Provider Client Agreement

W
Document Sample
scope of work template
							                                               Provider / Client Agreement



This is an agreement between the Client (a purchaser of services) and the Provider (one or more licensed providers of medical, dental,
chiropractic, vision and other related services). This agreement between the Client and the Provider is effective as of the date of
acceptance and entry into the Valorcare website/database of a monthly dollar amount to be paid for the Provider's services which is
confirmed with an acknowledgement email sent to both Provider and Client. This agreement shall continue on a monthly basis until
cancelled or terminated by the agreement of both parties.

The Provider agrees to provide:
1.   Services consistent with the scope of the provider's business and as agreed with the Client.
2.   Services that are both preventative and corrective as determined by the Client's need and the Provider's licensing/ability to fulfill
     the Client's need(s).
3.   Services in advance of or after receipt of payment as agreed between the Client and Provider and as needed by the Client.
4.   Services which include but are not limited to treatment, advice, counseling, education, etc. to the best of the Provider's ability.
5.   Work with the Client to determine a level of service with an associated monthly price that meets the unique needs of the
     respective Client.
6.   Accept payment from Valorcare on behalf of the Client as processed from the Client's preferred financial tool(s) or as otherwise
     directed by the Client.

The Client agrees to:

1.   Work with the Provider to determine a level of service with an associated monthly price that meets the unique needs of the
     respective Client.
2.   Work with the Provider to change their level of service and associated monthly payment as their unique healthcare needs so
     dictate/change.
3.   Continue with their monthly commitment for a period of time sufficient to allow the Provider to receive reimbursement for services
     provided.
4.   Work with the Provider to establish a posture of preventative observation and care.
5.   Utilize the services of the Provider as needed but not abuse the services and/or time of the Provider.
6.   Allow the Valorcare process to collect and distribute to the Provider(s) of their choice a monthly payment equally to the amount
     agreed to between themselves and the Provider.

The Provider and Client agree to:

1.    Be fair in their business dealings with each other.
2.   Work towards a posture of preventative care for the Client.
3.   Calculate the monthly fee for services on an annual basis (12 month interval) unless the Client's specific situation demands an
     interval of some other duration.
4.   In the event of disagreement over the price/quality of the services received, utilize a third party to mediate the disagreement so an
     equitable and timely solution can be found.
5.   Return unused funds to the Client in the event the Client elects to change their Provider(s).
6.   Complete the payment process for the services received as agreed between the Client and Provider.
7.   In the event the Client fails to complete the payment interval the Provider may proceed immediately with formal collection
     processes if so desired.

Valorcare agrees that at all times during and for a period of not less than 6 years following cancellation of services, Valorcare will hold
trust, keep confidential, and not disclose to any third party or make use of the confidential information provided by this process as
required by current HIPAA legislation and associated State and Federal rules, regulations, and laws.

						
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