Physicians (MD, DO, PhD, DPM, OD, DD) $425.00 Physicians - Add'l location $100.00 Allied Health Professionals $425.00 Allied Health Professionals - Add'l location $100.00
Average Daily Census Less Than 50 $3,250.00 Average Daily Census 51 - 100 $6,000.00 Average Daily Census More Than 100 $11,500.00
Initial Facility Fees $3,250.00
Home Health $800.00 Hospice $800.00 DME $800.00 RHC $800.00 FQHC $800.00 Other provider types as approved by the Ark-La-Tex Health Network Board of Directors $800.00
Physicians (MD, DO, PhD, DPM, OD, DD) $300.00 Physicians - Late Fee $90.00 Physicians - Add'l location $100.00 Allied Health Professionals $300.00 Allied Health Professionals - Late Fee $90.00 Allied Health Professionals - Add'l location $100.00
Average Daily Census Less Than 50 $2,750.00 Average Daily Census 51 - 100 $5,500.00 Average Daily Census More Than 100 $11,000.00
Annual Facility Fees $2,750.00
Home Health $550.00 Hospice $550.00 DME $550.00 RHC $550.00 FQHC $550.00 Other provider types as approved by the Ark-La-Tex Health Network Board of Directors $550.00
Tax Identification Number Modification, Additions or Changes $100.00 Other fees
Insurance Symposium - Non-Ark-La-Tex Health Network Members $129.00 Insurance Symposium - Ark-La-Tex Health Network Members $0.00
$0 TOTAL:

Refund Policy:

If an initial applicant is not approved for participation as a participating provider, the initial participation fee will be refunded, less operational expenses incurred.
Annual participation fees paid by current ALT providers will not be refunded under any circumstances.

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