TRADITIONAL PARTICIPATION AGREEMENT SIGNATURE DOCUMENTTraditional Participation Agreement • December 5th, 2012
IN WITNESS WHEREOF, the Provider wishing to be bound by the terms and conditions of the BCBSM Home Health Care Facility Traditional Participation Agreement (WP 12913 DEC 17) (Agreement) has affixed its signature to this Signature Document which is incorporated by reference in the Agreement.
PARTICIPATION AGREEMENTTraditional Participation Agreement • November 5th, 2022 • Michigan
This Agreement is made by and between Blue Cross Blue Shield of Michigan (BCBSM) and Facility, a Substance Abuse (SA) treatment facility whose tax name, business name and primary site address are listed on the accompanying Signature Document, and whose additional approved sites, if applicable, are listed on Addendum H.
BLUE CROSS BLUE SHIELD OF MICHIGAN HOME HEALTH CARE FACILITY TRADITIONAL PARTICIPATION AGREEMENTTraditional Participation Agreement • November 29th, 2017 • Michigan
This Agreement by and between Blue Cross Blue Shield of Michigan (“BCBSM”), a nonprofit health care corporation, and the undersigned Home Health Care Facility (“Provider”), that is located in Michigan and authorized under applicable state law to conduct business, and whose tax name, business name (or DBA) and primary site address are listed on the accompanying Signature Document. Pursuant to this Agreement, BCBSM and Provider agree as follows:
PARTICIPATION AGREEMENTTraditional Participation Agreement • November 29th, 2017 • Michigan
This Agreement is made by and between Blue Cross Blue Shield of Michigan (BCBSM) and Facility, a Substance Abuse (SA) treatment facility whose tax name, business name and primary site address are listed on the accompanying Signature Document, and whose additional approved sites, if applicable, are listed on Addendum H.
