What This Chronic Care Management Telehealth Agreement Template Covers

This Chronic Care Management Telehealth Agreement template is designed to establish a clear understanding between healthcare providers and patients regarding the delivery of telehealth services for chronic care management. It includes essential clauses such as Parties, Recitals, Definitions, Telehealth Services, Patient Obligations, Provider Obligations, Confidentiality, Termination, and General Provisions, ensuring compliance with healthcare regulations and patient privacy laws.

When to Use a Telehealth Agreement

This template is ideal for healthcare providers who are expanding their services to include telehealth options for patients managing chronic conditions. Use this agreement when initiating a telehealth service with a new patient or when transitioning existing in-person care to a telehealth format. It is also applicable when establishing clear expectations for patient engagement and provider responsibilities in a remote healthcare setting.

What's Included in This Telehealth Service Agreement Template

• Parties: Clearly identifies the healthcare provider and the patient involved in the agreement.
• Recitals: Provides context and purpose for the agreement, outlining the need for telehealth services.
• Definitions: Clarifies key terms used throughout the agreement to avoid misunderstandings.
• Telehealth Services: Details the specific telehealth services offered, including consultation methods and frequency.
• Patient Obligations: Outlines the responsibilities of the patient, such as providing accurate health information.
• Provider Obligations: Specifies the duties and responsibilities of the healthcare provider in delivering telehealth services.
• Confidentiality: Addresses the importance of patient privacy and data protection in compliance with healthcare regulations.
• Termination: Describes the conditions under which the agreement can be terminated by either party.
• General Provisions: Covers miscellaneous terms that govern the agreement.

Key Chronic Care Management Contract Provisions

• Confidentiality Clause: Ensures that all patient information remains private and secure, in line with HIPAA regulations.
• Termination Clause: Provides a clear process for ending the agreement, protecting both parties' rights.
• Patient Obligations: Emphasizes the need for patients to actively participate in their care for effective chronic management.

Disclaimer: This template is for informational purposes only and does not constitute legal advice.