CREDENTIALING AGREEMENT  (PLEASE READ & SIGN)

I understand / agree:

That Credentialing Solutions, LLC D/B/A Acier Healthcare Business Solutions ("Acier HBS") is not ultimately in control of how long the credentialing process takes. Often, credentialing takes between 90-120 days. However, at times the process can take longer. The Acier HBS team strives to make the credentialing process move as smoothly and quickly as possible.

Insurance companies do not make the process of credentialing easy, and have been known to ignore requests for applications, fail to receive sent applications, and lose supporting documentation. These challenges are remediable, but may slow the credentialing process.

All sales are final. Acier HBS cannot issue refunds.

While our success rate at credentialing is high, Acier HBS cannot guarantee that a provider will be ultimately accepted with any specific insurance company. If any insurance panel presents itself as closed, Acier HBS will make an appeal to the insurance company on the provider's behalf, should the insurance company be accepting appeals.

Your satisfaction is our number one priority! Our goal is to complete your credentialing quickly and with excellence!

LIMITED POWER OF ATTORNEY

I, _____________________________, appoint Credentialing Solutions, D/B/A Acier Healthcare Business Solutions, and employees thereof, my true and lawful attorney--in--fact for me, in my name and on my behalf, for the following specific and limited purposes only: Speaking with insurance companies; reviewing, signing, and submitting network provider applications and forms with requested insurance companies. I give and grant said attorney, full power and authority to do and perform all and every act and thing whatsoever necessary to be done in and about the specific and limited premises (set out herein) as fully, to all intents and purposes, as might or could be done if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that said attorney shall lawfully do or cause to be done by virtue hereof.