If at any time contract is out of compliance, there are penalties up to forfeiture of pay. If IC is eligible as a volunteer then IC will default to volunteer status if contractor wishes to continue to provide services outside of the IC realm while the out of compliance procedure is followed.
Data is due at the time of service with verification from family / client. Delay in data may result in fees, delayed reimbursement, or no reimbursement depending on funding sources and applicable regulations.
I attest that the documentation made provided in each record accurately reflect the services provided, diagnosis, treatments, and information as recorded during this session. The electronic health record does accurately reflect my role, relationship, position and intent as indicated by my name, title and capacity for the record. I attest that this information is true, accurate, and complete to the best of my knowledge. I understand that any falsification, omission, or concealment of material fact may subject me to administrative, civil, or criminal liability. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. I agree and understand that these statements are being made under penalty of perjury.
By working with any client I attest that I have read all available information in their file as there file functions as each client's person specific training. Furthermore, by accepting a client I attest that my expertise matches the clients needs and that I am a competent provider for that person's specific needs. If I’m not then I will decline working with client or create a client/family action plan on what needs to take place in order for there to be a client need / provider skill match.
I commit that all information providing is true and accurate to my knowledge. If at ANY TIME, any information on my part changes that would possibility violate this agreement I must stop seeing clients right away, contact ANGELS and determine an appropriate action plan. Examples would be, if I had a law suit filed against me, have been accused of a crime, my insurance or license lapsed, etc. (this in not an all-inclusive list). If any of my contact information or credentials needs to be updated I will contact Angels Service LLC immediately.
INDEPENDENT CONTRACTOR AGREEMENT between IC and ANGELS Service LLC (ANGELS), pursuant to the laws of Colorado.
· Notices will be in writing and will be deemed given when sent via email or scomm in Therap. All mail will be sent to address provided on w9.
· Notices to ANGELS will be addressed to:
ANGELS Service LLC
18224 E Layton Place
Aurora, CO 80015
Contracts will remain active as long as requirements are met.
IC Core Agreements
· Serve the best interests of my clients. I will provide the highest quality of care that I am able to with the sole objective of benefitting the client.
· Be responsible for building and maintaining an effective, healthy, and safe environment and relationship with my clients as their provider. This includes: refraining from and preventing to the best of my ability, behaviors that may be considered sexual during my sessions. I will not date a client, engage in sexual acts, or allow any level of sexual impropriety from my clients or myself. I understand that sexual impropriety will lead to serious consequences.
· I commit to do no harm, I will conduct a thorough review of each case, making sure that I am competently trained for each specific person that I work with, through review of information in case file and client / family interview to determine appropriate session techniques in order to meet needs and goals. If I see signs of, or suspect and undiagnosed condition or other item of concern I will refer client / family to appropriate services or make an incident report depending on the concern I witness.
· Only work within my scope of practice and skills. I will evaluate the needs of each recipient and refer the client to another provider if the client requires services beyond my capabilities of my expertise or I will create an approved action plan with client and family to increase my expertise. I will acknowledge any services limitations by refraining from exaggerating the benefits of services.
· Nurture and upload the inherent worth of all individuals. I will demonstrate compassion, respect, and acceptance of others. I will work to decrease instances of discrimination, mistreatment, abuse, neglect, exploitation, misunderstandings, and prejudice. I understand that all individuals have a right to rights, respect, and dignity. I will uphold client by being respectful, by understanding each specific person's needs and goals, by providing a clean, comfortable, and safe environment (to the extent my control allows), for sessions.
· Understand there are situations when it is appropriate to decline services to a client because it is in the best interests of the client or for my own personal safety. I will not refuse services based on disability, ethnicity, gender, marital status, physical build, sexual orientation, religious, national affiliation, political views, or social / economic status.
· Recognize that everyone has the right to provide informed consent to the best of their ability. I understand that a client may suffer emotional and physical harm if a provider fails to listen other client's communication, including verbal, non-verbal, or any other form of communication, and imposes the provider's own beliefs on a situation. I will fully inform my clients of choices relating to their services and disclose policies and limitations that may impact their services.
· Know and follow relevant good business practices. I’m aware that my behavior and appearance reflects on my professional image and am aware of the type of professional image I want to craft and project.
· Not accept gifts, compensation, or other benefits intended to influence a decision related to a client. You may accept reasonable gifts that to not compromise client's wellbeing.
· Maintain clear and honest communication with my clients, my clients team members (family, case manager, etc.) and other professionals.
· Not use recreational drugs, prescribed drugs, or any other substance that may impact my ability to perform my tasks while providing services to clients.
· Not actively disrespect a client or colleague or willingly malign another provider. Any provider who demonstrates behavior or lack their of that potentially negatively impacts the well being of the agency, other agencies that are connected, clients, families, or the community it general may face contract termination, remediation, or legal action.
· I have a basic understand of what has been shared as what many families what me, as a provider to know. Such as: https://adiaryofamom.com/2013/05/14/what-we-told-them-part-one/
· Be open to new strategies and information. That even if I am great with one case, the information I have may not apply to my next client. I understand that I am part of a network and that I can reach out any time and find support and well as be a valuable source of support for other.
Terms & Conditions
In this Agreement Contractor, Provider, Independent Contractor, IC are used interchangeably.
IC agrees to abide by all policies, procedures, advices, and guidelines issued by ANGELS, the case management CCB of each client, the Colorado Department of Human Services, the Colorado Department of Health Care Policy Financing, Colorado Department of Health and Environment and their designees, as they currently exist or may hereafter be amended.
To the extent authorized by law, ICs shall indemnify and hold harmless ANGELS and all those connected, the CCB, the State of Colorado, the Colorado Department of Human Services, and the Colorado Department of Health Care, Policy and Financing their employees, officers, agents, and assignees from and against any and all claims, damages, liability, and court award including costs, expenses, and attorney fees incurred as a result of any act or omission by the contractor, subcontractor, or by its employees, agents, sub-subcontractors, or assignees.
Services & Inspection
· Contractors will provide services in accordance with the individualized service plan governed by the rules and regulations provided by the state of Colorado which are reflected in ANGELS policies and procedures. -Colorado rules and regulations including the Business Associate Agreement.
· ICs shall permit access to sessions, or cooperate with request for information such as a phone call, meeting, or report, to ANGELS, the CCB, the State of Colorado Department of Human Services, the Colorado Department of Health Care Policy and Financing, the U.S. Department of Health and Human Services, and any other duly authorized agent or governmental agency including the Medicaid Fraud Control Unit.
· Have access to any place where service is being provided at any reasonable time during the term of this contract to observe the operation of the programs carried on by the Contractor with or without notice.
· The Contractor shall submit any final Plans of Correction required to ANGELS within 24 hours of a request and respond to request for client / provider information within 24 hours.
· ICs may provide any of the services for which the credentials and contract demands are met that ANGELS is qualified to provide.
· Provide information for the development of the service plan.
· Document methods and procedures used and outcome on session data and reviews.
· Provide necessary support to client / caregiver to achieve the outcomes identified in the service plan.
· Determine how plans are implemented to gain the desired results.
Status & Expectations
THE IC SHALL PERFORM THE DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE . IC SHALL BE ACCOUNTABLE TO ANGELS FOR THE ULTIMATE RESULTS OF ITS ACTIONS BUT SHALL NOT BE SUBJECT TO DIRECTION AND CONTROL OF ANGELS. NEITHER THE IC NOR ANY AGENT OR EMPLOYEE OF THE IC SHALL BE DEEMED TO BE AN EMPLOYEE OF ANGELS. IC SHALL PAY WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX WITHHOLDINGS, INCLUDING ALL FEDERAL AND STATE INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID PURSUANT TO THIS CONTRACT, IC WILL RECEIVE A 1099 AT THE END OF THE YEAR. THE CONTRACTOR ACKNOWLEDGES THAT THE CONTRACTOR AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS IC OR A THIRD PARTY PROVIDES SUCH COVERAGE AND THAT ANGELS DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE. IC SHALL HAVE NO AUTHORIZATION, EXPRESS OR IMPLIED, TO BIND ANGELS TO ANY AGREEMENTS, LIABILITY, OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. IC SHALL PROVIDE AND KEEP IN FORCE WORKER’S COMPENSATION (AND SHOW PROOF OF SUCH INSURANCE) AND UNEMPLOYMENT COMPENSATION INSURANCE IN THE AMOUNTS REQUIRED BY LAW, AND SHALL BE SOLELY AND ENTIRELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR, ITS EMPLOYEES AND AGENTS. ANGELS SERVICES LLC DOES NOT PROVIDE WORKERS COMPENSATION INSURANCE. IC SHALL FURNISH ANGELS WITH WRITTEN CERTIFICATION OF THE EXISTENCE OF SUCH COVERAGE, PRIOR TO THE FINALIZATION OF CONTRACT PROVISIONS.
TERMINATED CONTRACTS ARE NOT ELIGIBLE FOR FINAL PAY RULES AND REGULATIONS AND FINAL PAY RULES AND REGULATIONS ARE ONLY FOR EMPLOYEES AND DO NOT APPLY TO INDEPENDENT CONTRACTS. REIMBURSEMENT UPON CONTRACT TERMINATION WILL REMAIN IN ACCORDANCE TO CONTRACT.
· IC is engaged in a trade, occupation, profession, or business related to the services performed under this agreement with ANGELS. IC is a registered business and is entitled to operate under the business name stated on this agreement under the laws of the State of Colorado.
· IC is free from control and direction by ANGELS in the performance of the Services covered under this Agreement, except the extent that supervision is required by law.
· IC is not required to work exclusively with ANGELS.
· A business decision to accept referrals / work only with ANGELS does NOT change the IC status and does not entitle contractor access to any benefits.
· IC will maintain the proper credentials / contractual documentation to perform the Services covered by this Agreement at all times while providing services and guarantee that ANGELS has current copies.
· IC will pay for all costs / time associated with credentials / contractual documentation and with complying with the provisions of all laws, regulations, requirements and codes which are applicable to the performance of the services.
· ANGELS DOES NOT pay the individual a salary or an hourly rate instead of a fixed or contract rate.
· ANGELS DOES NOT terminate the work or the service unless the company / owner / or an agent, such as an employee violates the terms of the contract or fails to produce a result that meets the specification of the contract or does not satisfy the client.
· ANGELS DOES NOT provide more than minimal training for the individual
· Mentorship is available upon request and does not constitute training
· Some training may be available at certain points without violating this
· Some training may be required based on rules and regulations changes
· ANGELS relies upon IC's expertise and experience to provide the services in a competent and professional manner.
*Monthly documentation of current competency in rules and regulations, policies, etc. is required in order for ANGELS to document IC is in compliance.
· ANGELS DOES NOT provide tools or benefits to the company / owner (except that materials and equipment may be supplied). IC will provide their own tools, labor, and supplies in such quantities and of the proper quality to professionally and reliably perform the services as defined on the service plan.
· ANGELS DOES NOT dictate the time or performance (except that a completion schedule and a range of agreeable work hours may be establish)
· ANGELS ONLY makes payments to the trade or business name.
· If the IC wish to seek workers' compensation insurance, here is a resource: https://www.pinnacol.com/
We are a paperless company. All agents must have tools in order to access and participate fully in order to meet requirements of contract. Agents understand and acknowledge that communication will be processed via email only and that it is agent's responsibility to maintain a valid email address and check it regularly and their Therap Account in regards to communication. All signatures are completed electronically, “electronic signature” means an electronic sound, symbol, or process, attached to or logically associated with a contract or other record and executed or adopted by a person with the intent to sign the record. 15USC 7006(5). By selecting "I agree or acknowledge" IC is submitting a legally binding signature.
Employment & Volunteers of Contractors
· IC is free to employ other individuals skilled in providing the Services or work with volunteers (used interchangeably) covered by this Agreement in order to meet Contractor's obligations provided that such other individual(s) satisfy all state required licensures and certifications applicable to preforming the Services.
· Individuals providing the Services are to be treated as IC's employees and not as the employees of ANGELS. IC will comply with all federal and state tax laws, unemployment tax laws, workers' compensation laws, wage and hour laws, and any other federal or state laws governing the employer employee relationship.
· All IC’s agents must meet the requirements that ANGELS requires to gain and maintain as the IC agreement at the minimum.
· IC will hold ANGELS harmless from any liability arising out or failure to fulfill these Obligations.
· IC agrees to provide to ANGELS proof of workers compensation coverage for such employees.
· IC shall make appropriate and reasonable efforts to verify references and work histories, including appropriate criminal checks, for all its volunteers, independent contractors, agents, and employees. IC shall not employ, or accept volunteer services from individuals who would have unsupervised contact with or access to persons receiving services under this contract, or their property and who have been convicted of abuse, neglect, or mistreatment of a child, adult or person receiving services, or of a felony involving physical harm or violence to another individual, or distribution of controlled substances. IC shall avoid hiring applicants and/or utilizing volunteers who would have unsupervised contact with or access to persons receiving services or their property, and which applicants or volunteers have known substantiated histories indicating abuse, neglect, or mistreatment of a child or adult or persons receiving services, distribution of controlled substances, a criminal record that indicates violence or substance abuse, or a criminal record that indicates patterns of the following: abuse, mistreatment, neglect, or exploitation of a person receiving services. IC shall, from time to time, and at such other times as the ANGELS may require, provide written assurance that all new employees of the IC are examined for and meet the requirements set forth herein.
· IC does not have the right to assign this Agreement to another independent contractor.
ANGELS is contracting with the Contractor for services to be provided to a public entity. Incorporated into this Agreement is an Agreement to Comply Certification of Compliance with C.R..S. 8-17.5-101. el. seq., regarding the prohibition against knowingly employing or contracting with an unlawful alien to perform work under the Agreement, which must be signed as a condition of this Agreement, and regarding the parties' participation in the E-Verify program.
Payment for Services.
· ANGELS will pay IC for satisfactory provided services rendered in accordance with the provisions below. Payments are based on the number of units specified in the service plan.
· All providers may only use the units designated for their specific use, in the amount, scope, frequency, and duration outlined in the service plan. Each service may only be provided for the time span listed for that service. Providers who bill beyond the approved amount, scope, frequency, or duration WILL NOT BE PAID FOR SERVICES rendered and that family is NOT RESPONSIBLE for payment if payment cannot be collected due to inappropriate billing. You must have written authorization in order to document that you have authorization of services.
· It is the responsibility of the provider to make sure that enough units are available to last each client the ENTIRE SERVICE PLAN YEAR! Even with a fluctuation statement, a provider may not use an excessive amount of units that leaves a client not able to get their needs met throughout the year or to significantly reduce utilization to make the units "stretch." If the provider neglects this duty the provider is responsible for providing the services for the remainder of the service plan, without reimbursement or to reimburse the service plan the dollar amount needed to fund the remaining of the service plan for the units that were over utilized otherwise this would be considered fraud.
· If there is a special circumstance that requires a mass amount of units be used and the family wishes to change the expectation of services being available throughout the entire year, the provider, case manager, family, and the contract holding agency must all be made aware, agree, and have written documentation to the fact.
· IC shall comply with all ANGELS billing procedures and requirements, which may be amended by ANGELS.
· All submissions of required documentation in order to maintain funding sources, remain in compliance with the State of Colorado rules and regulations, and ANGELS policies and procedures including needed documentation for client and IC file alike.
· Failure of the IC to submit the claim information in a timely fashion as required hereunder may cause the claim to be rejected. The Contractor shall not be paid for the amounts set forth in the untimely claim unless the funds for such untimely claims are actually received by ANGELS.
· ANGELS shall review session data to generate and submit claims to the Medicaid Fiscal Agent or appropriate agency in accordance with instructions provided by the agent.
· Denials of payment by the Fiscal Agent which are the result of the IC’s failure to follow the terms of this contract shall release ANGELS from any obligation for payment for services rendered.
· If there is an instance of fraud, contractors agree to reimbursement ANGELS double the billable amount that was billed.
· Pay all associate fees, including but not limited to fines, court costs, etc.
· Pay a 20% fee of all billed services in order for services to be audited for further fraud.
· Over Payment
· In the event that overpayments are made by the ANGELS due ANGELS error, or IC’s omission, error, fraud, or in the event that the State or Federal government seeks to recover from ANGELS any sums of money based upon a claim on behalf of the IC after said funds have been paid to the IC, the Contractor shall immediately reimburse such funds to ANGELS in accordance with the Medical Assistance Act, C.R.S., Section 26-4-112, or as otherwise allowed by law.
· The parties understand and agree that ANGELS shall have the right to offset against payments due to the IC hereunder, or by other legal means recover any debts owed by the Contractor to the CCB or to the State.
· Any amounts which have been paid by ANGELS and which are found to be improper in accordance with the terms of this contract shall be immediately returned to ANGELS, or may be withheld from future payments.
· Contractors must provide tools to be able to access documentation in addition to providing services, such as but not limited to, the ability to access the internet securely, etc.
· Please note, accessing confidentially information on a public Wi-Fi source is a violation of HIPPA
· ANGELS shall receive, on behalf of IC, all payments and payment transmittal documents from Medicaid and the State of Colorado or relevant agent. ANGELS shall release the funds for all reimbursable services the last business day of the month following the month service was provided. No payments shall be due from ANGELS to the Contractor unless the funds for such payments are received by ANGELS
· Outside forms are permissible. Forms must have all information that is mandated in order to bill and meet rules and regulations including verification policy. There is an additional 5% to 10 % fee per month for providers who submit documentation in alternative methods.
Rate sheets are published here: http://www.watchingfish.com/rates . Rates may be amended.
· All required insurance be provided by IC’s own expense during the term of this Agreement. Insurance coverage will not be reduced below limits described below or canceled without notice of such reduction or cancellation.
· IC will require that any of its agents who perform services will maintain like insurance.
· Standard Workers Compensation as required by state statute and Employer's Liability Insurance covering all of IC's employees acting within the course and scope of their employment.
· Commercial General Liability, if the independent contractor has employees, insurance for operations and contractual liability adequate to cover the liability assumed hereunder and limits of not less than $1,000,000 (one million) on account of any one person, and $1,000,000 (one million) for each occurrence of property damage and personal injury. This insurance must be listed under General Liability, not Workplace Liability. If the contractor or subcontractor.
· If IC only delivers services in a client's home or other community setting and does not have a clinic where they provide services; the State of Colorado will exempt them from this requirement.
Automobile Liability for providers NOT transporting clients is not required.
· Automobile Liability for providers transporting clients
· Bodily Injury, 100,000 each person and 300,000 each accident
· Property Damage, 100,000 each accident
· Medical Payments, $5000 each person
· Uninsured Motorists, $25,000 each person, $50,000 each accident
· IC is not to provide transportation services at any time for any reason for the individuals and families they serve outside of the service plan, if they so do so, they are in violation of this agreement and are responsible for all risk.
· Transportation waiver: If transportation is taking place with a provider and a client due to dual relationships, a statement must be the client's digital file AND the provider's digital file, stating the dual relationship and that transportation is taking place outside of services and all liability is waived, including in the case of negligence.
· Professional Liability Insurance with minimum limits of $1,000,000.
· IC and its subcontractors, employees, agents, etc. will obtain and maintain during the term of this Contract liability insurance covering all loss of Protected Information data and claims based upon alleged violations of privacy rights through improper use or disclosure of Protected Health Information with minimum coverage of $50,000
Remedies & Termination
ANGELS may utilize the following remedial actions, in addition to all other remedial actions authorized by law, should it find that IC substantially failed to satisfy the scope of work found in this contract. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by IC as determined by ANGELS . These remedial actions are as follows:
· IC is deemed to be out of compliance at any time, then corrections or a plan of correction will be required. Written notification will specify if corrections are to be made immediately, or, if a plan of correction shall be developed and the deadline for correction specified. IC is responsible for responding within 24 hours of a request for phone conference or other communication.
· If corrections are not made by the time frame specified by ANGELS , or an acceptable plan of correction is not submitted by the deadline specified in the notification of non-compliance, and if the health, safety and welfare of persons is not found to be in jeopardy, IC and ANGELS may renegotiate time frames and plan(s) of action.
· Payment to IC may be withheld until the necessary services or corrections in performance are satisfactorily completed.
· Payments may be denied or recovered from IC for those services or deliverables which have not been performed and which, due to circumstances caused by IC, cannot be performed or, if performed would be of no value to ANGELS . Determination of the amount of payment denied shall be reasonably related to the amount of work or deliverables lost to ANGELS . In addition to other fees, contracts under remediation may have associated fees.· This contract is subject to immediate cancellation by ANGELS in the event that:
· ANGELS determines that the health, safety, or welfare of persons receiving services from IC may be in jeopardy.
· Core agreement has been violated.
· IC's performance of services not satisfying state-mandated specifications or the individual(s)' service plan or contract has been violated.
· Funding sources change or become unavailable as determined by ANGELS . ANGELS may immediately terminate this contract or amend it.
· Final payment may be withheld pending an audit of outstanding payables due when a contract is terminated. If outstanding payables related to an individual’s care are due, they may be paid by ANGELS and the balance withheld from final payment to Contractor.
To align with client respect and to protect client well being in the event of:
Termination of client specific service at client request agent IS NOT permitted to contact client further. Any needs will be directed towards agency.
Provider initiated termination with notice, statement may be shared with clients
Termination of contract due to violation, agent IS NOT permitted to contact client further. Client's may initiate contact with provider.
· If either party in any one or more instances to insist upon strict performance of any of the terms and provisions of this Agreement, will not be considered as a waiver of the right to assert any such terms and provisions on any future occasion or of damages caused thereby.
· If any of the provisions of Agreement will be invalid or unenforceable. The entire Agreement will be construed as if not containing the invalid or unenforceable provision(s), rights and obligations of the parties will be construed and enforced accordingly, to the essential intent and purposes of this agreement.
· Agreement does not grant IC an exclusive privilege or right to supply Services to ANGELS. ANGELS makes no representations or warranties as to procurement of services.
· This Agreement will be in accordance with the laws of the State of Colorado. Venue for any litigation which may arise out of this Agreement will be in Colorado and, if only state claims are involved, in the County where the main office of ANGELS is located.
· Contract is binding upon the parties, successors and assigns. Parties agree that nothing in this Agreement will be construed to counter upon or give any person other than ANGELS and Contractor and respective Successors and assigns any rights or remedies under or by reason of this Agreement.
Entire Agreement & Modification
This is the entire Agreement between ANGELS and IC, these provisions will supersede all others. Contract modifications may take place in hardcopy, digital format, or through the software that ANGELS utilizes as a signup agreement.
Contract is subject to change at any time. This includes, but is not limited to, rates, qualifications, licensure, policies & procedures, or liability insurance requirements, etc.
Feb. 2018 Published by Serena Akinahew