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Health Care Service Provider Agreement

Health Care Service Provider Agreement Template for Philippines

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Key Requirements PROMPT example:

Health Care Service Provider Agreement

"I need a Health Care Service Provider Agreement for my private medical clinic in Manila to partner with three major insurance companies, including provisions for both in-person and telemedicine services, with the agreement to commence on March 1, 2025."

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Document background
The Health Care Service Provider Agreement serves as a crucial legal framework in the Philippine healthcare system, establishing formal relationships between healthcare providers and various contracting entities such as insurance companies, HMOs, or employers. This agreement is essential when healthcare providers wish to join networks, provide services to insured patients, or enter into corporate healthcare arrangements. It must comply with key Philippine legislation including the Universal Health Care Act (RA 11223), the National Health Insurance Act, and the Data Privacy Act. The document typically covers service standards, payment terms, quality metrics, and regulatory compliance requirements, while incorporating specific provisions for PhilHealth coordination and local healthcare delivery standards. It's particularly relevant in the context of the Philippines' push toward universal healthcare coverage and increased access to quality medical services.
Suggested Sections

1. Parties: Identification of the contracting parties including full legal names, addresses, and registration details

2. Background: Context of the agreement and brief description of the parties' business relationship

3. Definitions: Detailed definitions of terms used throughout the agreement

4. Scope of Services: Detailed description of healthcare services to be provided, including specific medical procedures, treatments, and specialties covered

5. Provider Obligations: Healthcare provider's responsibilities, including quality standards, staffing requirements, and compliance with Philippine healthcare regulations

6. Accreditation and Licensing: Requirements for maintaining necessary licenses, permits, and accreditations under Philippine law

7. Quality Assurance: Standards of care, quality metrics, and monitoring procedures

8. Compensation and Billing: Payment terms, fee schedule, billing procedures, and claim submission requirements

9. Patient Rights and Responsibilities: Protection of patient rights and outline of patient responsibilities in accordance with Philippine healthcare laws

10. Records and Data Protection: Requirements for maintaining medical records and protecting patient data under the Data Privacy Act

11. Term and Termination: Duration of the agreement and conditions for termination

12. Insurance and Liability: Insurance requirements and allocation of liability between parties

13. Dispute Resolution: Procedures for resolving disputes, including mediation and arbitration processes

14. General Provisions: Standard contractual clauses including governing law, amendments, and notices

Optional Sections

1. Emergency Services Protocol: Specific procedures for emergency services, required if provider offers emergency care

2. Teaching and Research: Terms for academic activities, required for teaching hospitals or research institutions

3. Electronic Health Records: Specific provisions for EHR systems and integration, if applicable

4. Specialty Care Services: Additional terms for specialized medical services, if offered

5. Network Participation: Terms for participation in healthcare networks or insurance panels, if applicable

6. Facility Requirements: Specific facility standards and equipment requirements, for facility-based services

7. Telehealth Services: Provisions for virtual healthcare services, if offered

8. International Patient Services: Additional requirements for treating international patients, if applicable

9. PhilHealth Coordination: Specific procedures for PhilHealth claims and coordination, if provider accepts PhilHealth

10. Sub-contractor Relations: Terms governing relationships with sub-contracted healthcare providers, if any

Suggested Schedules

1. Schedule A - Fee Schedule: Detailed listing of fees for all covered services and procedures

2. Schedule B - Service Locations: List of approved facilities and service locations

3. Schedule C - Covered Services: Comprehensive list of medical services covered under the agreement

4. Schedule D - Quality Metrics: Specific quality standards and performance indicators

5. Schedule E - Required Documentation: List of required licenses, certifications, and documentation

6. Schedule F - Reporting Requirements: Details of required reports and reporting frequencies

7. Appendix 1 - Claims Submission Procedures: Detailed procedures for submitting and processing claims

8. Appendix 2 - Credentialing Requirements: Detailed provider credentialing and re-credentialing requirements

9. Appendix 3 - Emergency Protocols: Detailed emergency care protocols and procedures

10. Appendix 4 - Data Protection Protocols: Specific procedures for handling patient data and ensuring privacy

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok成人版 | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions











































Clauses

































Relevant Industries

Healthcare

Insurance

Corporate Services

Government & Public Sector

Education (Medical Institutions)

Pharmaceuticals

Medical Devices

Technology (Healthcare IT)

Professional Services

Social Services

Relevant Teams

Legal

Compliance

Medical Operations

Provider Relations

Quality Assurance

Risk Management

Finance

Claims Processing

Business Development

Regulatory Affairs

Data Protection

Healthcare Operations

Contract Administration

Insurance Coordination

Clinical Services

Relevant Roles

Medical Director

Hospital Administrator

Healthcare Compliance Officer

Legal Counsel

Contract Manager

Insurance Relations Manager

Chief Medical Officer

Healthcare Operations Manager

Quality Assurance Manager

Risk Management Officer

Finance Director

Claims Processing Manager

Provider Relations Manager

Corporate Benefits Manager

Healthcare Facility Manager

Medical Services Coordinator

Regulatory Affairs Specialist

Data Protection Officer

Healthcare Program Manager

Business Development Manager

Industries










Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks, 聽Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination, 聽Severance Pay, Governing Law, Entire Agreemen

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