Contracts with providers Sample Clauses
The 'Contracts with providers' clause establishes the terms and conditions under which a party may engage third-party service providers to perform certain obligations or services related to the agreement. This clause typically outlines requirements for selecting providers, such as ensuring they meet specific standards or obtain prior approval, and may address issues like confidentiality, liability, and compliance with applicable laws. Its core function is to ensure that any subcontracted or outsourced work maintains the quality and legal compliance expected under the main contract, thereby managing risk and clarifying responsibilities when external providers are involved.
Contracts with providers. All contracts with providers or with entities subcontracting for the provision of limited health services to enrollees on a prepayment or other basis must contain or must be construed to contain the following terms and conditions:
1. In the event the prepaid limited health service organization fails to pay for limited health services for any reason whatsoever, including insolvency or breach of this contract, the enrollees are not liable to the provider for any sums owed to the provider under this contract.
2. No provider, agent, trustee, or assignee thereof may maintain an action at law or attempt to collect from the enrollee sums owed to the provider by the prepaid limited health service organization.
3. These provisions do not prohibit collection of uncovered charges consented to by enrollees or collection of copayments from enrollees.
4. These provisions survive the termination of this contract, regardless of the reason giving rise to termination.
5. Termination of this contract does not release the provider from completing procedures in progress on enrollees then receiving treatment for a specific condition for a period not to exceed sixty days, at the same schedule of copayment or other applicable charge in effect upon the effective date of termination of this contract.
6. Any amendment to these foregoing provisions of this contract must be submitted to and be approved by the commissioner prior to becoming effective.