Common Contracts

2 similar Organizational Provider Agreement contracts

ORGANIZATIONAL PROVIDER AGREEMENT FOR FOSTER CHILDREN PLACED OUT OF COUNTY
Organizational Provider Agreement • April 14th, 2022

This Contract is entered into on __________________ “Contract Date” between the Mental Health Plan of _____________ hereinafter referred to as MHP and ______________________, hereinafter referred to as “Contractor” for access to Medi-Cal Specialty Mental Health Services for Foster Children placed out-of-county. Contractor is located in the County of ________________ and is certified by an MHP to provide Medi-Cal services, as evidenced by the attached Certification.

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ORGANIZATIONAL PROVIDER AGREEMENT FOR FOSTER CHILDREN PLACED OUT OF COUNTY
Organizational Provider Agreement • September 16th, 2020

This Contract is entered into on __________________ “Contract Date” between the Mental Health Plan of _____________ hereinafter referred to as MHP and ______________________, hereinafter referred to as “Contractor” for access to Medi-Cal Specialty Mental Health Services for Foster Children placed out-of-county. Contractor is located in the County of ________________ and is certified by an MHP to provide Medi-Cal services, as evidenced by the attached Certification.

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