Healthcare Connected Contract

HEALTHCARE CONNECTED CONTRACT

Parties and Effective Date

This Healthcare Connected Contract (the "Contract") is entered into by and between Provider Name: located at Provider Address: and Recipient Name: .

Effective Date: . This Contract governs the provision and use of connected health services as described below.

Patient / Recipient Information

Insurance and Billing

Medical History (relevant to connected services)

Scope of Connected Services

Provider will furnish connected health services including remote physiological monitoring, secure transmission of clinical data, scheduled telemedicine consultations, and device management (collectively, "Services"). Services are limited to those expressly set forth in any attached service plan and any clinical orders provided by Provider's licensed clinicians.

Recipient consents to the use of specified devices for data collection and transmission. Recipient shall follow device use instructions and notify Provider promptly of device malfunction or data irregularities.

Data Security, Privacy and Use

Provider will collect, store, transmit, and use Protected Health Information (PHI) in connection with Services. Provider will implement administrative, physical, and technical safeguards to protect PHI in accordance with applicable law. Provider may disclose PHI to its clinicians, affiliated service providers, contractors performing Services, and other parties as permitted or required by law or as expressly authorized herein.

Recipient authorizes Provider to transmit health data electronically and acknowledges that electronic transmission carries inherent risks. Recipient's authorization for data sharing will expire on: unless earlier revoked in writing consistent with this Contract.

Fees, Billing and Payment

Fees for Services will be billed to Recipient's insurer when applicable and/or directly to Recipient. Recipient is responsible for co-payments, deductibles, and charges not covered by insurance. Provider may suspend non-emergency Services for failure to pay undisputed charges after providing notice and an opportunity to cure.

Equipment, Maintenance and Returns

Provider may supply devices necessary for monitoring. Ownership of devices, responsibility for damage, and return procedures will be specified in the equipment addendum. Recipient shall maintain devices in good order and return them upon termination of Services. Recipient is responsible for reasonable care and for charges associated with loss or irreparable damage.

Term, Termination and Suspension

This Contract shall commence on the Effective Date and continue until terminated by either party upon thirty (30) days' written notice. Provider may immediately suspend Services if Recipient poses a risk to clinical safety, breaches material terms, or fails to pay undisputed amounts after notice. Termination does not relieve Recipient of payment obligations for Services rendered prior to termination.

Liability, Indemnification and Dispute Resolution

Provider's liability for damages arising under this Contract is limited to direct damages and shall not exceed the total amounts paid by Recipient to Provider for Services during the twelve (12) months preceding the event. Neither party is liable for indirect, incidental, special, or consequential damages except for willful misconduct or gross negligence. Recipient agrees to indemnify and hold Provider harmless from claims arising from Recipient's failure to follow instructions or from misuse of equipment.

Disputes will be resolved first through good-faith negotiation. If unresolved, disputes shall be submitted to binding arbitration under the rules of the selected arbitration forum, with the place of arbitration being the Provider's principal place of business, and governed by the substantive law of the state indicated in the Notices section.

Notices and Governing Law

Notices under this Contract shall be in writing and delivered to the contact information provided above or to an updated address provided in writing. This Contract is governed by the laws of the state where Provider's principal place of business is located, without regard to choice of law principles.

Amendment, Assignment and Severability

No amendment will be effective unless in writing and signed by both parties. Recipient may not assign this Contract without Provider's prior written consent. If any provision is found unenforceable, the remainder will continue in effect as permitted by law.

Authorization and Patient Acknowledgment

By signing below, Recipient authorizes Provider to deliver connected health Services, to receive and transmit Recipient's health data as necessary for clinical care, and acknowledges having read and understood the rights, risks, and responsibilities described in this Contract. Recipient affirms that all information provided is true and accurate to the best of Recipient's knowledge.

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