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Provider Participation Request Form Members are to use this form when you would like to have Sanford Health Plans Provider Contracting team contact a nonparticipating provider for inclusion in Sanford

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How to fill out moda healths provider contracting

01

Step 1: Obtain the necessary documents and forms from Moda Health, such as the Provider Contracting Application.

02

Step 2: Read through the application and instructions carefully to ensure that you understand all the requirements and information needed.

03

Step 3: Fill out the application form accurately and completely, providing all the requested information.

04

Step 4: Attach any supporting documents or credentials required by Moda Health, such as copies of licenses, certifications, or proof of malpractice insurance.

05

Step 5: Review the completed application and make sure all information is correct and all required documents are attached.

06

Step 6: Submit the completed application and any required supporting documents to Moda Health either by mail or through their online portal.

07

Step 7: Wait for a response from Moda Health regarding your contracting application. They will review your application and contact you if any additional information is needed.

08

Step 8: Once your application is approved, review the terms and conditions of the provider contract offered by Moda Health.

09

Step 9: If you agree to the terms and conditions, sign the provider contract and return it to Moda Health.

10

Step 10: Keep a copy of the signed provider contract for your records.

Who needs moda healths provider contracting?

01

Healthcare providers, such as physicians, dentists, hospitals, clinics, and other medical professionals, who wish to participate in Moda Health's network and provide healthcare services to Moda Health's members.

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What is moda healths provider contracting?

Moda Health's provider contracting refers to the process of creating agreements with healthcare providers to establish network partnerships.

Who is required to file moda healths provider contracting?

Healthcare providers who wish to be a part of Moda Health's network are required to file provider contracting.

How to fill out moda healths provider contracting?

To fill out Moda Health's provider contracting, healthcare providers need to provide detailed information about their practice, services offered, and fees.

What is the purpose of moda healths provider contracting?

The purpose of Moda Health's provider contracting is to establish a network of healthcare providers who can deliver quality care to Moda Health's members.

What information must be reported on moda healths provider contracting?

Information such as provider credentials, services offered, fees, and availability must be reported on Moda Health's provider contracting.

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