SAMPLE CARE COORDINATION AGREEMENTSample Care Coordination Agreement • May 13th, 2016
This sample Care Coordination Agreement is between a fictional Certified Community Behavioral Health Clinic (CCBHC), Behavioral Health Clinic, and a fictional hospital, Community Hospital, for the provision of acute care and hospital outpatient services. Note that this sample Care Coordination Agreement is not a template, but is provided as an example. Care Coordination Agreements must be drafted to reflect the unique characteristics of each care coordination relationship.
