• US Legal Forms

Service Agreement Provider Without Changing Number In Hennepin

State:
Multi-State
County:
Hennepin
Control #:
US-00448BG
Format:
Word; 
Rich Text
Instant download

Description

The Service Agreement between Internet Service Provider and Subscriber establishes the terms under which a subscriber engages the ISP provider for internet services in Hennepin. Key features include the payment structure, where subscribers are responsible for setup charges and monthly fees that are non-refundable unless services are defective. The agreement mandates that subscribers provide their own equipment and abide by acceptable use policies, which prohibit illegal activities and unsolicited bulk emails. A liquidated damages clause specifies penalties for violations, reinforcing accountability among users. Importantly, the ISP provider retains the right to modify services and terminate accounts for improper use. This form is particularly useful for a range of legal professionals, including attorneys and paralegals who may need to understand the legal ramifications of service agreements. It serves as a template for creating enforceable agreements that protect both the ISP provider and the subscriber, aiding legal assistants and associates in drafting clear, compliant contracts.
Free preview
  • Preview Service Agreement between Internet Service Provider and Subscriber with a Liquidated Damage and Exculpatory Provision
  • Preview Service Agreement between Internet Service Provider and Subscriber with a Liquidated Damage and Exculpatory Provision
  • Preview Service Agreement between Internet Service Provider and Subscriber with a Liquidated Damage and Exculpatory Provision
  • Preview Service Agreement between Internet Service Provider and Subscriber with a Liquidated Damage and Exculpatory Provision

Form popularity

FAQ

Applying for an initial provider number Log on to HPOS using your PRODA account. Select My Details. Select My provider numbers. Select Create a new provider location. Complete the questions in the application and select Submit location.

On the other hand, a refer and request provider number does not allow you to bill Medicare, but permits you to offer services in a private billing context, recommend other practitioners to your patients, and request diagnostic tests.

What are the claims submission payer ID's? Please use payer ID 60058 to send claims directly to Hennepin Health's claims preprocessor, Availity.

Applying for an initial provider number Log on to HPOS using your PRODA account. Select My Details. Select My provider numbers. Select Create a new provider location. Complete the questions in the application and select Submit location.

Simply enter the organization's name (Hennepin Healthcare System Inc.) or EIN (421707837) in the 'Search Term' field.

The payer ID is often located on the back of the insurance card in the Provider or Claims Submission section. Below are some common examples. If you are unable to locate the payer ID, please enter NA or None.

MHCP claims, including original claims, replacement claims (frequency code 7) and void claims (frequency 8) must be submitted to Blue Cross using payer ID 00726.

Home State's Payer ID is 68069. Behavioral Health Payer ID is 68068. The clearinghouses are: All Scripts/Payerpath.

What are the claims submission payer ID's? Please use payer ID 60058 to send claims directly to Hennepin Health's claims preprocessor, Availity.

Trusted and secure by over 3 million people of the world’s leading companies

Service Agreement Provider Without Changing Number In Hennepin