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A frame agreement is a special type of rate agreement entered with a set of suppliers, with a specific subset (may be just one) chosen as preferred. Frame agreements possess similar clauses as standard rate agreements with a few additional (optional) points such as decreasing prices over time; quality control obligations for the supplier
The US government healthcare website defines usual, customary and reasonable as being "The amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. The UCR amount sometimes is used to determine the allowed amount."
In the United States, an independent practice association (IPA) is an association of independent physicians, or other organizations that contracts with independent care delivery organizations, and provides services to managed care organizations on a negotiated per capita rate, flat retainer fee, or negotiated fee-for-service basis. [1] [2]
Purchasing cooperatives bring together multiple organizations, such as government entities, educational institutions, and non-profit organizations, to collectively pool their purchasing power. These cooperatives negotiate and establish pre-negotiated contracts with suppliers, covering a wide range of products and services.
Minimum and maximum quantity limits are specified in the basic contract as either number of units (for supplies) or as dollar values (for services). The government uses an IDIQ contract when it cannot predetermine, above a specified minimum, the precise quantities of supplies or services that it will require during the contract period.
Chargemasters include thousands of hospital services, medical procedures, equipment fees, drugs, supplies, and diagnostic evaluations such as imaging and blood tests. [6] Each item in the chargemaster is assigned a unique identifier code and a set price that are used to generate patient bills. [6]
Third parties can be both 'upstream' (suppliers and vendors) and 'downstream', (distributors and re-sellers) as well as non-contractual parties. [ 2 ] Firms do not have to conduct critical activities to be considered a 'third party'; a cleaning services firm responsible for maintaining a company's office space is a third party as much as a ...
Additionally, in parallel to the single-payer healthcare system there are private insurers, which provide coverage for some private doctors and hospitals. Employers will sometimes offer private health insurance as a benefit, with 14.8% of the Spanish population being covered under private health insurance in 2013. [51] [52]