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INITIATIVE POTENTIAL EPISODE INITIATOR PARTICIPANT CONSENT FOR SUBMISSION Signature Medical Group, Inc. (SMG) is a current Awardee Convener in the Bundled Payments for Care Improvement Model 2 Initiative
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To fill out the BPCI Advanced Consent Form, follow these steps:
02
Begin by providing your personal information, including your name, address, phone number, and email address.
03
Specify whether you are an individual or representing an organization.
04
If representing an organization, provide the organization's name and address.
05
Indicate the type of legal entity you are, such as an individual, corporation, partnership, or other forms.
06
Specify whether you are a participating entity or non-participating entity.
07
If you are a participating entity, provide the list of participants with their respective CMS Certification Numbers (CCN).
08
Include any additional information or attachments required as per the instructions on the form.
09
Review the completed form to ensure all information is accurate and complete.
10
Sign and date the form.
11
Submit the form as indicated in the instructions.

Who needs bpci advanced consent for?

01
The BPCI Advanced Consent form is required for healthcare providers and organizations participating in the Bundled Payments for Care Improvement Advanced (BPCI Advanced) program. This program is open to hospitals, physician group practices, skilled nursing facilities, and other eligible healthcare providers who meet the program's criteria and have been accepted as participants.
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BPCI Advanced Consent is for healthcare providers to participate in the Bundled Payments for Care Improvement Advanced (BPCI Advanced) model.
Healthcare providers who wish to participate in the BPCI Advanced model are required to file the advanced consent.
Healthcare providers can fill out the advanced consent form online through the BPCI Advanced portal.
The purpose of bpci advanced consent is to officially enroll healthcare providers in the BPCI Advanced model.
The advanced consent form requires providers to report basic information such as name, contact details, and practice information.
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