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NETWORK NEWS June 2008 Empire Plan Participating Providers for Laboratory Services As you know, on January 1, 2007, United Healthcare made important changes to its contracted laboratory service providers.
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Who needs participating providers?

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Insurance companies: Insurance companies typically require participating providers to offer their services to policyholders. This ensures that policyholders have access to a network of qualified providers and can benefit from predetermined rates and coverage.
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Healthcare organizations: Hospitals, clinics, and other healthcare organizations often need participating providers to be part of their network. This enables them to offer comprehensive medical services to patients and coordinate care effectively.
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Patients: Patients who have insurance policies or are seeking medical services from a specific healthcare organization may need participating providers. By choosing a participating provider, patients can often receive enhanced insurance benefits or have a more streamlined healthcare experience.
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Participating providers are healthcare professionals or organizations that have agreed to provide services to patients who are covered under a specific health insurance plan at a pre-negotiated rate.
Healthcare professionals or organizations that have agreed to be participating providers for a specific health insurance plan are required to file participating providers.
To fill out participating providers, healthcare professionals or organizations should provide the necessary information such as their contact details, services offered, and agreed-upon rates for the specific health insurance plan.
The purpose of participating providers is to ensure that patients covered under a specific health insurance plan have access to healthcare services at pre-negotiated rates, and to streamline the billing process between healthcare providers and insurance companies.
The information that must be reported on participating providers includes the name of the healthcare professional or organization, contact details, services offered, agreed-upon rates, and any other relevant information specified by the health insurance plan.
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