Common Contracts

HEALTH SERVICES AGREEMENT

Health Services Agreement • May 31st, 2022 • North Carolina

• Contract Type
  Health Services Agreement
• Filed
  May 31st, 2022
• Jurisdiction
  North Carolina

This Health Services Agreement (“Agreement”) shall become effective as of the 1st day of December 2022, is between Eastpointe Human Services (“Plan”), a North Carolina Local Management Entity/ Managed Care Organization with a principal place of business in North Carolina, and «Facility_Name». (“Provider Organization” or “PO”), a North Carolina [entity] with a principal place of business at «Address_1» «City», «State» «Zip» (each individually referred to in this Contract as “Party” or collectively as “Parties”). The effective date for individual physicians or other healthcare providers operating through PO shall be the later of the Effective Date or credentialing approval date of such provider(s), if required.