Managed Care Contract Termination Letter

July 24, 2015

Use this simple letter to send notice of contract termination.

To download this letter, click here: Managed Care Contract Termination Letter


Date

Payer Name
Payer Address
City, State, Zip

Via Facsimile: ______________[fax number] (Hard Copy to Follow by Registered Mail)

To Whom It May Concern:

Pursuant to Section ___, Paragraph ___ of the Participating Medical Group Specialist Physician Agreement between __________________[payer name] and ___________________[practice or physician name], this letter serves as sufficient notice by ______________________[practice or physician name] of its termination of the aforementioned agreement. This termination shall be become effective _________________.

Respectfully,

_____________________
Office Administrator or Physician


To download this letter, click here: Managed Care Contract Termination Letter

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