Common use of PRACTITIONER’S OBLIGATIONS Clause in Contracts

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT] 5.1.2 to adhere to the Billing Principles set out at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?source=published#billing 5.1.3 to charge in accordance with the AXA PPP Schedule of Procedures. The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Schedule of Procedures; 5.1.4 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and e) The Practitioner continues to apply the rates set out in the AXA PPP Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a) to 5.1.4(c) above. 5.1.5 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.5; 5.1.6 to provide an average of [5.5] sessions per Member for the Treatment of each Medical Condition; 5.1.7 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, within six months of the commencement of Treatment; 5.1.9 to ensure its details are accurate at all times and all changes are promptly notified to AXA PPP on the following website: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) e-mail address; e) contact telephone numbers with relevant names; f) all the hospitals in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults only or undertakes treatment at those hospitals; g) the Practitioner’s speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance information; 5.1.10 to comply with all Regulatory Requirements; 5.1.11 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of Procedures, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Fee Approved Practitioner Agreement

AutoNDA by SimpleDocs

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT] 5.1.2 to adhere to the Billing Principles set out at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?source=published#billingxxxxx://xxxxxxxxxxxxxxx.xxxxxxxxxx.xxxxxxxxx.xx.xx/SpecialistCode.mvc/Introduction 5.1.3 to charge in accordance with the AXA PPP Schedule of Procedures. The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. xxxxx://xxxxxxxx.xxxxxxxxx.xx.xx/individual/individual-provider-support/query-billing- principles/ For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Schedule of Procedures; 5.1.4 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and e) The Practitioner continues to apply the rates set out in the AXA PPP Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a) to 5.1.4(c) above. 5.1.5 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.5; 5.1.6 to provide an average of [5.5] sessions per Member for the Treatment of each Medical Condition; 5.1.7 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, within six months of the commencement of Treatment; 5.1.9 to ensure its details are accurate at all times and all changes are promptly notified to AXA PPP on the following website: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) e-mail address; e) contact telephone numbers with relevant names; f) all the hospitals in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults only or undertakes treatment at those hospitals; g) the Practitioner’s speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance information; 5.1.10 to comply with all Regulatory Requirements; 5.1.11 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of Procedures, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Fee Approved Practitioner Agreement

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT] 5.1.2 to adhere to the Billing Principles set out at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?sourcexxxxx://xxxxxxxxxxxxxxx.xxxxxxxxxx.xxxxxxxxx.xx.xx/SpecialistCode.mvc/Introduction? source=published#billing 5.1.3 5.1.2 to charge in accordance with the AXA PPP Schedule of Procedures. The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. xxxxx://xxxxxxxx.xxxxxxxxx.xx.xx/individual/individual-provider-support/query-billing- principles/ For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Schedule of Procedures; 5.1.4 5.1.3 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and e) The Practitioner continues to apply the rates set out in the AXA PPP Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a5.1.3(a) to 5.1.4(c5.1.3(c) above. 5.1.5 5.1.4 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 5.1.4 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.55.1.4; 5.1.6 5.1.5 to provide an average of [5.5] 5.5 sessions per Member for the Treatment of each Medical Condition; 5.1.7 5.1.6 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 5.1.7 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, within six months of the commencement of Treatment; 5.1.9 5.1.8 to ensure its details are accurate at all times and all changes are promptly notified to AXA PPP on the following website: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) e-mail address; e) contact telephone numbers with relevant names; f) all the hospitals in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults only or undertakes treatment at those hospitals; g) the Practitioner’s speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance information; 5.1.10 5.1.9 to comply with all Regulatory Requirements; 5.1.11 5.1.10 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of Procedures, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 5.1.11 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Fee Approved Practitioner Agreement

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT] 5.1.2 to adhere to the Billing Principles set out at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?source=published#billing 5.1.3 5.1.2 to charge in accordance with the AXA PPP Schedule of Procedures. The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Schedule of Procedures; 5.1.4 5.1.3 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and e) The Practitioner continues to apply the rates set out in the AXA PPP Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a5.1.3(a) to 5.1.4(c5.1.3(c) above. 5.1.5 5.1.4 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 5.1.4 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.55.1.4; 5.1.6 5.1.5 to provide an average of [5.5] 5.5 sessions per Member for the Treatment of each Medical Condition; 5.1.7 5.1.6 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 5.1.7 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, within six months of the commencement of Treatment; 5.1.9 5.1.8 to ensure its details are accurate at all times and all changes are promptly notified to AXA PPP on the following website: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) e-mail address; e) contact telephone numbers with relevant names; f) all the hospitals in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults only or undertakes treatment at those hospitals; g) the Practitioner’s speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance information; 5.1.10 5.1.9 to comply with all Regulatory Requirements; 5.1.11 5.1.10 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of Procedures, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 5.1.11 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Fee Approved Practitioner Agreement

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT] 5.1.2 to adhere to the Billing Principles set out at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?source=published#billing; 5.1.3 5.1.2 to charge in accordance with the AXA PPP Schedule of Procedures. The following rules must be followed in all circumstances: a) where the Practitioner is providing a remote consultation to the Member, the Practitioner shall charge the applicable standard consultation rate as set out in the AXA PPP Schedule of Procedures; and b) the Practitioner may only provide family therapy to Members if the Members have been referred by a psychiatrist who is recognised by AXA PPP and it has been agreed by AXA PPP’s psychiatric team in advance who can be contacted either by telephone on 00000 000000 or by submitting a Medical Report via the website at xxxxx://xxxxxxxx.xxxxxxxxxxxxxxxx.xx.xx/microsites/pss/hcep-widget/. If approved, the Practitioner must charge the rate for family therapy as set out in the AXA PPP Schedule of Procedures; 5.1.3 The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Schedule of Procedures; 5.1.4 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and e) The Practitioner continues to apply the rates set out in the AXA PPP Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a) to 5.1.4(c) above. 5.1.5 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.5; 5.1.6 when providing Psychological Therapy, to provide an average of [5.5] 10 Psychological Therapy sessions per Member for the Treatment of each Medical Condition; 5.1.7 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, within six months of the commencement of Treatment; 5.1.9 to ensure its details are accurate at all times and all changes are promptly notified to AXA PPP on the following website: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) e-mail address; e) contact telephone numbers with relevant names; f) all the hospitals in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults only or undertakes treatment at those hospitals; g) the Practitioner’s speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance information; 5.1.10 to comply with all Regulatory Requirements; 5.1.11 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of Procedures, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Fee Approved Practitioner Agreement

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT] 5.1.2 to adhere to the Billing Principles set out at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?sourcexxxxx://xxxxxxxxxxxxxxx.xxxxxxxxxx.xxxxxxxxx.xx.xx/SpecialistCode.mvc/Introducti on?source=published#billing 5.1.3 5.1.2 to charge in accordance with the AXA PPP Schedule of Procedures. The following rules must be followed in all circumstances: a) where the Practitioner is providing a remote consultation to the Member, the Practitioner shall charge the applicable standard consultation rate as set out in the AXA PPP Schedule of Procedures; and b) the Practitioner may only provide family therapy to Members if the Members have been referred by a psychiatrist who is recognised by AXA PPP and it has been agreed by AXA PPP’s psychiatric team in advance who can be contacted either by telephone on 00000 000000 or by submitting a Medical Report via the website at xxxxx://xxxxxxxx.xxxxxxxxx.xx.xx/individual/individual-provider- support/medical-report/ If approved, the Practitioner must charge the rate for family therapy as set out in the AXA PPP Schedule of Procedures; 5.1.3 The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. xxxxx://xxxxxxxx.xxxxxxxxx.xx.xx/individual/individual-provider- support/contract-review/. For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Schedule of Procedures; 5.1.4 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and e) The Practitioner continues to apply the rates set out in the AXA PPP Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a) to 5.1.4(c) above. 5.1.5 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.5; 5.1.6 when providing Psychological Therapy, to provide an average of [5.5] 10 Psychological Therapy sessions per Member for the Treatment of each Medical Condition; 5.1.7 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, within six months of the commencement of Treatment; 5.1.9 to ensure its details are accurate at all times and all changes are promptly notified to AXA PPP on the following website: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) e-mail address; e) contact telephone numbers with relevant names; f) all the hospitals in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults only or undertakes treatment at those hospitals; g) the Practitioner’s speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance information; 5.1.10 to comply with all Regulatory Requirements; 5.1.11 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of Procedures, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Fee Approved Practitioner Agreement

AutoNDA by SimpleDocs

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT] 5.1.2 to adhere to the Billing Principles billing guideline set out in the AXA PPP Schedule of Procedures at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?source=published#billingxxxxx://xxxxxxxxxxxxxxxxxxxxxxx.xxxxxxxxxxxxxxxx.xx.xx/supporting-you-and-your- practice/schedule-of-procedures-and-fees/; 5.1.3 5.1.2 to charge in accordance with the AXA PPP Schedule of ProceduresFees. The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. by e-mail to xxxxxxxxxx.xxxxxxxxxxx@xxx-xxx.xx.xx or by telephone on 00000 000000. For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Schedule of ProceduresFees; 5.1.4 5.1.3 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) THAT the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and; e) The Practitioner continues to apply the rates set out in the AXA PPP Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a) to 5.1.4(c) above. 5.1.5 5.1.4 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees Fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 5.1.4 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.55.1.4; 5.1.6 5.1.5 to provide an average of [5.5] 5.5 sessions per Member for the Treatment of each Medical Condition; 5.1.7 5.1.6 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 5.1.7 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, . Invoices must be submitted within six months of the commencement of Treatment; 5.1.9 5.1.8 to ensure its details are updated and accurate at all times and all changes are promptly notified (including but not limited to AXA PPP on the following websitefollowing: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) , e-mail address; e) , contact telephone numbers with relevant names; f) , all the hospitals facilities in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults Practitioners consult only or undertakes treatment undertake Treatment at those hospitals; g) the Practitioner’s , their speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance informationinterest); 5.1.10 5.1.9 to comply with all Regulatory Requirements; 5.1.11 5.1.10 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of ProceduresFees, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 5.1.11 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Practitioner Agreement

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT]. 5.1.2 to adhere to the Billing Principles set out at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?sourceat: xxxxx://xxxxxxxxxxxxxxx.xxxxxxxxxx.xxxxxxxxx.xx.xx/SpecialistCode.mvc/Introducti on?source=published#billing 5.1.3 to charge in accordance with the AXA PPP Schedule of Procedures. The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. xxxxx://xxxxxxxx.xxxxxxxxx.xx.xx/individual/individual-provider-support/query-billing- principles/. For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Schedule of Procedures; 5.1.4 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and e) The Practitioner continues to apply the rates set out in the AXA PPP Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a) to 5.1.4(c) above. 5.1.5 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.5; 5.1.6 to provide an average of [5.5] sessions per Member for the Treatment of each Medical Condition; 5.1.7 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, within six months of the commencement of Treatment; 5.1.9 to ensure its details are accurate at all times and all changes are promptly notified to AXA PPP on the following website: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) e-mail address; e) contact telephone numbers with relevant names; f) all the hospitals in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults only or undertakes treatment at those hospitals; g) the Practitioner’s speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance information; 5.1.10 to comply with all Regulatory Requirements; 5.1.11 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of Procedures, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Fee Approved Practitioner Agreement

PRACTITIONER’S OBLIGATIONS. 5.1 The Practitioner shall comply with the following obligations: 5.1.1 To only provide services to Members who have been referred to the Practitioner by a Specialist; [NOTE: PLEASE DELETE THIS CLAUSE IF THE PRACTITIONER IS A PODIATRIC SURGEON AS NOT RELEVANT] 5.1.2 to adhere to the Billing Principles set out at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/SpecialistForms/SpecialistCode.mvc/Introdu ction?source=published#billing 5.1.3 5.1.2 to charge in accordance with the AXA PPP Schedule of Procedures. The Practitioner agrees to contact AXA PPP in the event that a particular case warrants an extraordinary charge. Contact can be made via the by visiting our website and contacting using our Specialist Fees Enquiry Form available at xxxxx://xxxxxx.xxxxxxxxxxxxxxxx.xx.xx/fee-query-hpec/. For the avoidance of doubt, the Practitioner shall require the prior consent of AXA PPP in respect of any charge in excess of the AXA PPP Fees or the Schedule of ProceduresProcedures (whichever is applicable); 5.1.4 5.1.3 no other charges will be made to Members and the Practitioner will not recover or seek to recover additional amounts directly from a Member other than: a) costs incurred by the Member which are not covered by the Policy including, for the avoidance of doubt, any excess or cost sharing associated with the policy; b) any shortfall between the amount of benefit to which a Member is entitled under the Policy and the amount the Practitioner may charge under the terms of this Agreement; or c) cancellation or non-attendance charges in connection with any Treatment reasonably levied by the Practitioner in accordance with a reasonable written cancellation and/or non-attendance policy which the Member had sufficient advanced notice of, unless the Treatment was cancelled by or as an indirect or direct result of the actions of the Practitioner; PROVIDED THAT: d) the Practitioner has, where appropriate, informed the Member in advance of such costs and obtained the Member’s consent in writing to pay for such costs; and e) The Practitioner continues to apply the rates set out in the AXA PPP Error! Reference source not found. Schedule of Procedures when charging Members directly for all Treatment in the circumstances described in Clauses 5.1.4(a5.1.3(a) to 5.1.4(c5.1.3(c) above. 5.1.5 5.1.4 to keep all Confidential Information strictly confidential and not disclose the details to any third party except by prior written consent of AXA PPP or where the Confidential Information has become publicly available through no fault of the Practitioner. The Practitioner may only disclose the Confidential Information to its personnel who are directly involved in the administration of the fees and who need to know the information and the Practitioner shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement. The Parties acknowledge and agree that monetary damages may not be an adequate remedy for any breach of this Clause 5.1.5 5.1.4 and, consequently, that either Party shall be entitled (but not limited) to injunctive or other equitable relief with respect to any actual or threatened breach of this Clause 5.1.55.1.4; 5.1.6 5.1.5 to provide an average of [5.5] 5.5 sessions per Member for the Treatment of each Medical Condition; 5.1.7 5.1.6 to submit invoices electronically through Healthcode or our online portal or any other electronic billing system AXA PPP recognises; 5.1.8 5.1.7 to submit invoices, and where necessary completed AXA PPP claim forms which have been signed by the Member and the supervising Practitioner or referring GP, . Invoices must be submitted within six months of the commencement of Treatment; 5.1.9 5.1.8 to ensure its details are accurate at all times and all changes are promptly notified to AXA PPP on the following website: xxxx://xxx.xxxxxx.xxx.xx/ this includes (without limitation) the following information: a) correspondence address; b) treatment address; c) billing address; d) e-mail address; e) contact telephone numbers with relevant names; f) all the hospitals in which the Practitioner has admitting rights and identify specifically whether the Practitioner consults only or undertakes treatment at those hospitals; g) the Practitioner’s speciality, sub-speciality and specialist areas of interests; and h) the Practitioner’s professional indemnity insurance information; 5.1.10 to comply with all Regulatory Requirements; 5.1.11 in the event that the Practitioner charges a Member (either directly or indirectly) any amount in excess of the amount set out in the AXA PPP Schedule of Procedures, or where the Practitioner’s has charged, and AXA PPP has paid, for services in connection with Treatment received by a Member that are ineligible for payment by AXA PPP, AXA PPP reserves the right to clawback a sum equal to 125% of the all such amounts and reserves the right to set-off such amount from future fees due to the Practitioner; and 5.1.12 to use resources efficiently when treating Members.

Appears in 1 contract

Samples: Fee Approved Practitioner Agreement

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!