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Asuris Agreement
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2018-06-05 10:00 AM - Commissioners' Agenda
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Asuris Agreement
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Last modified
1/18/2019 2:03:50 PM
Creation date
1/18/2019 2:03:02 PM
Metadata
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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
Fully Executed Version
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
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ASURIS NORTHWEST HEAL TH <br />PARTICIPATING PROVIDER MEDICAL GROUP AGREEMENT <br />PREFERRED PLAN PROVIDER NETWORK ADDENDUM <br />EFFECTIVE DATE: <br />r nis Addendum lo the Paftlcfpating Provider Med/cal Group Agreement, herein referred to as the <br />"Medical Group Agreement", amends the Med ical Group Agreement between Asur is Nor1hwest <br />Health (the "Company ") and KITTITAS COUNTY HEALTH DEPT ("Medical Group"), to recognize <br />additional provisions Which apply to the Preferred Plan Provider Network . and to provide ror the <br />recognnfon of health care services, and for payment ot benefits for health care services , provided <br />to Prererred Members . Except as specifically amended he rein , all terms and condit Qns of the <br />Medical Group Agreement remain in effect. <br />I. DEFINITIONS <br />A. 'Preferred Member" Is any subscriber or enrolled dependent entitled to benefits under a <br />Preferred Plan offered or administered by the Company or Payor, or any sub,crlber or <br />enrolled de pendent entitled to benefits under a Subs.crlber Agreemanl offered or <br />adml li stereo by the Company or Payor that provides lncen Uves for Members to seek <br />seTVices from Prefer red Plan Providers and Participating Providers in the Company's <br />Partici pating Provider Network. <br />B. "Preferred Plan" la any Subscriber Agreement that provides a benefit incentive for <br />subscribers or enrolled dependents lo seek health care services from Preferred Plan <br />Providers . <br />C. Preferred Plan Provider" is a Participating Provider in the Company's Preferred Plan <br />Provi der Network. <br />D. 'Preferred Plan Provider Network' is lhe collecllve group oT hosp itals , facilities, cllrrfcs . <br />physicians and olher t\ealth -care profeaslonals under contract with the Company through <br />a Preferred Plan Prov der Network Addendum . <br />II. PROVISIONS <br />A. Medloal Gmup agrees to be a Preferred Plan Provider, part icipate in the Preferred Plan <br />Provider Network and provide health oare services to Pref!lrred Members. <br />B. The Company shall acti vely market Preferred Plana that provide lncentiv«iis for Preferred <br />Membe.rs to se,ek services from Preferred Plan Prov ders with the Company's Preferred <br />Plan Provider Network . <br />C. The Company shall 11lso aoUvely market a Subscriber Agreement that provides lru;ent111e.s <br />for Members to seek services rrom Preferred Plan Providers and Particl pe Ung Providers <br />in the Company's Par11cfpating Provide~ Network . If Medical Group provides services for <br />Member s w1'0 are covered l\nder sucn a subscriber Agreement, the rates and terms <br />asaoclaled with the Preferred Pl.an Prov ider Network , as well as the oost snaring amounts <br />and terms in the Subscriber Agreerrient assoc iated with the Preferred Plan Prollfder <br />Network, shall be used to determine the reimbursement amount for Medical Group. <br />Aaurls Medical Standard MGA Prvlerred Plan Addendum A18816854AA Paga 1 of'Z
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