Below is the same sample medical billing contract text if you want to cut and paste in your own word processor document. Use the pricing table in this medical services proposal template to thoroughly detail any prices taxes fees or discounts associated with the services being provided.
Any representative acting on behalf of the client by signing this agreement warrants that they have the legal right and power to do so by initialing the agreement here.
Medical services agreement template. A medical service agreement template is a contractual agreement between the employerclient and the medical service provider. This medical services agreement agreement is made and entered into on january 6th by and between albitar oncology consulting llc a delaware limited liability corporation medical group with its mailing address at 27165 kiavo drive valley center ca 92082 and neogenomics laboratories inc a florida corporation neogenomics. A medical service contract is a legal document drafted when an individual avails the medical service of a medical service provider hospital nursing home or a medical centre.
The table below details the actual prices that will be charged to clientcompany for the medical services listed in this proposal. A texas corporation hereinafter referred. Some people also refer to a contract as a service agreement.
A service agreement also sometimes called a general services agreement is a document between a service provider and a client. Sample medical service contract. Items licensed to practice medicine andor provide medical services in the state or states where services are provided and usa managed care organization inc.
Whereas echoscribe is a medical billing services company which provides computerized claims billing and collection services to healthcare providers. The parties entering into the contract are known as medical service provider and the client. Medical dental and allied health practice management agreements.
Provider agrees to provide services under this agreement for the treatment and care of illnesses. Medical services agreement. And whereas client wishes to retain echoscribe to provide for medical billing services services pursuant to the terms and conditions of this agreement.
I know its a little difficult to copy from a pdf document. In a service agreement the service provider agrees to provide certain services these can be any type of services from small individual oriented services like dog walking to larger more professional services like freelance accounting to a client. By signing this agreement client hereby consents to receive in home non medical services as outlined in the agencys attached care plan.
Heres an example medical billing contract in pdf form. It ensures that the service provider fulfills only those medical services that are mentioned in the agreement and provides services only to the specified parties. Health care service provider agreement.
We have produced with an independent law firm the following templates that can be modified by practices to suit their individual needs.
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