Welcome, Facility Members!
Please see the information below for the documents required for Membership.
All Facility Members:
An authorized staff member representing the facility shall review and/or sign the following:
- For Review and Signature for All Facility Members: Master Agreement Document – Terms and Conditions
- For Review: Attachment A: Facility Membership Services and Rates
- For Review: Attachment B: Sample Service Request / RFP
- For Review and Signature (Only Required for Custom Services): Attachment C: Business Associate Agreement– The Business Associate Agreement (BAA) is required for any facility utilizing the support services, including email, phone and live support for MDS Coordinators, Rehab Managers or any other facility personnel. This Agreement protects the facility (Covered Entity) and Montero Therapy Services (Business Associate) by including all requirements by the Health Insurance Portability and Accountability Act of 1996, and the Health Information Technology for Economic and Clinical Health Act (found in Title XIII of the American Recovery and Reinvestment Act fo 2009) (HIPAA and HITECH)
- Facility Copy of Company W9: Download and Print for facility records if needed
Please review, sign and return #1 and #4 to us via any option below:
a. Fax: 1-844-582-8326
b. Email: [email protected]
c. US Mail: Montero Therapy Services, 15 Skyline Dr, Troy, NY 12180
Any questions? Please call Member Support Toll Free at 1-844-LTC-TEAM
or email us at [email protected]s.com
Submit A Request For Additional Consultation Services / Informal RFP