Provider Credentialing Agreement Sample Contracts

Standard Contracts

School District Assurance Agreement Provider Credentialing of Behavioral Sciences Staff
Provider Credentialing Agreement • May 24th, 2023

The __________ County school district agrees and maintains the necessary documentation that Florida Medicaid credentialing requirements for behavioral services staff are met prior to billing, as follows:

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School District Assurance Agreement Provider Credentialing of Psychologists, Behavior Analysts, and Social Workers
Provider Credentialing Agreement • September 25th, 2021

The__________County school district agrees that Florida Medicaid reimbursable services will be billed only for those employed or contracted staff rendering health-related services who meet Florida Medicaid credentialing requirements. All services billed to Florida Medicaid must be within the validity period on the individual’s license and/or certification.

County Health Department Agreement Provider Credentialing of Behavioral Health Providers and Social Workers
Provider Credentialing Agreement • September 8th, 2021

The ________________county health department (CHD) agrees that Florida Medicaid will cover services rendered to recipients by employees or contracted staff who meet Florida Medicaid credentialing requirements, as follows:

School District Assurance Agreement Provider Credentialing of Therapists and Therapy Assistants
Provider Credentialing Agreement • November 28th, 2021

The _________ County school district agrees that Florida Medicaid reimbursable services will be billed only for employed or contracted staff rendering health-related services who meet Florida Medicaid credentialing requirements. All services billed to Florida Medicaid must be within the validity period on the individual’s license or certification.

School District Assurance Agreement Provider Credentialing of School Health Aides
Provider Credentialing Agreement • November 5th, 2021

The __________ County school district agrees and maintains the necessary documentation to validate that Florida Medicaid credentialing requirements for school health aides are met as follows:

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