Obligations of Provider. 3.1 Provider shall submit information to InterWest, upon request, as may be required to support InterWest’s provider credentialing process. Provider warrants and represents that all such information is true, accurate, and complete and shall notify InterWest promptly of any changes.
3.2 Provider shall accept as patients those Enrollees of Health Benefit Plans that provide access to Health Care Networks in which Provider has agreed to participate, as identified by the Schedules incorporated as attachments to this Agreement. This obligation does not prohibit Provider from refusing to render non-Emergency services to any Enrollee that demonstrates violent, threatening, abusive, or otherwise inappropriate behavior. Provider may close his or her practice to new Enrollees upon ninety (90) days’ advance written notice to InterWest.
3.3 Provider shall provide Covered Services to Enrollees within the scope of his or her license, certification, and specialty. Provider shall make best efforts to ensure that such services are Medically Necessary and are provided in a cost effective manner consistent with quality of care.
3.4 Provider shall make best efforts to provide Covered Services in the same manner, with the same availability, and in accordance with the same standards as provided to other patients, without regard to an Enrollee’s participation as a private purchaser or as a participant in a publicly financed program of health care services. Provider shall not discriminate against an Enrollee on the basis of race, color, national origin, ancestry, religion, sex, marital status, sexual orientation, age, handicap, source of payment, or lawful employment.
3.5 Provider shall make best efforts to cooperate with the utilization management requirements of Payors, as documented on Enrollees’ ID cards and other materials issued by Payors or by InterWest on a Payor’s behalf. Such requirements include, but are not limited to, preadmission certification, emergency admission notification, continued stay review, discharge planning, prior approval for outpatient procedures, and case management.
3.6 Provider shall submit claims data to Payors for Covered Services rendered to Enrollees. Such data shall be submitted electronically or on UB-04 or CMS 1500 claim forms (or successor forms) in accordance with:
(a) Procedures established by Payors or by InterWest on a Payor’s behalf; and
(b) Standard industry conventions for CPT, HCPCS, ICD-9, and other coding. Claims shall be submitted ...
Obligations of Provider a. Provider represents and warrants to Business Associate that its Notice of Privacy Practices permits Provider to disclose PHI to Business Associate, and that the Notice of Privacy Practices used by Provider incorporates the terms and statements required by the Privacy Rule. Provider agrees that Provider shall not modify such notice or its privacy procedures in any manner that may affect Business Associate’s authority to use or disclose PHI pursuant to this Agreement without the consent of Business Associate, except as may be required by applicable law.
b. If applicable, Provider shall notify Business Associate of any changes in, or revocation of, permission by a Patient to use or disclose PHI, to the extent that such changes may affect the permitted uses or disclosures of such PHI by Business Associate.
c. Provider shall not request that Business Associate use or disclose PHI in any manner that would not be permissible under the Privacy Rule, Security Rule or other applicable law or its Notice of Privacy Practices if done by Provider except the uses specifically permitted under Section IV. above, where Business Associate may use or disclose PHI for data aggregation or management and administrative activities of Business Associate.
d. Provider represents and warrants to Business Associate that Provider shall comply with all requirements of the Privacy Rule, Security Rule, and any similar federal or state requirements relating to privacy concerns.
Obligations of Provider. From and after the Execution Date, subject to Section 11.3 and the rights of PROVIDER with respect to the CUSTOMER Licensed Technology pursuant to Exhibit I, and except as otherwise contemplated by this Agreement or any PSA, the PROVIDER shall not, and shall cause its Affiliates and their respective officers, directors, employees, and other agents and representatives, including attorneys, agents, customers, suppliers, contractors, consultants and other representatives of any Person providing financing (collectively, “Representatives”), not to, directly or indirectly, disclose, reveal, divulge or communicate to any Person other than Representatives of such party or of its Affiliates who reasonably need to know such information in providing Services to CUSTOMER or use or otherwise exploit for its own benefit or for the benefit of any third party, any CUSTOMER Confidential Information. If any disclosures are made in connection with providing Services to CUSTOMER, its Affiliates or Representatives under this Agreement, then the CUSTOMER Confidential Information so disclosed shall be used only as required to perform the Services. PROVIDER shall use the same degree of care to prevent and restrain the unauthorized use or disclosure of the CUSTOMER Confidential Information by any of its Representatives as it currently uses for its own confidential information of a like nature, but in no event less than a reasonable standard of care. For purposes of this Section 11.1, any Information, material or documents relating to the Genworth Business currently or formerly conducted, or proposed to be conducted, by any member of the Genworth Group furnished to or in possession of the PROVIDER and its Affiliates and Representatives, irrespective of the form of communication, and all notes, analyses, compilations, forecasts, data, translations, studies, memoranda or other documents prepared by PROVIDER, its Affiliates and their respective Representatives, that contain or otherwise reflect such Information, material or documents is hereinafter referred to as “CUSTOMER Confidential Information.” “CUSTOMER Confidential Information” does not include, and there shall be no obligation hereunder with respect to, Information that (i) is or becomes generally available to the public, other than as a result of a disclosure by PROVIDER, its Affiliates or Representatives not otherwise permissible hereunder, (ii) PROVIDER or such Affiliate or Representative can demonstrate was or became avail...
Obligations of Provider. 1. During the entire term of this Agreement, Provider shall remain in good standing of the medical staff of the Primary Hospital(s) as referenced in Exhibit “B” with privileges in Inpatient Intensive Medicine. Loss of such medical staff membership or loss, impairment, suspension or reduction in privileges shall result in immediate termination of this Agreement.
2. Provider shall advise Group of each malpractice claim filed against Provider and each settlement or judgment of malpractice within fifteen (15) days following said filing, settlement, or judgment. Provider represents and warrants that no claims of malpractice have been made against Provider except as previously indicated in writing to the Group.
3. Provider has agreed to provide Covered Inpatient Intensive Medical Services as referenced in Exhibit “A,” Exhibit “B,” and Exhibit “C.”
4. Provider shall maintain active licenses and DEA numbers in the State of California. Group shall pay all associated licensing fees and expenses. Provider may also maintain active or inactive licenses in other states at Provider’s sole expense.
5. Provider shall cooperate with independent quality review and improvement organization activities pertaining to provision of services. Provider shall comply with M+CO medical policies, quality assurance programs and medical management programs. Provider shall fully cooperate with and adhere to Medicare's appeals, expedited appeals and expedited review procedures for M+CO Members, including gathering and forwarding information on appeals to M+CO as necessary.
6. Provider shall abide by all standards specified by the Healthcare Facilities Accreditation Program (the “HFAP”) or the Joint Commission on Accreditation of Healthcare Organizations (“JCAHO”) (whichever is applicable), or any comparable deemed status organization in the current accreditation manual for hospitals and all regulations set forth in Title 22, Division 5 of the California Code of Regulations, with respect to the provision of the Services.
7. As to those patients assigned to Provider, Provider shall:
(a) Timely assess all newly admitted patients in accordance with the following timelines:
Obligations of Provider. 2.1 PROVIDER shall perform the Installation Services described in the dispatch scope of work. PROVIDER shall not subcontract or delegate the Installation Services to be performed under this Agreement to another third party, unless PROVIDER obtains ESSENTIAL’s prior consent. If PROVIDER subcontracts or delegates any of the Services to be performed under this Agreement to another party, with or without ESSENTIAL’s consent, PROVIDER shall be solely responsible to ensure that the third Party is in compliance with all of the terms and conditions of this Agreement, including, but not limited to, the insurance requirements set forth herein.
2.2 During the performance of Installation Services PROVIDER shall refrain from performing any services beyond the scope of services outlined in the dispatch scope of work, unless PROVIDER has given ESSENTIAL a good faith estimate of the cost of such additional services and has received prior authorization from ESSENTIAL to perform such services.
2.3 In the event PROVIDER is solicited directly by Customer for Installation Services of ESSENTIAL POS equipment, PROVIDER shall immediately refer such opportunities to ESSENTIAL.
2.4 In the event PROVIDER is solicited directly by Customer for services other than Installation Services, including, but not limited to, on-site maintenance services, PROVIDER shall immediately refer such Customer to ESSENTIAL.
2.5 Unless otherwise directed by ESSENTIAL, PROVIDER should identify themselves to Customers as providing services on behalf of ESSENTIAL.
2.6 PROVIDER agrees to use its best efforts to perform each of the duties described in this Agreement in a manner that preserves and protects ESSENTIAL's business reputation and its proprietary rights in the marketplace. In carrying out its obligations under this Agreement, PROVIDER shall act in accordance with good faith and fair dealing.
Obligations of Provider. 19. Provider agrees to carry out the following obligations under this Agreement:
Obligations of Provider. A. Provider represents and warrants to Associate that Provider shall comply with all requirements of the Privacy of Individually Identifiable Health Information, at 45 Code of Federal Regulations (“CFR”) part 160 and part 164 subpart E (the “Privacy Rule”), the Security Standards issued at 45 CFR part 160 and part 164 subpart C (the “Security Rule”).
B. Provider represents and warrants to Associate that its Notice of Privacy Practices permits Provider to disclose PHI to Associate, and that the Notice of Privacy Practices used by Provider incorporates the terms and statements required by the Privacy Rule. Provider agrees that Provider shall not modify such notice or its privacy procedures in any manner that may affect Associate’s authority to use or disclose PHI pursuant to this Agreement without the consent of Associate, except as may be required by applicable law.
C. Provider shall notify Associate of any changes in, or revocation of, permission by a Patient, or other third party, to use or disclose PHI, to the extent that such changes may affect the permitted uses or disclosures of such PHI by Associate.
D. Provider shall not request that Associate use or disclose PHI in any manner that would not be permissible under the Privacy Rule, Security Rule or other applicable law.
Obligations of Provider. Without limiting the duty of confidentiality arising from this Agreement and under the law, Provider agrees not to use IIBA’s Confidential Information for its benefit or for the benefit of third parties, including but not limited to: (i) assisting individuals preparing for examinations conducted by IIBA; (ii) sharing of Confidential Information during private instruction, workshops, or training Programs; (iii) development, modification, or enhancement of training Programs, Courses, or workshops based on this Confidential Information, except where the Confidential Information is Limited Disclosure Confidential Information that IIBA expressly permits for internal use only; and
Obligations of Provider a. PROVIDER agrees to enroll in the North Dakota Medicaid program, if not already enrolled, and to remain in good standing as a participating provider in such program. If PROVIDER is a group of practitioners, each practitioner in the group who furnishes specified services to a Medicaid- enrolled IHS beneficiary under a care coordination arrangement described in section V of this Agreement must be enrolled and in good standing as a provider in the North Dakota Medicaid program.
b. PROVIDER agrees to carry out and comply with the requirements of the care coordination arrangement set forth in section V of this Agreement.
c. PROVIDER is responsible for billing for all services furnished, regardless of whether the IHS Beneficiary is enrolled in Medicaid or covered by another alternate resource. For Medicaid claims, the PROVIDER’s claim must contain the information specified by the North Dakota Medicaid program to document the care coordination arrangement under this Agreement.
d. PROVIDER shall not condition the provision of services to a Medicaid-Enrolled IHS Beneficiary on a Request for Services from IHS. Nothing in this Agreement shall preclude a Medicaid- Enrolled IHS Beneficiary from receiving care from any qualified Medicaid-enrolled provider who undertakes to furnish such service, and nothing in this agreement shall preclude PROVIDER from furnishing care that is not covered by this agreement.
e. PROVIDER agrees not to refuse a Request for Services to an individual on the basis that the payment for such service is authorized under PRC, and further agrees to accept applicable PRC payments rates and methodologies for the provision of requested services.
f. PROVIDER shall maintain malpractice insurance in the form and minimum amount required by the State in which the services are performed, and shall keep and maintain all required records of care, referrals, invoices, and billing documents. Services provided by PROVIDER pursuant to this Agreement are not covered by the Federal Tort Claims Act.
g. PROVIDER agrees to comply with the General Obligations described in section VIII of this Agreement.
Obligations of Provider. From and after the Execution Date, subject to Section 11.c and the rights of PROVIDER with respect to the CUSTOMER Licensed Technology pursuant to Exhibit I, and except as otherwise contemplated by this Agreement or any PSA, the PROVIDER shall not, and shall cause its Affiliates and their respective officers, directors, employees, and other agents and representatives, including attorneys, agents, customers, suppliers, contractors, consultants and other representatives of any Person providing financing (collectively, “Representatives”), not to, directly or indirectly, disclose, reveal,
