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R93-167 AUTHORIZING AGREEMENT - CARLE CLINIC ASSOCIATION, P.C.
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R93-167 AUTHORIZING AGREEMENT - CARLE CLINIC ASSOCIATION, P.C.
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7/14/2016 2:44:18 PM
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Resolution/Ordinance
Res Ord Num
R93-167
Res Ord Title
AUTHORIZING AGREEMENT - CARLE CLINIC ASSOCIATION, P.C.
Approved Date
11/15/1993
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� , . <br /> � � . <br /> S��'lON IV - COMPENSATION FOR SERVIC�S <br /> 4.1 Carle Clinic shaJl callect all applicable ca-payrnents and/or deductihles <br /> directfy from the Fatient and/or their representative. <br /> . 4.2 Carle Clinic shatt, upon receipt ftom Provider of invoices for c�vered <br /> services rendered ta Patients by the Provider, pay the Provider for such services in accordance <br /> with tiie terms and conditions set fortfi in Exhibit 'C', which is attached hereto and by this <br /> reference incorpor�ted herein. • <br /> 4.3 Frovider shall accept such compensation as fuli and camplete payment for <br /> the Demonsuation �ervices rendered to the Patients and shatl not biil any Patient and/or their <br /> representative for any residuaf amount which might be in exc�ss of the compensation <br /> � r in. � <br /> provided for he e <br /> . 4.4 The Provider shall be subject to the provisions of 42 CFR 413.17 (a-d) <br /> regarding related organizations. Services from parties related to tf�e Provider will be def►ned <br /> as directiy provided services and wiil be reimbursed using the same cost criteria as the <br /> demonstration site. <br /> ScCT10N V- LOCATION AND AVAII.ABILITY OF Sc�V10ES <br /> 5.1 Carie Clinic shali notify Patients residing in or near tfie Location of the <br /> avaiiability of the Demonstration Services covered under this Agresment and that Patients <br /> andlor their represzntative may elect to receive such Demonsvation Servic�s from Provider. <br /> SECTiON Vl - PROMOTIONAL MATERIAI FOR THE DEUIONSTRATION <br /> fi.1 Carie Clinic shall not us� in written materia[ promoting Demonssavon <br /> Services the name of Provider without permission of the Provider who has reviewed and <br /> approved the material, which approvai shail not be unreasonabiy witiiheld. <br /> 6.2 Provider shaU not make reference in written pramotional materials to its <br /> participation in the Demonsvation or its relationship to Carie Clinic witt�out approva! in writing <br /> af a designated afficial of Carie Clinic. <br /> SECTiON VIt - ACC�SS TO BOOKS AND RECORDS <br /> 7.'1 As provided in Health Care Fnancing Adminisuaiion Publication 15, <br /> Chapter 24,Section 2440,the Health and Human Services Secretary and the U.S.Compuolier <br /> � General (o� theu representatives), sfiall have accEss to Provider`s books, documents and <br /> -. .- <br /> • 3 <br />
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