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�r� P.O. Box 21267 <br />ANS, <br />�c�Seattle, WA 98111-3267 <br />ORTHWEST HEALTH <br />April 25, 2018 <br />KITTITAS COUNTY HEALTH DEPT <br />507 N NANUM ST <br />STE 102 <br />ELLENSBURG, WA 98926-2886 <br />Dear KITTITAS COUNTY HEALTH DEPT: <br />Thank you for your interest in becoming a participating provider with Asuris Northwest Health (Asuris). <br />Strong provider networks are essential for the delivery of quality health care to our members, and we <br />appreciate your willingness to join our networks. <br />Enclosed are the necessary documents required to join our provider network(s). Please review and sign <br />each agreement using the following steps: <br />1. Carefully review all documents <br />2. If you agree with the terms of the agreement, click "Continue" in the green "Accept Terms" box <br />3. Follow the instructions to electronically sign your agreement <br />4. A confirmation message will display once the terms of the agreement have been accepted <br />5. A final copy of the agreement will be electronically returned to you, along with an eSignature <br />receipt document containing signature information <br />You'll receive an email from us that will confirm the network(s) you are participating on and your <br />effective date of participation. <br />Important notes: <br />Claims submitted before your effective date of participation will be processed as out -of - <br />network. <br />• You must agree to the terms and electronically sign your provider agreement(s) to complete the <br />contracting process. <br />• Delays in signing your agreement(s) will impact your network participation date and may require <br />that you complete the credentialing process again. <br />Visit our provider website at asuris.com to view the tools and resources available to assist you in the <br />contracting process. If you have any questions, please contact our Provider Relations team. Contact <br />information is available in the Contact us section of our website. <br />Sincerely, <br />John S. Partin <br />Vice President <br />Network Management <br />Enclosures <br />Our provider website, asuris.com, offers extensive information and resources to support you. <br />You can find information about member cards, pre -authorization requirements and much more. <br />