Billing and Collection Agreement Sample Contracts

This Billing and Collection Agreement (“Agreement”) by and among United HealthCare Services, Inc., and its subsidiaries and affiliates (collectively “UHS”), the designated service provider(s) (individually and collectively, “Service Provider”) indicated on the attached Exhibit 1 to this Agreement (“Exhibit 1”), and [CUSTOMER NAME] (“Customer”), sets forth the terms and conditions under which UHS will assist in the billing and collection of Service Fees from Customer, and the processing and remittance of the Service Fees to Service Provider. This Agreement is effective as of [EFFECTIVE DATE] (the “Effective Date”).

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This Billing and Collection Agreement (“Agreement”) by and among United HealthCare Services, Inc., and its subsidiaries and affiliates (collectively “UHS”), the designated service provider(s) (individually and collectively, “Service Provider”) indicated on the attached Exhibit 1 to this Agreement (“Exhibit 1”), the [NAME of THE CUSTOMER] (“Customer”), sets forth the terms and conditions under which UHS will assist in the billing and collection of Service Fees from the Customer, and the processing and remittance of the Service Fees to Service Provider. This Agreement is effective as of [EFFECTIVE DATE] (the “Effective Date”).

This Billing and Collection Agreement (“Agreement”) is entered into as of the effective date below among Aetna Health Management, LLC, a Delaware limited liability company, Customer (specified below) and Producer (specified below). Aetna Health Management, LLC and its affiliates are collectively referred to as “Aetna.” Aetna, Customer and Producer are collectively referred to as the “Parties”.

This Billing and Collection Agreement (“Agreement”) by and among United HealthCare Services, Inc., and its subsidiaries and affiliates (collectively “UHS”), the designated service provider(s) (individually and collectively, “Service Provider”) indicated on the attached Exhibit 1 to this Agreement (“Exhibit 1”), the Customer Name (“Customer”), sets forth the terms and conditions under which UHS will assist in the billing and collection of Service Fees from the Customer, and the processing and remittance of the Service Fees to Service Provider. This Agreement is

Billing and Collection Agreement • May 2nd, 2016 • Quorum Health Corp • Services-general medical & surgical hospitals, nec • Tennessee

THIS BILLING AND COLLECTION AGREEMENT (the “Agreement”) is made and entered into effective as of the 29th day of April, 2016, by and between PHYSICIAN PRACTICE SUPPORT, LLC, a Delaware limited liability company (“PPS”), and QHCCS, LLC, a Delaware limited liability company (“QHCCS”).

[Insert Legal Name of Broker or Consultant] (“Service Provider”) and [Insert Name of Employer Member and WMC Association Health Plan] (“Clients”) (collectively, the “Parties”) enter into this agreement on [Insert Date].

This BILLING AND COLLECTION AGREEMENT (this “Agreement”) is entered into as of November 30, 2007 (the “Effective Date”), by and between Windstream Communications, Inc., a Delaware corporation (“WCI”), and Windstream Yellow Pages, Inc., an Ohio corporation (“Publisher”). Promptly after the date hereof, Publisher will change its name to Local Insight Yellow Pages, Inc. WCI and Publisher are each sometimes referred to herein as a “Party” and together as the “Parties”. Capitalized terms not otherwise defined herein will have the meanings assigned to such terms in Article I.

This BILLING AND COLLECTION AGREEMENT (this “Agreement”) is entered into as of November 30, 2007 (the “Effective Date”), by and between Windstream Communications, Inc., a Delaware corporation (“WCI”), and Windstream Yellow Pages, Inc., an Ohio corporation (“Publisher”). Promptly after the date hereof, the Publisher will change its name to Local Insight Yellow Pages, Inc. WCI and Publisher are each sometimes referred to herein as a “Party” and together as the “Parties”. Capitalized terms not otherwise defined herein will have the meanings assigned to such terms in Article I.

This Billing and Collection Agreement (“Agreement”) by and among United HealthCare Services, Inc., and its subsidiaries and affiliates (collectively “UHS”), the designated service provider(s) (individually and collectively, “Service Provider”) indicated on the attached Exhibit 1 to this Agreement (“Exhibit 1”), and [CUSTOMER NAME] (“Customer”), sets forth the terms and conditions under which UHS will assist in the billing and collection of Service Fees from Customer, and the processing and remittance of the Service Fees to Service Provider. This Agreement is effective as of [EFFECTIVE DATE] (the “Effective Date”).

Billing and Collection Agreement • October 6th, 2000 • Healthcomp Evaluation Services Corp • Non-operating establishments • Georgia