, 2022

If your specialty of practice is listed above, you MUST complete the Primary Care Physician Participation Agreement and the EPSDT Agreement to participate in the Arkansas Medicaid Program. Please refer to Section I of your Arkansas Medicaid Provider manual for information concerning the Primary Care Physician Program.

Sample 1
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