My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
Asuris and KCPHD Agreement
>
Meetings
>
2018
>
06. June
>
2018-06-05 10:00 AM - Commissioners' Agenda
>
Asuris and KCPHD Agreement
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/31/2018 1:16:16 PM
Creation date
5/31/2018 1:14:19 PM
Metadata
Fields
Template:
Meeting
Date
6/5/2018
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
k
Item
Request to Approve an Agreement between Asuris Northwest Health and the Kittitas County Public Health Department
Order
11
Placement
Consent Agenda
Row ID
45299
Type
Agreement
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
48
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
5.4 PARTICIPATION OF OTHER PROVIDERS IN PRACTICE — Medical Group understands <br />and agrees that continued participation in any of Company's Provider Networks requires <br />that all Medical Group Providers must apply and be accepted for participation in the <br />Provider Network. The failure of one or more of the health care providers in Medical <br />Group to be accepted for participation or their refusal to apply for or, upon approval, <br />accept such participation, may result in termination of this Agreement pursuant to Section <br />7.3. Accordingly, Medical Group must provide Company with at least thirty (30) days' <br />advance notice if one or more physicians/health care providers intend to join Medical <br />Group. <br />5.5 NON -EXCLUSIVITY — This Agreement will not be construed to be an exclusive <br />agreement between Company and Medical Group. Nothing in this Agreement or any <br />related documents will be construed to restrict the participation of any of the parties in <br />any other health care delivery system or payment plan. <br />5.6 PROVIDING SERVICES TO MEMBERS OF PAYORS — Medical Group understands and <br />agrees that the Company may enter into an agreement with Payors that want access to <br />and use of those Provider Networks in which Medical Group participates. Medical Group <br />hereby authorizes Payors contracting with Company to offer Medical Group's services to <br />groups of employees or individuals in accordance with the terms of this Agreement and <br />the provision of any Subscriber Agreement offered or administered by Payor for the <br />payment of Covered Services. Medical Group agrees to furnish services to Members of <br />such Payors when those Members utilize the Company's Provider Networks in <br />accordance with the same terms and conditions of participation and compensation as <br />apply when such services are furnished to Members under this Agreement. A list of the <br />Company's subsidiaries and affiliates is set forth on Exhibit A hereto. Company will <br />provide Medical Group with advance written notice should the list of affiliates and <br />subsidiaries in Exhibit A change and if Company enters into an agreement with a Payor <br />that is not specifically named in Section 1.16 or Exhibit A hereto. <br />5.7 USE OF NETWORK PROVIDERS — Unless Covered Services are unavailable from <br />Participating Providers, Medical Group will refer to and accept all coverage from <br />providers who are participating in Company's Provider Network. <br />5.8 RATE INFORMATION — Both parties agree that, unless required by law or authorized <br />by this Agreement, a party shall not disclose the reimbursement rates set forth in this <br />Agreement without prior written consent of the other party. The parties acknowledge that <br />the unauthorized disclosure of rate information may cause irreparable damage to the <br />other party. Notwithstanding the above, Company may disclose to Participating <br />Providers in Medical Group's service area the information and data required to allow <br />those Participating Providers to effectively manage the quality, care and cost of Members <br />Company has attributed to them. Company may also disclose health care claims and cost <br />data to community organizations, such as Puget Sound Health Alliance (PSHA) that seek <br />to improve health care quality and affordability by reporting aggregated data to <br />purchasers of health care services. <br />5.9 DISCLOSURE OF RATES TO MEMBERS — Notwithstanding any other provision of this <br />Agreement to the contrary, either party may disclose to Members the reimbursement rate <br />or allowed amount set forth in this Agreement for a Covered Service and/or the Member's <br />actual or estimated cost-sharing amount (e.g., copayment, deductible, and/or <br />coinsurance) for a Covered Service to explain claims payment and to facilitate informed <br />decisions regarding health care services use and cost. <br />VI. INSURANCE AND INDEMNIFICATION <br />6.1 PROFESSIONAL LIABILITY COVERAGE — Medical Group will obtain, at Medical <br />Group's own cost, and keep in force, adequate policies providing comprehensive general <br />liability, professional liability and other insurance, as may be necessary to insure Medical <br />Group, Medical Group's Providers, agents and employees against any claim or claims for <br />damages arising out of the rendering of or failure to render professional services <br />Asuris MGA Agreement (Rev. 05/2017) Al8816854AA Page 12 of 20 <br />
The URL can be used to link to this page
Your browser does not support the video tag.