Membership dues are based upon combined Program Service Revenues for Home Health, Hospice and Palliative Care/Advanced Illness from all payers. All dues will be pro-rated quarterly for partial year memberships. Please use the chart below to determine your annual dues.
The undersigned hereby certifies that in making application for Provider Membership in ElevatingHOME, all information supplied on this form is true and correct, and that the undersigned is authorized to apply for membership on behalf of the company named above.
To submit by standard mail, please print and send your completed application to:
ElevatingHOMEATTN: Membership2121 Crystal Drive, Suite 750Arlington, VA 22202