Get the free Ancillary Network Contracting and Credentialing Information Form

This form is used by non-behavioral health providers to provide necessary information for credentialing and contracting with Harvard Pilgrim Health Care and Tufts Health Plan. It requires details about the facility, including accreditation, licensing, services offered, and compliance with various regulations.

How to fill out ancillary network contracting and

How to fill out ancillary network contracting and

1. Gather necessary information about your business and services offered.
2. Obtain the ancillary network contracting forms from the relevant authority or organization.
3. Fill out the application form accurately with business details, including NPI, tax ID, and services provided.
4. Provide any necessary documentation that supports your application, such as licenses, insurance, and financial statements.
5. Review the completed application for accuracy and completeness.
6. Submit the application along with required documentation to the designated network or contracting authority.
7. Follow up on the application status after a few weeks to ensure it is being processed.

Who needs ancillary network contracting and?

1. Healthcare providers looking to expand their service offerings.
2. Organizations aiming to provide ancillary services such as physical therapy, radiology, or lab work.
3. Health systems seeking to establish networks with ancillary service providers.
4. Insurance companies wanting to include additional service providers in their network.
5. Patients or clients seeking access to a broader range of healthcare services.

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What is ancillary network contracting?

Ancillary network contracting refers to the process of establishing agreements between healthcare providers and networks that offer supplemental services beyond primary medical care, such as physical therapy, laboratory services, or radiology.

Who is required to file ancillary network contracting?

Healthcare providers and organizations that wish to participate in an ancillary network must file ancillary network contracting.

How to fill out ancillary network contracting?

To fill out ancillary network contracting, providers must provide information about their services, credentials, billing practices, and comply with the specific requirements set by the network they are contracting with.

What is the purpose of ancillary network contracting?

The purpose of ancillary network contracting is to facilitate the integration of supplementary healthcare services, ensuring that patients have access to a comprehensive range of treatments and diagnostics.

What information must be reported on ancillary network contracting?

The information that must be reported includes provider identification details, service descriptions, fee schedules, insurance information, and compliance with legal and regulatory requirements.