Get the free UCCI FFS Provider Agreement -- 052010 Final.doc

19. Dentist s contractual rights and responsibilities hereunder shall not be assigned or delegated without the prior written consent of United Concordia. This Agreement shall be assignable by United Concordia to a subsidiary affiliate or Successor Corporation. 20. 15. United Concordia shall indemnify and hold harmless Dentist from any and all claims liability cost damage or expense to the extent that such claims liability costs damages or expenses are solely caused by the negligence...

How to fill out ucci ffs provider agreement

How to fill out ucci ffs provider agreement

1. Read the UCCI FFS Provider Agreement carefully to understand the terms and conditions.
2. Gather all the necessary information and documents required for filling out the agreement, such as your personal information, contact details, and credentials.
3. Prepare a list of the services you will be providing as a FFS provider under the agreement.
4. Fill out the agreement form accurately, providing all the requested information as per the guidelines.
5. Review the completed agreement form to ensure all the details are correct and nothing is missed.
6. Sign the agreement form using your legal signature.
7. Submit the filled-out and signed agreement form to the relevant UCCI authority or administrator.
8. Keep a copy of the agreement for your records.

Who needs ucci ffs provider agreement?

1. Healthcare practitioners who wish to provide services on a Fee-for-Service (FFS) basis under the UCCI system.
2. Individuals or organizations that meet the eligibility criteria and want to participate as FFS providers in the UCCI network.
3. Those who want to establish a formal agreement with UCCI to ensure compliance and payment for services rendered.
4. Existing or new healthcare providers who want to expand their patient base and reach by becoming part of the UCCI FFS provider network.

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What is ucci ffs provider agreement?

The UCCI FFS provider agreement is a contract between a provider and a healthcare organization that outlines the terms and conditions for providing fee-for-service healthcare services.

Who is required to file ucci ffs provider agreement?

Healthcare providers who wish to participate in a fee-for-service agreement with a UCCI organization are required to file a provider agreement.

How to fill out ucci ffs provider agreement?

Providers must complete all required fields on the UCCI FFS provider agreement form and submit it to the appropriate UCCI organization for review and approval.

What is the purpose of ucci ffs provider agreement?

The purpose of the UCCI FFS provider agreement is to establish a formal relationship between a provider and a healthcare organization for the provision of fee-for-service healthcare services.

What information must be reported on ucci ffs provider agreement?

The UCCI FFS provider agreement typically requires providers to report their contact information, credentials, services offered, billing practices, and compliance with applicable laws and regulations.