Physicians (MD, DO, PhD, DPM, OD, DD) $425 Physicians - Add'l location $100 Allied Health Professionals $425 Allied Health Professionals - Add'l location $100
Average Daily Census Less Than 50 $3,250 Average Daily Census 51 - 100 $6,000 Average Daily Census More Than 100 $11,500
Initial Facility Fees $3,250
Home Health $800 Hospice $800 DME $800 RHC $800 FQHC $800 Other provider types as approved by the Ark-La-Tex Health Network Board of Directors $800
Physicians (MD, DO, PhD, DPM, OD, DD) $300 Physicians - Late Fee $90 Physicians - Add'l location $100 Allied Health Professionals $300 Allied Health Professionals - Late Fee $90 Allied Health Professionals - Add'l location $100
Average Daily Census Less Than 50 $2,750 Average Daily Census 51 - 100 $5,500 Average Daily Census More Than 100 $11,000
Annual Facility Fees $2,750
Home Health $550 Hospice $550 DME $550 RHC $550 FQHC $550 Other provider types as approved by the Ark-La-Tex Health Network Board of Directors $550
Tax Identification Number Modification, Additions or Changes $100 Other fees
Insurance Symposium - Non-Ark-La-Tex Health Network Members $129 Insurance Symposium - Ark-La-Tex Health Network Members $0
$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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