The Health Care Service Provider Agreement serves as a crucial document in the U.S. healthcare system, establishing the professional relationship between healthcare providers and organizations. This agreement is essential when medical services are being contracted, whether for individual practitioners joining a practice, facilities engaging specialist services, or organizations establishing network relationships. It encompasses critical aspects of modern healthcare delivery, including HIPAA compliance, quality metrics, liability provisions, and payment terms, while ensuring adherence to both federal and state healthcare regulations.
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1. Parties: Identification of the healthcare provider and the entity engaging their services
2. Background: Context of the agreement and basic premises
3. Definitions: Key terms used throughout the agreement including HIPAA-related definitions
4. Scope of Services: Detailed description of healthcare services to be provided
5. Term and Termination: Duration of agreement and conditions for termination
6. Compensation: Payment terms, fee schedule, and billing procedures
7. HIPAA Compliance: Privacy and security requirements for protected health information
8. Insurance and Liability: Required insurance coverage and liability provisions
9. Compliance with Laws: Obligations to comply with healthcare regulations and laws
1. Quality Assurance: Standards and metrics for service quality - include when specific quality metrics need to be monitored
2. Equipment and Facilities: Provisions regarding use of facilities or equipment - include when services are provided at specific locations or using specific equipment
3. On-Call Coverage: Requirements for after-hours availability - include when 24/7 coverage is needed
4. Medical Records: Specific requirements for maintaining patient records - include when additional record-keeping requirements exist beyond HIPAA
1. Schedule A - Services Description: Detailed list of services to be provided
2. Schedule B - Fee Schedule: Detailed breakdown of fees and payment terms
3. Schedule C - Insurance Requirements: Specific insurance coverage requirements
4. Schedule D - Quality Metrics: Performance indicators and quality standards
5. Schedule E - HIPAA Business Associate Agreement: Detailed HIPAA compliance requirements
6. Schedule F - Credentialing Requirements: Required qualifications and certifications
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