ANTHEM BLUE CROSS STATE SPONSORED BUSINESS POLICY ...

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SECTION

Medi-Cal _X_

Provider Network

Hlthy Fam HMO _X_

Hlthy Fam EPO ___

MRMIP ___ AIM _X_

SUBJECT

Provider Termination - Member Notification

(Physicians and Hospitals)

Reporting

Corporate Legal

Network Development

Credentialing

Provider Contracting and Database Administration

Policy Number: PNXX_303

QOC Approval Date: 04/22/09

PAGE 10 OF 10

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SECTION Medi-Cal _X_ Provider Network Hlthy Fam HMO _X_ Hlthy Fam EPO ___ MRMIP ___ AIM _X_ SUBJECT Provider Termination - Member Notification (Physicians and Hospitals) Reporting Corporate Legal Network Development Credentialing Provider Contracting and Database Administration Policy Number: PNXX_303 QOC Approval Date: 04/22/09 PAGE 10 OF 10

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Page 3 and 4: SECTION Medi-Cal _X_ Provider Netwo
Page 5 and 6: SECTION Medi-Cal _X_ Provider Netwo
Page 7 and 8: SECTION Medi-Cal _X_ Provider Netwo
Page 9: SECTION Medi-Cal _X_ Provider Netwo

ANTHEM BLUE CROSS STATE SPONSORED BUSINESS POLICY ...

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