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DocuSign Envelope ID: CD3D70F4F4BF446D9944D1 DB540D0BB3Health Care uthorityHCA Contract Number: K3923CLIENT SERVICES Washington S t a t e CONTRACT RESTATEMENTAmendment Number: 1For CPI Prevention
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How to fill out health care uthority contract

01
To fill out a health care authority contract, follow these steps:
02
Obtain the contract form from the health care authority or its website.
03
Read the instructions and carefully review the contract terms and conditions.
04
Provide all the required information such as your personal details, contact information, and profession.
05
Fill in the specific sections of the contract related to the services you will provide.
06
Include any additional terms or conditions that you require or negotiate with the health care authority.
07
Review the completed contract thoroughly for any errors or omissions.
08
Sign the contract and have it witnessed or notarized if required.
09
Submit the contract to the health care authority by the specified deadline.
10
Keep a copy of the signed contract for your records.

Who needs health care uthority contract?

01
Health care professionals, facilities, or organizations that wish to enter into an agreement or provide services on behalf of the health care authority.
02
Insurance providers, medical practitioners, hospitals, clinics, nursing homes, and other health care entities may need a health care authority contract.
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A health care authority contract is a legal agreement between a health care provider and a government agency or authority.
Health care providers who receive funding or services from a health care authority are required to file a health care authority contract.
Health care providers must fill out the health care authority contract form provided by the respective authority, ensuring all required information is accurately and completely filled.
The purpose of a health care authority contract is to establish the terms and conditions under which a health care provider will deliver services to patients covered by the authority's programs.
Information such as provider details, services offered, reimbursement rates, compliance with regulations, and quality measures must be reported on the health care authority contract.
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