Telehealth Provider Agreements

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Negotiate important provisions of the treaty. Suppliers should pay particular attention to provisions affecting reimbursement, such as payment of fees, coverage, verification of usage and the right of payers to recover. Other essential non-price conditions could also entail legal and financial risks and should be carefully audited and negotiated by suppliers. For example, compensation and restrictions on damages, intellectual property, confidentiality and security standards, audit and reporting obligations, force majeure and termination and termination rights. Unfortunately, payers are not always flexible in adapting the language in their standard non-price conditions. In addition, almost all payers require suppliers to comply with payers` guidelines and procedures, which often contain provisions that conflict with the terms of payment contracts, which create barriers to coverage of services (for example. (B prior authorization) or have a negative effect on the refund. Suppliers should carefully request and review the payers` directives and procedures prior to the conclusion of a payment agreement and, if necessary, negotiate a specific treatment of certain material provisions or, in the event of a conflict, qualify the payer contract as a document in accordance with the dispute. Ensure compliance with the law. Payment contracts generally include representations and guarantees that require compliance with existing federal and regional laws. In the case of telehealth, such requirements would apply to laws such as national telemedicine legislation, drug practice, licensing of public medical practices and similar requirements.

Suppliers must ensure that their operations and services meet all applicable requirements. Determine the refund and refund. While the most linear payment model to consider might be reimbursement of Dener`s fees, some payers do not offer payment parity by paying for telehealth services at the same rate as those paid personally. Providers should evaluate the type of reimbursement that works best for their telehealth offering and remain open to alternative payment models, such as. B as payment per member and month for a defined level of health services or other value-based or risk-based agreements, such as full or partial funding. Payers may vary depending on the types and rates of repayment they are willing to offer and may impose different payment terms. The spread of the new coronavirus pandemic (COVID-19) has significantly influenced the provision of health services. In particular, it has significantly increased the demand for telemedicine services, pushing both health care providers and professionals to enter into telehealth contracts.

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