Provider User Agreement Sample Contracts

Provider User Agreement
Provider User Agreement • August 9th, 2022

The San Bernardino County Department of Public Health (SBCDPH) greatly appreciates your participation in the SBCDPH COVID-19 Antigen Testing Program. Your Organization’s Chief Medical Officer or main point of contact must complete the SBCDPH Antigen Test Program Requirements and Legal Agreement (Section A) and sign the Certification of Adherence to Agreement (Section B).

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GEORGIA MEDICAID AND PEACHCARE FOR KIDS®: PROVIDER USER AGREEMENT FOR CLINICAL VIEWER
Provider User Agreement • January 27th, 2016

The State of Georgia Department of Community Health, Division of Medical Assistance Plans (“DCH” or “Medicaid”) has entered into that certain Georgia Health Information Network Member Agreement dated February 6, 2014 (the “Member Agreement”) with Truven Health Analytics Inc. (“Vendor”), a vendor engaged by GaHIN, Inc. (“Network Facilitator”), in order to participate as a Member in a statewide exchange of Health Data (the “Network”) by and among Members and their respective Member Affiliates (as more fully described in the Member Agreement (a copy of which may be accessed below). Pursuant to the terms and conditions of the Member Agreement, DCH is requiring that any User (as hereinafter defined) that is interested in becoming a Member Affiliate of DCH to enter into a written agreement which governs such Member Affiliate’s access or use of the Network.

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