PROVIDER PORTAL AGREEMENTProvider Portal Agreement • October 7th, 2021 • Florida
This Provider Portal Agreement ("Agreement") is entered into by and between HS1 Medical Management, Inc. ("HS1", "We", "Us", or "Our") and the Provider ("Provider", "You", or "Your" means a medical provider or medical provider group that provides medical goods and services to an individual) named herein, a "Covered Entity" as defined in 45 CFR §160.103. HS1 and You are sometimes hereinafter referred to individually as the "Party" or collectively as the "Parties".
Provider PORTAL AGREEMENTProvider Portal Agreement • January 26th, 2022
I, the undersigned, request access to the Driscoll Health Plan (DHP) Provider portal on behalf of the provider office or facility shown below for the purposes of: (1) verifying DHP member eligibility, (2) verifying the status of claims submitted to DHP, and (3) other functionalities that may be provided in the future.
SeaCare® Provider Portal AgreementProvider Portal Agreement • August 19th, 2020
By executing this SeaCare® Provider Portal Agreement (“Agreement”), both Parties are entering into and agreeing to be bound by the terms and conditions for this Agreement, accessible at www.tritansoft.com/ppa-termsandconditions (“Terms and Conditions”). The Terms and Conditions are incorporated into this Agreement and shall be binding on the Parties. All capitalized terms used, but not defined, in this Agreement, have the meaning set forth in the Terms and Conditions.
Provider PORTAL AGREEMENTProvider Portal Agreement • January 21st, 2019
I, the undersigned, request access to the Driscoll Health Plan (DHP) Provider portal on behalf of the provider office or facility shown below for the purposes of: (1) verifying DHP member eligibility, (2) verifying the status of claims submitted to DHP, and (3) other functionalities that may be provided in the future.
Provider PORTAL AGREEMENTProvider Portal Agreement • June 7th, 2017
I, the undersigned, request access to the Driscoll Health Plan (DHP) Provider portal on behalf of the provider office or facility shown below for the purposes of: (1) verifying DHP member eligibility, (2) verifying the status of claims submitted to DHP, and (3) other functionalities that may be provided in the future.
