Get the free Ancillary Group Provider Application - April 2024
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ANCILLARY GROUP PROVIDER APPLICATION Thank you for your interest in Health Alliance Plan (HAP) and HAP Resource. To begin the contracting process, please follow the instructions below. Note: Behavioral
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What is ancillary group provider application?
The ancillary group provider application is a form required for certain healthcare providers to enroll in health plans and networks, allowing them to offer ancillary services such as physical therapy, radiology, and laboratory services.
Who is required to file ancillary group provider application?
Healthcare providers who wish to offer ancillary services within a health plan or network must file the ancillary group provider application.
How to fill out ancillary group provider application?
To fill out the ancillary group provider application, providers must complete all required sections including practice information, services offered, and provider details, and submit any necessary supporting documentation.
What is the purpose of ancillary group provider application?
The purpose of the ancillary group provider application is to ensure that ancillary service providers meet the necessary qualifications and standards to be part of a health plan or network.
What information must be reported on ancillary group provider application?
The information that must be reported includes practice details, provider credentials, services provided, contact information, and any ownership or financial information as required.
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