WITNESSETH:Provider Agreement • December 21st, 2004 • Safe Auto Group, Inc. • Fire, marine & casualty insurance
Provider AgreementProvider Agreement • May 4th, 2023
Appendix 1: Application to be included in the Sunderland Directory of Providers of Free Early Education Entitlement for Two, Three and Four Year
PROVIDER AGREEMENT - APPENDIX CProvider Agreement • April 6th, 2018
This policy and its accompanying procedures are based on the following: (1) DHSS’s obligations under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) (42 U.S.C. 1320d – 3120d- 8), the Health Information Technology for Economic and Clinical Health Act of 2009 (P.L. 111-5) (the “HITECH Act”) and their implementing regulations at 45 C.F.R. 160 and 45 C.F.R. 164 (the “Privacy and Security Rule”) to protect the privacy and security of protected health information (2) where applicable, the obligations of Providers under HIPAA, HITECH Act and the Privacy and Security Rule;
Provider Agreement for funded early education and childcare (FEE) for two- three- and four-year-olds Effective from: 1 September 2023Provider Agreement • July 11th, 2023
Provider Agreement BetweenProvider Agreement • January 19th, 2021 • North Carolina
This Provider Agreement (hereinafter “Agreement” or “Contract” (used interchangeably)) establishes the relationship between the Department of Health and Human Services, Division of Public Health, Women’s and Children’s Health Section, Early Intervention Branch, Children’s Developmental Services Agency (hereinafter “CDSA”) and a Service Provider (hereinafter “Service Provider” or “Contractor” (used interchangeably)). This executed Agreement certifies that the Service Provider accepts the terms and conditions of the Agreement, which includes the Contract Documents listed below. The Service Provider is then eligible to provide authorized services under the Individualized Family Service Plan.
Local Provider AgreementProvider Agreement • July 14th, 2017
This document sets out what the local authority will do, and what providers must and should do, based on the following local authority responsibilities as set out in regulation:
NexgenRx Inc.Provider Agreement • May 11th, 2020 • Ontario
In order for NexgenRx Inc. ("we" or "us") to properly identify and pay the pharmacy identified below ("you" or "your") for pharmaceutical and other claims submitted by you to us for adjudication and payment under pharmacy benefit plans administered by us on behalf of various pharmacy benefit plan sponsors and their respective eligible plan beneficiaries ("Cardholders"), it is necessary for you to provide us with the following information and agreement:
Provider Agreement Number: Provider Agreement #4 Service Type: Supervised VisitationProvider Agreement • March 29th, 2023
This Agreement is entered into by and between the State of Connecticut Department of Children and Families, with a primary business location of 505 Hudson Street / Hartford, CT 06106 (hereinafter “the Department” or "the Agency") and
ContractProvider Agreement • October 11th, 2022 • New Mexico
This Provider Agreement is entered into by and between the DEPARTMENT OF HEALTH, hereinafter referred to as the "DEPARTMENT", and Name of Provider, hereinafter referred to as the "PROVIDER".
Provider Agreement For the Provision of Chaplaincy Services in Victorian Government Schools The State of Victoria through the Department of Education and Training (the Department) and Chaplaincy Services Provider (Provider)Provider Agreement • December 4th, 2020
SOONERCARE GENERAL PROVIDER AGREEMENTProvider Agreement • November 7th, 2017
OHIO MEDICAL ASSISTANCE PROVIDER AGREEMENT FOR MANAGED CARE PLANProvider Agreement • June 15th, 2016
This Provider Agreement (herein “Provider Agreement” or “Agreement”) is entered into this first day of July, 2016, at Columbus, Franklin County, Ohio, between the State of Ohio, The Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal offices are located in
OHIO MEDICAL ASSISTANCE PROVIDER AGREEMENT FOR MANAGED CARE PLANProvider Agreement • June 17th, 2015 • Ohio
This Provider Agreement (herein “Provider Agreement” or “Agreement”) is entered into this first day of July, 2015, at Columbus, Franklin County, Ohio, between the State of Ohio, The Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal offices are located in the City of Columbus, County of Franklin, State of Ohio, and , Managed Care Plan (hereinafter referred to as MCP), an Ohio corporation, whose principal office is located in the city of , County of , State of Ohio.
SOONERCARE GENERAL PROVIDER AGREEMENTProvider Agreement • July 9th, 2021 • Oklahoma
IBM Digital Provider AgreementProvider Agreement • February 2nd, 2022
This Digital Provider Agreement (the “Agreement”) sets forth the terms and conditions under which Provider may offer one or more Products in through an IBM website.
CAREERSOURCE PASCO HERNANDO TRAINING PROVIDER AGREEMENTProvider Agreement • January 19th, 2024
This Agreement is made and executed in duplicate by and between Pasco Hernando Workforce Board, Inc., dba CareerSource Pasco Hernando whose address is P.O. Box 6589 Spring Hill, FL 34611, hereinafter called CSPH, and the Eligible Training Provider whose name is Pasco- Hernando State College and whose address is 10230 Ridge Road, New Port Richey FL 34654 hereinafter called the Training Institution.
PROVIDER AGREEMENTProvider Agreement • September 19th, 2018
THIS PROVIDER AGREEMENT is made as of the day of 20 , by and between the City of Philadelphia (the “City”), acting by and through its
MASTER PHARMACY PROVIDER AGREEMENTProvider Agreement • July 13th, 2007 • Safari Holding Corp • Retail-drug stores and proprietary stores • Kentucky
THIS MASTER PHARMACY PROVIDER AGREEMENT (“Agreement”) dated as of July 1, 2004 (the “Effective Date”) is made by and among Kindred Healthcare Operating, Inc., a Delaware corporation (“Kindred”) and Kindred Hospitals East, L.L.C., a Delaware corporation, Kindred Hospitals West, L.L.C., a Delaware corporation, Kindred Hospitals Limited Partnership, a Delaware limited partnership, THC – Seattle, Inc., a Washington corporation, THC – Chicago, Inc., an Illinois corporation, and Kindred Pharmacy Services, Inc., a Delaware corporation (each of which is hereinafter sometimes referred to each as a “KPS Person”, and collectively as “KPS”).
Approved Provider AgreementProvider Agreement • May 25th, 2022
Thank you for your interest in the National Association for Fitness Certification (NAFC) Continuing Education Approved Provider program. Our program is designed to provide continuing education opportunities for NAFC Certified Fitness Professionals to enhance their professional knowledge and skills beyond those achieved in certification.
Provider Agreement for Funding Free Places for 2, 3 and 4 Year OldsProvider Agreement • May 5th, 2020
Provider Agreement Attachment AProvider Agreement • March 11th, 2015
Companion services are non-medical care, supervision, and socialization provided to a functionally impaired adult. Companions may assist or supervise the elder with such tasks as meal preparation, laundry and shopping. Providers may also perform light housekeeping tasks that are incidental to the care and supervision of the elder. This service is provided in accordance with a therapeutic goal in the service plan.
Provider AgreementProvider Agreement • April 20th, 2020
Terms and conditions for Bournemouth, Christchurch and Poole childcare providers to deliver funded early education places for 2, 3 and 4 year olds
PROVIDER AGREEMENT for FUNDED EARLY YEARS PROVISION 2021 – 2024Provider Agreement • September 16th, 2022
This Provider Agreement has been prepared in line with the Department for Education Model Agreement 2018 and Department for Education Statutory Guidance which should be read alongside this Agreement.
OHIO MEDICAL ASSISTANCE PROVIDER AGREEMENT FOR MANAGED CARE PLANProvider Agreement • June 17th, 2014 • Ohio
This Provider Agreement (herein “Provider Agreement” or “Agreement”) is entered into this first day of July, 2014, at Columbus, Franklin County, Ohio, between the State of Ohio, The Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal offices are located in the City of Columbus, County of Franklin, State of Ohio, and , Managed Care Plan (hereinafter referred to as MCP), an Ohio corporation, whose principal office is located in the city of , County of , State of Ohio.
Provider Agreement Attachment AProvider Agreement • January 13th, 2021
Personal Emergency Response System (PERS) is an electronic device connected to a client’s telephone line. In an emergency, it can be activated either by pushing a small button on a pendant, pressing the help button on the console unit, or by an adaptive switch set-up. When the device is activated, a person from the 24-hour-a-day, seven-day-a-week central monitoring station answers the call, speaks to the client via the console unit, assesses the need for help, and takes appropriate action. PERS includes all four of the following requirements:
Provider Agreement for Mental Health Billing ServicesProvider Agreement • November 4th, 2022
This Provider Agreement for Mental Health Billing Services (Contract) is between TheraThink, hereafter known as “TT,” and ; hereafter known as the “Provider,” for the billing practices described in the Contract below:
ContractProvider Agreement • December 15th, 2016
PROVIDER AGREEMENT To receive publicly funded vaccines at no cost, I agree to the following conditions, on behalf of myself and all the practitioners, nurses, and others associated with the health care facility ofwhich I am the medical director or equivalent: 1. I will annually submit a provider profile representing populations served by my practice/facility. I will submit more frequently if 1) the number of children served changes or 2) the status of thefacility changes during the calendar year. 2. I will screen patients and document eligibility status at each immunization encounter for VFC eligibility (i.e., federally or state vaccine-eligible) and administer VFC-purchased vaccine by such category only to children who are 18 years of age or younger who meet one or more of the following categories: A. Federally Vaccine-eligible Children (VFC eligible)1. Are an American Indian or Alaska Native;2. Are enrolled in Medicaid;3. Have no health insurance;4. Are underinsured: A child who ha
Provider Agreement Number 14: School TransportationProvider Agreement • October 1st, 2014
PROVIDER AGREEMENTProvider Agreement • September 22nd, 2005
Provider Agreement Number 15: Community Based Life Skills (CBLS) ProgramProvider Agreement • December 15th, 2017
PROVIDER AGREEMENTProvider Agreement • June 2nd, 2014
By execution of this Agreement, the undersigned entity (“Provider”) requests enrollment as a provider of services or supplies to participants in one of Indiana's Medicaid-approved Community-Based Options for Youth and Families Wraparound Services Programs. The federally-and/or State-funded Home and Community-Based Service programs (hereinafter, "HCBS") are authorized by Medicaid. As a condition of enrollment, Provider agrees:
Addendum to Provider AgreementProvider Agreement • April 16th, 2015
WHEREAS, the Department of Human Services (“the Department”) administers the Pennsylvania Medical Assistance (MA) Program; and
ContractProvider Agreement • November 21st, 2019
Provider Agreement Number 14: School Transportation State of Connecticut Department of Children and Families 505 Hudson Street
Luton Council Provider AgreementProvider Agreement • September 2nd, 2020
This agreement sets out the requirements Luton providers are expected to meet when receiving funding for the supply of free of charge early years provision.
PROVIDER AGREEMENTProvider Agreement • October 18th, 2018
provided with this recertification packet is current and accurate. I understand and agree that the skill(s) for which we are authorized is contingent upon the continuance of sponsor hospital medical control and compliance with Section 19a-179-12 of the Regulations which govern the delivery of prehospital emergency medical services.
