BLUE CROSS BLUE SHIELD OF MICHIGAN AMBULATORY SURGERY FACILITY PARTICIPATION AGREEMENTParticipation Agreement • July 4th, 2022 • Michigan
Contract Type FiledJuly 4th, 2022 JurisdictionThis Agreement by and between Blue Cross Blue Shield of Michigan (BCBSM), a nonprofit health care corporation, and the undersigned Ambulatory Surgical Facility (Provider), that is duly licensed under applicable state law to conduct business, and whose tax name, business name (or DBA) and primary site address are listed on the accompanying Signature Document, and whose additional approved sites, if applicable, are listed on Addendum H. Pursuant to this Agreement, BCBSM and Provider agree as follows:
BLUE CROSS BLUE SHIELD OF MICHIGAN AMBULATORY SURGERY FACILITY PARTICIPATION AGREEMENTParticipation Agreement • November 30th, 2017 • Michigan
Contract Type FiledNovember 30th, 2017 JurisdictionThis Agreement by and between Blue Cross Blue Shield of Michigan (BCBSM), a nonprofit health care corporation, and the undersigned Ambulatory Surgical Facility (Provider), that is duly licensed under applicable state law to conduct business, and whose tax name, business name (or DBA) and primary site address are listed on the accompanying Signature Document, and whose additional approved sites, if applicable, are listed on Addendum H. Pursuant to this Agreement, BCBSM and Provider agree as follows: