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DocuSign Envelope ID:977F9724-0D69-4F35-BE42-796A38945969 <br /> ii) Refer patients covered under this program to receive laboratory services from <br /> providers other than the Orange County Health Department. The Provider will inform <br /> these patients of their options and potential costs as the patients will be responsible for <br /> any laboratory charges. <br /> iii) Referred patients shall be responsible for a minimum of $20 co-pay if income <br /> eligible, and a percentage of the charges as indicated by where their income falls on <br /> the DHHS Sliding Fee Schedule, to be provided to the Provider. Referred patients are <br /> also responsible for charges as a result of laboratory services provided by the <br /> Provider. <br /> iv) The Provider shall invoice Orange County Health Department on a monthly basis <br /> for services rendered in the prior month. Monthly reimbusement shall be based on <br /> reports detailing actual procedures provided to referred patients during the <br /> reimbursement period. Approved procedures will be reimbursed at the current Local <br /> Health Department (LHD) Medicaid rate, to be furnished to the Provider as updated <br /> by the NC State Department of Medical Assistance (DMA.) Monthly reports shall <br /> detail date of service, Patient ID number, CPT code, and diagnosis code for each <br /> procedure provided to an eligible, referred patient. <br /> v) The Provider shall provide current regisration and licensure for all physicians, <br /> Family Nurse Practitioners, and Physician Assistants in the practice as appendices to <br /> this contract. <br /> 4. Duration of Services <br /> a. Term. The term of this Agreement shall be from July 1, 2016 to June 30, 2017. <br /> b. Scheduling of Services. <br /> i) The Provider shall schedule and perform its activities in a timely manner. <br /> ii) Should the County determine that the Provider is behind schedule, it may require <br /> the Provider to expedite and accelerate its efforts, including providing additional <br /> resources and working overtime, as necessary, to perform its services in <br /> accordance with the approved project schedule at no additional cost to the <br /> County. <br /> iii) The Commencement Date for the Provider's Basic Services shall be July 1, 2016. <br /> 5. Compensation <br /> a. Compensation for Basic Services. Compensation for Basic Services shall include all <br /> compensation due the Provider from the County for all services under this Agreement. <br /> The maximum amount payable for Basic Services shall not exceed Thirty thousand <br /> Dollars ($30,000). Payment for Basic Services shall become due and payable within <br /> thirty (30) days of Provider properly invoicing County. Payment shall be subject to <br /> provisions of Section 5(b). <br /> Revised 6/16 <br /> 3 <br />