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FOUNDATION ACCOUNTABLE CARE NETWORK ACO PARTICIPANT AGREEMENT This ACO Participant Agreement (Agreement), is by and between FOUNDATION ACCOUNTABLE CARE NETWORK (ACO), 3993 Jurupa Avenue, Riverside,

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How to fill out this aco participant agreement

01

Step 1: Read the ACO Participant Agreement thoroughly and understand its terms and conditions.

02

Step 2: Fill in your personal information, such as your name, address, contact details, and social security number, in the designated fields.

03

Step 3: Provide information about your healthcare practice or organization, including its name, address, and tax identification number.

04

Step 4: Review the agreement sections related to financial arrangements, quality measures, and reporting requirements.

05

Step 5: If applicable, consult with legal or financial professionals to ensure you understand the legal implications and financial obligations of the agreement.

06

Step 6: Sign and date the ACO Participant Agreement.

07

Step 7: Submit the completed agreement to the appropriate authority or organization as instructed.

08

Step 8: Keep a copy of the signed agreement for your reference.

Who needs this aco participant agreement?

01

Healthcare providers or organizations participating in an Accountable Care Organization (ACO) need this ACO Participant Agreement.

02

Individuals or entities seeking to collaborate and coordinate care with other healthcare providers to improve quality and reduce costs can benefit from this agreement.

03

ACO Participant Agreements ensure that all parties involved in an ACO understand their roles, responsibilities, and financial arrangements.

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What is this aco participant agreement?

The ACO participant agreement is a contract that outlines the terms and conditions for healthcare providers to participate in an Accountable Care Organization (ACO).

Who is required to file this aco participant agreement?

Healthcare providers who are part of an ACO are required to file the participant agreement.

How to fill out this aco participant agreement?

The ACO participant agreement can be filled out by providing all the necessary information and signatures as outlined in the document.

What is the purpose of this aco participant agreement?

The purpose of the ACO participant agreement is to establish the responsibilities and expectations of healthcare providers who are part of an ACO.

What information must be reported on this aco participant agreement?

The ACO participant agreement may require information such as provider names, contact information, payment arrangements, and terms of participation.

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