Participating Provider Responsibilities
Below outlines important contract reminders for participating providers. Please note this is an overview and not intended to include all contractual provider obligations.
Below outlines important contract reminders for participating providers. Please note this is an overview and not intended to include all contractual provider obligations.
Provider will offer 24/7 telephone access to patients for their safety and protection, and will have procedures in place to respond to patients’ calls and requests after normal business hours.
Provider will not balance bill the member beyond patient responsibility, such as co-payments, coinsurance, and deductibles.
Facilities (and other designated providers) will send The Alliance information regarding any modifications related to their charge master.
Provider will notify The Alliance in a timely manner of claim(s) processed or submitted incorrectly.
Provider will submit claims according to regulations and in a timely manner to The Alliance.
Provider will comply with the requirements of The Alliance’s Provider Credentialing Program, including the timely completion of a credentialing application if requested.
Provider will provide services to all individuals in a prompt manner, consistent with professional, clinical, and ethical standards and without bias.
Using the Provider Update Form, provider will notify The Alliance 30 business days prior to a change in the following: