Financial Assistance Policy – Appendix B

1 Financial Assistance Policy – Appendix B Approved by: BHSM Rehabilitation Board of Directors Date Last Approved: 10/16/2019 Date of Issue: 1/1/2024 Version: 2024-1 Printed copies are for reference only. [...] Please refer to the electronic copy for the latest version. [...] Financial Assistance Policy Appendix B Providers Not Covered Under the Financial Assistance Policy The Financial Assistance Policy (FAP) applies to BHSM Rehabilitation, LLC. [...] Services provided by the practitioner groups listed below are not covered under this FAP. [...] Services Provided under Banner Health providers, while not covered under this FAP, may be covered under the Banner Health Financial Assistance Policy. [...] To verify whether a provider is a Banner Health provider please call 1-480-684-7409 if you are in Arizona or 1-855-244-7460 if you are outside of Arizona or see the Banner Health Financial Assistance Policy online at . [...] This listing is effective as of 1/1/2024 and is updated quarterly. [...] If you do not see a provider listed here and want to verify whether that person is covered under this FAP, please contact our customer service department at 1-888-868-1103. [...] Practice Name: PHYSICIAN NAME ASSOCIATES NAME STATT JUSTIN THE CORE INSTITUTE MHATRE MONA THE CORE INSTITUTE BEN-AVIV DAVID THE CORE INSTITUTE MAKHIJA MANOJ SUNRISE MEDICAL ASSOC PAUL KULBHUSHAN SUNRISE MEDICAL ASSOC SINGH GAGANDIP SU