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7.14 Status as Independent Entities. None of the provisions of this Agreement is intended to create,
nor shall be deemed or construed to create any relationship between Provider and All Health or a Payor other than
that of independent entities contracting with each other solely for the purpose of effecting the provisions of this
Agreement Neither Provider nor All Health /Payor. nor any of their respective agents, employees or representatives
shall be construed to be the agent employee or representative of the other
7.15
Addenda Each Addendum to this Agreement is made a part of this Agreement as though set
forth fully herein Any provision of an Addendum that is in conflict with any provision of this Agreement shall take
precedence and supersede the conflicting provision of this Agreement with respect to the subject matter of the
Addendum
7.16 Calculation of Time. The parties agree that for purposes of calculating time under this
Agreement any time period of less than ten (10) days shall be deemed to refer to business days and any time period
of ten (10) days or more shall be deemed to refer to calendar days unless the term "business" precedes the term
"days"
7.17
Waiver of Breach The waiver of any breach of this Agreement by either party shall not
constitute a continuing waiver of any subsequent breach of either the same or any other provision(s) of this
Agreement Further, any such waiver shall not be construed to be a waiver on the part of such party to enforce strict
compliance in the future and to exercise any right or remedy related thereto
THIS CONTRACT CONTAINS A BINDING ARBITRATION CLAUSE, WHICH MAY BE ENFORCED
BY THE PARTIES
IN WITNESS WHEREOF the parties have executed this Agreement
PROVIDER
ALL HEALTH
Smith
Signature
Health Net Signature
Peanth
Harvey
DUONG MS
Steve Carrol
Print Name
Print Name
MEDICAL DIRECTOR
VP Provider Network Management & Strategy
Title
Title
Dummy Group Name Inc.
Group Name (If Applicable)
Date
3/28/2011
01-2345678
Tax Identification Number
Effective Date
4/15/2011
2/2/2011
Date
California Provider Participation Agreement
For-Service Direct Network Template
HN-DN-PPA-11-03-2010
18

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EXHIBIT A-1
COMMERCIAL BENEFIT PROGRAMS
DIRECT NETWORK FEE-FOR-SERVICE
RATE EXHIBIT
Subject to the terms of this Agreement, including without limitation the Payment Conditions set forth in Addendum E.
All Health or Payor shall pay and Provider shall accept as payment in full for non-capitated Medically Necessary
Covered Services delivered under commercial Benefit Programs pursuant to this Addendum, the lesser of (i) the rates
listed below. or (ii) 100% of Provider's billed charges.
-------Table Start--------
[["Category of Service","Compensation"],["Covered Services delivered or arranged by Provider. excluding Laboratory services","95% of CMS Allowable"],["Anesthesia Services when provided by an Anesthesiologist or Certified Registered Nurse Anesthetist (American Society of Anesthesiology (ASA) unit scale)","$39 ASA unit"],["Medical/Surgical Services by an Anesthesiologist or Certified Registered Nurse Anesthetist","95% of CMS Allowable"],["Laboratory Services performed in Provider or Professional Provider office","95% of CMS Allowable"],["Pharmaceuticals","95% of the Average Wholesale Price (AWP)"],["OB Services - CPT 59400: Global Obstetric care with vaginal delivery - CPT 59510: Global Obstetric care with cesarean delivery - CPT 59610: Vaginal Delivery after previous cesarean delivery - CPT 59618: Attempted vaginal delivery, resulting in cesarean","$1,700.00 $1,700.00 $1,700.00 $1,700.00"],["Immunizations","95% of the Average Wholesale Price (AWP) as determined by Health Net."],["General Health Panel - CPT 80050: General Health Panel CPT 80055: Obstetric Panel","$20.00 $15.00"],["By Report (BR) Procedures, Procedures not Listed and Procedures with Relativities not Established","75% of billed charges for Covered Services"]]
-------Table End--------
California Provider Participation Agreement
Fee-For-Service Direct Network Template
HN-DN-PPA-11-03-2010
22


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EXHIBIT B-1
MEDICARE ADVANTAGE PROGRAM
DIRECT NETWORK FEE-FOR-SERVICE
RATE EXHIBIT
I. Payment Rates
Subject to the terms of this Agreement, including without limitation the Payment Conditions set forth in Addendum E,
All Health shall pay and Provider shall accept as payment in full for non-capitated Medically Necessary Covered
Services delivered under Medicare Advantage Benefit Programs pursuant to this Addendum, the lesser of: (i) the rates
listed below, or (ii) 100% of Provider's billed charges
-------Table Start--------
[["Category of Service","Compensation"],["Covered Services delivered or arranged by Provider","100% of CMS Allowable"],["General Health Panel",""],["- CPT 80050 General Health Panel","$20.00"],["- CPT 80055: Obstetric Panel","$15.00"],["By Report (BR) Procedures. Procedures not Listed and Procedures with Relativities not Established","75% of billed charges for Covered Services"]]
-------Table End--------
California Provider Participation Agreement
Fee-Fer-Service Direct Network Template
HN-DN-PPA-11-03-2010
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EXHIBIT C-1
MEDI-CAL BENEFIT PROGRAM
DIRECT NETWORK FEE-FOR-SERVICE
RATE EXHIBIT
Subject to the terms of this Agreement, including without limitation the Payment Conditions set forth in Addendum E,
All Health shall pay and Provider shall accept as payment in full for non-capitated Medically Necessary Covered
Services delivered pursuant to this Addendum, the lesser of: 100% of the State of California Medi-Cal Fee Schedule
rates in effect at the time of service, subject to any adjustments made by the State of California under the applicable
Medi-Cal Fee-For-Service Program; (ii) Fee-for-service rates for the commercial Benefit Program set forth in
Addendum A. Exhibit A-1: or (iii) Provider's billed charges.
California Provider Participation Agreement
Fee-For-Service Direct Network Template
HN-DN-PPA-11-03-2010
34


