提供者手册

不续签供应商协议

Carelon practitioner/facility agreements are effective from the date specified on the execution page and continue in effect for one year and will automatically renew for additional one-year terms, unless and until either party notifies the other party 30 days prior to the renewal date that the agreement will not be renewed.

以下是退出的类型：

• 自主性
• 非自愿
• 违约终止

自主性

Either Carelon or a participating provider may terminate the provider agreement without cause upon 60 days written notice.

However, Carelon will not disenroll a provider on the grounds that the provider:

• 代表会员主张；
• Filed a complaint against Carelon;
• Appealed a decision of Carelon; or
• Requested a review or challenged a decision of Carelon to terminate the practitioner or facility from the Carelon network.

非自愿终止或暂停

根据合同，如果出现以下任何一种情况，供应商可能会被立即终止或暂停：

• 暂停或撤销提供者的许可证或凭据，以提供先前获得许可提供的任何涵盖服务的提供者；
• 提供者对重罪的起诉、逮捕或定罪，或与提供从业者/设施协议预期类型的服务有关的任何刑事指控；
• 从业者/机构协议中规定的保险要求的终止或失效；
• Provider’s failure to remain in compliance with Carelon licensure and credentialing standards;
• Provider’s action or inaction that, in Carelon’s sole discretion, results in a threat to the health, well-being or best interest of a member.

违约终止

Either Carelon or a participating provider may terminate the practitioner/facility agreement by giving the other party 30 days written notice of a breach by such other party of its obligation under the agreement. Any such termination shall be effective if the other party has failed to cure the breach within 30 days following receipt of such written notice.