抖阴短视频

Participating Provider Agreement Template for Philippines

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Key Requirements PROMPT example:

Participating Provider Agreement

"I need a Participating Provider Agreement for my multi-specialty clinic in Manila to join a national HMO network, with specific provisions for telemedicine services and electronic health records integration, to be effective from March 1, 2025."

Document background
The Participating Provider Agreement serves as the foundational contract between healthcare providers and healthcare networks/payors in the Philippines, establishing the framework for delivering medical services to network members. This agreement is essential when healthcare providers wish to join a network of providers or contract with insurance companies/HMOs to provide services to their members. It includes detailed provisions on service delivery, quality standards, compensation, compliance with Philippine healthcare regulations, and operational procedures. The document ensures alignment with key legislation such as the Universal Health Care Act (RA 11223), the National Health Insurance Act (RA 10606), and the Data Privacy Act (RA 10173), while addressing practical aspects of healthcare service delivery and payment mechanisms.
Suggested Sections

1. Parties: Identification of the contracting parties - the healthcare network/payor and the healthcare provider

2. Background: Context of the agreement and brief description of the parties' business activities

3. Definitions: Definitions of key terms used throughout the agreement

4. Scope of Services: Detailed description of medical services to be provided, including covered procedures and treatments

5. Provider Obligations: Key responsibilities of the healthcare provider, including quality standards, licensing requirements, and service levels

6. Payor Obligations: Responsibilities of the payor/network, including patient referrals and support services

7. Compensation and Billing: Payment terms, fee schedule, claims submission process, and reimbursement procedures

8. Quality Assurance: Quality standards, performance metrics, and monitoring procedures

9. Compliance Requirements: Regulatory compliance obligations, including licensing, accreditation, and reporting requirements

10. Records and Reporting: Requirements for maintaining medical records, reporting obligations, and documentation standards

11. Confidentiality and Data Protection: Obligations regarding patient privacy, data security, and compliance with privacy laws

12. Term and Termination: Duration of the agreement, renewal provisions, and termination rights

13. Liability and Indemnification: Allocation of risks, insurance requirements, and indemnification obligations

14. Dispute Resolution: Procedures for resolving disputes, including mediation and arbitration provisions

15. General Provisions: Standard contractual provisions including notices, amendments, and governing law

Optional Sections

1. Exclusivity: Terms regarding exclusive arrangements, if the provider agrees to work solely with the network

2. Marketing and Branding: Guidelines for use of names, logos, and marketing materials, if joint marketing is contemplated

3. Electronic Health Records: Specific provisions for EHR systems and integration, if electronic records are used

4. Telehealth Services: Requirements and procedures for providing telehealth services, if applicable

5. Training Requirements: Specific training obligations for provider staff, if required by the network

6. Emergency Services Protocol: Special procedures for emergency services, if the provider offers emergency care

7. Pharmacy Services: Specific requirements for prescription drugs and pharmacy services, if provided

8. Research and Clinical Trials: Provisions for participation in research or clinical trials, if relevant

Suggested Schedules

1. Schedule A - Fee Schedule: Detailed list of covered services and corresponding payment rates

2. Schedule B - Quality Metrics: Specific performance indicators and quality standards to be maintained

3. Schedule C - Required Insurance Coverage: Details of mandatory insurance coverage and minimum limits

4. Schedule D - Credentialing Requirements: List of required credentials, certifications, and licensing requirements

5. Schedule E - Service Locations: List of approved facility locations where services can be provided

6. Schedule F - Claims Submission Procedures: Detailed procedures for submitting and processing claims

7. Appendix 1 - Required Forms: Standard forms for claims, referrals, and other administrative processes

8. Appendix 2 - Network Policies: Key network policies and procedures that providers must follow

Authors

Alex Denne

Head of Growth (Open Source Law) @ 抖阴短视频 | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions




















































Clauses


















































Relevant Industries

Healthcare

Insurance

Medical Services

Healthcare Technology

Pharmaceuticals

Diagnostics

Ambulatory Care

Primary Care

Specialty Care

Healthcare Administration

Relevant Teams

Legal

Compliance

Provider Relations

Network Management

Operations

Quality Assurance

Claims Processing

Risk Management

Medical Affairs

Contract Administration

Healthcare Services

Business Development

Relevant Roles

Healthcare Network Manager

Provider Relations Director

Medical Director

Compliance Officer

Healthcare Administrator

Contract Manager

Legal Counsel

Claims Processing Manager

Quality Assurance Manager

Operations Director

Healthcare Facility Administrator

Risk Management Officer

Business Development Manager

Medical Services Coordinator

Network Development Manager

Industries










Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks, 聽Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination, 聽Severance Pay, Governing Law, Entire Agreemen

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