Implement a care coordination program (the “Program”) in collaboration with Client to support Client’s care coordination and care management of qualifying patients (“Covered Patients”).
Identify Covered Patients who may be eligible pursuant to the relevant provider arrangements and evidence-based medicine pathways to receive services.
Perform outreach for Covered Patients, including supporting patient education and coordinating care services rendered by Client.
Implement operational pathways designed to enhance Covered Patient navigation of their health and care management.
Exchange clinical information governing Covered Patients in order to perform effective clinical follow-up and care coordination.
Coordinate the monitoring, analysis, and reporting of relevant outcomes, performance, and quality metrics collected by each of the Covered Patients to be shared with Client.
Provide Client with requested information for Client to share with its that providers and workforce members about the existence and use of the Program.
Communicate the benefits of the Program to Covered Patients, as appropriate.
Configurate and share health notifications via omnichannel (SMS Text, Email, or other permitted format of Covered Patient) specific to care plans, care gaps, and treatment protocols to Covered Patients.
Maintain operational tracking of opt outs by Covered Entity which are communicated to Andor by such Covered Patients or in writing by Client.
Maintain independence from the exercise of any control, influence, or direction over the number, type, or recipient of patient referrals to Client.
Comply with all applicable federal, state, and local laws, rules, and regulations concerning the care coordination and management services for Client.
Patient PHI
Client will maintain the authority and ability to access Covered Patient’s electronic health records and is solely responsible for securing the appropriate authorizations and consents which allow Andor, to the extent necessary to facilitate the Program, the right to use and access Covered Patients’ protected health information (“PHI”) (as that term is defined under the Health Insurance Portability and Accountability Act (“HIPAA”)).
Client is solely responsible for making all disclosures and obtaining all consents and authorizations necessary for Andor’s use and disclosure of PHI under this SOW, including but not limited to communications via text message. In addition, Client is solely responsible for the accuracy of the contact information and consents it obtains from Covered Patients for purposes of this SOW. Client represents that to the extent Client provides Andor with contact information for a Covered Patient, Andor will be entitled to communicate with such Covered Patient for purposes of the Program unless Client informs Andor to the contrary in writing.
Client will be solely responsible for ensuring the accuracy and completeness of any PHI and records, and Andor shall be entitled to reasonably rely on the accuracy and completeness of such PHI and records.
The care coordination and management activities contemplated under this program are considered to fall under the definition of “treatment” and “health care operations” as set forth in the HIPAA and its implementing regulations, and not marketing activities.
All use of PHI and records by Andor will be subject to the terms of a Business Associate Agreement executed with Client to further ensure that all parties protect PHI.
