TRADITIONAL PARTICIPATION AGREEMENTTraditional Participation Agreement • May 18th, 2022 • Michigan
THIS AGREEMENT is made by and between Blue Cross Blue Shield of Michigan (“BCBSM”) a Michigan nonprofit healthcare corporation, and the undersigned Independent Therapist (“Provider”) who is licensed or legally authorized to practice in Michigan.
BLUE CROSS AND BLUE SHIELD OF MICHIGAN PRACTITIONER TRADITIONAL PARTICIPATION AGREEMENTTraditional Participation Agreement • January 28th, 2022 • Michigan
THIS AGREEMENT is made by and between Blue Cross Blue Shield of Michigan, a Michigan nonprofit healthcare corporation, (“BCBSM”) and the undersigned Practitioner who is fully licensed or legally authorized to practice in the state of Michigan ("PRACTITIONER").
OUTPATIENT PHYSICAL THERAPY FACILITY TRADITIONAL PARTICIPATION AGREEMENTTraditional Participation Agreement • April 18th, 2022 • Michigan
This Agreement by and between Blue Cross Blue Shield of Michigan (“BCBSM”), a nonprofit health care corporation, and the undersigned Outpatient Physical Therapy 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:
BLUE CROSS BLUE SHIELD OF MICHIGAN END-STAGE RENAL DISEASE FACILITY TRADITIONAL PARTICIPATION AGREEMENTTraditional Participation Agreement • November 7th, 2022 • Michigan
This Agreement is made by and between Blue Cross Blue Shield of Michigan (BCBSM) and Facility, an End-Stage Renal Disease (ESRD) facility whose tax name, business name (dba) and address are listed on the accompanying Signature Document.
