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AGREEMENT BY AND BETWEEN
MANAGED CARE OF AMERICA PPO, INC.
AND
OPTIMUM HEALTH SERVICES OF FLORIDA, INC.
1. Parties
This agreement is between MANAGED CARE OF AMERICA PPO, INC. (MCA) and
OPTIMUM HEALTH SERVICES OF FLORIDA, INC. (OHS) MCA and OHS are
separate independent entities. Neither party shall be liable for any
actual or alleged acts or omissions of the other party.
2. Purpose
A.
(1) A network of contracted health care providers ("Providers") is
developed and maintained through OHS and through MCA on behalf
of participating payors for the purpose of obtaining rates and
terms favorable to participating health care reimbursement
plans ("payors").
(2) This contracted network is for the sole purpose of
establishing financial reimbursement terms for payment by the
participating payors for covered services. The health care
services rendered by the provider are solely within the
authority and responsibility of the provider.
The purpose of this agreement is to make available a provider contract
network for use by participating payors represented by MCA and OHS;
and to make available the provider network to MCA participating payors
and clients.
B. This agreement shall not apply for services already being used by
a payor independently of this agreement.
3. Reimbursement
A. For services furnished through this agreement, each
participating payor shall pay a fee. The fee shall be based
on scope of services used and split between OHS and MCA.
B. ATTACHMENT A to this agreement shall specify the participating
payor fee, and also shall specify the portion of the fee
payable to MCA and OHS. Unless otherwise specified in
Attachment A and mutually agreed in writing, the client fee
will be divided 50% to OHS and 50% to MCA.
C. Payor shall reimburse OHS for all claims within thirty (30)
days of the date of submission.
4. Confidentiality
OHS and MCA each acknowledge that as a result of this agreement each
may learn or gain access to trade secrets, or other confidential or
proprietary information of the other party such as cost containment
methodology, processes, techniques, client lists, pricing data, and
other such information. Each party acknowledges that such
confidential information is the property of the other party and it
shall not at any time during or after this agreement directly or
indirectly use, disclose, or transfer such information without the
prior written approval of the other party. The parties acknowledge
that such unauthorized use, disclosure or transfer will cause harm to
the other party and the breaching party may be liable.
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5. Term of Agreement
A. This agreement is effective August 1st 1998. The specified
effective date for each applicable payor is shown in
ATTACHMENT A.
B. This agreement may be amended by mutual written consent of the
parties.
C. The term of this agreement shall be for three years. Either
party may terminate this agreement by providing thirty days
written notice to the other party without cause.
D. In the event of termination of this agreement, the
reimbursement and services specified in ATTACHMENT A shall
continue for the earlier of thirty days from the date of
termination or until care may be transferred to another in
network provider.
6. General Provision
A. This agreement represents the entire agreement between the
parties.
7. Notices
A. Any notice given pursuant to this agreement shall be in
writing and shall be delivered personally or sent by certified
mail, return receipt requested, postage paid, addressed as
follows:
MCA - PPO: Xxxxx X. Xxxxxxx
Vice President Managed Care of America PPO, Inc.
000 Xxxxx xx Xxxx Xxxx. - Xxxxx 000
Coral Gables, Florida 33134
OHS: Xxxxx May
Vice President of Corporate Development
Optimum Health Services of Florida
17757 XX 00 Xxxxx, Xxxxx 000
Xxxxxxxxxx, Xxxxxxx 00000
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IN WITNESS WHEREOF, MANAGED CARE OF AMERICA PPO, INC. and OPTIMUM HEALTH
SERVICES OF FLORIDA, INC., have caused this agreement to be executed on this
1st day of August, 1998
MANAGED CARE OF AMERICA PPO, INC.
NAME: XXXXX X. XXXXXXX
TITLE: VICE PRESIDENT
DATE: 7/8/98
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SIGNATURE: /s/ XXXXX X. XXXXXXX
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OPTIMUM HEALTH SERVICES OF FLORIDA, INC.
NAME: XXXXX MAY
TITLE: VICE PRESIDENT OF CORPORATE DEVELOPMENT
DATE: 7/7/98
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SIGNATURE: /s/ XXXXX MAY
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ATTACHMENT A
PAYOR:
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EFFECTIVE DATE:
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SERVICES TO BE PROVIDED BY MANAGED CARE OF AMERICA PPO:
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SERVICES TO BE PROVIDED BY OPTIMUM HEALTH SERVICES OF FLORIDA, INC.:
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MANAGED CARE OFAMERICA PPO FEE:
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OPTIMUM HEALTH SERVICES OF FLORIDA, INC. FEE:
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OPTIMUM HEALTH SERVICES MANAGED CARE OF AMERICA
