This Agreement, entered into on _________________ (date) by __________________________ (Client) and Pathways in Aging (Pathways) is for the provision of Care Management services to ________________________ (Care Recipient). Client, Care Recipient and Pathways are collectively referred to in this Agreement as the Parties. The Parties hereby agree as follows:
Financial Responsibility. Client agrees to pay professional fees, all reasonable out-of-pocket expenses incurred on behalf of the Client in accordance with Fee Schedule attached hereto and made part of this Agreement.
Confidentiality and Liability. Pathways understands that any and all private information obtained about the Client and Care Recipient and their family or relatives during the course of this agreement (including but not limited to medical, financial, legal, career and assets) are strictly confidential and may not be disclosed except as required for care coordination purposes. By executing this Agreement, Client, for him/herself or on behalf of the Care Recipient, consents to the release of information by Pathways to individuals acting in official capacities as Client’s advocates representing third party payers, law enforcement or other health care or service providers involved in Care Recipient’s care.
Pathways in Aging utilizes technology including but not limited to email, medical charting software, healthcare system portals, applications, HIPAA compliant fax and cell phones while coordinating care. Technology increases our efficiency and is a necessity in the modern world, but also comes with risk. We utilize best practices to minimize the risk of privacy breaches.
Client agrees and understands that as part of the services provided, Pathways may refer you to third party service providers. While we strive to refer to the highest quality providers, we cannot guarantee and expressly do not assume liability for the actions of third party service providers. Client is responsible for investigating and evaluating programs, providers, and is solely responsible for their charges. Client, Care Recipient and their heirs, successors and assigned all hold Pathways harmless from and against all claims, damages, suits, charges, liabilities, costs and expenses (including legal fees and expenses) arising as a result of negligent, intentional or other acts of independent contractors or their representatives. Any person signing this agreement as a Client will be bound by its terms, and is jointly and severally liable with Care Recipient to Pathways.
Service Area. Care Management services are provided throughout Northern Virginia and the Greater Seattle Area in Washington State.
Driver’s Release. In the event that the Service Recipient requires transportation services by Pathways, the Care Recipient and /or ClientAuthorized Representative understands and acknowledges that Pathways, its employees and agents, are not liable for any injuries, damages, loss or suffering (“injuries”) to the Care Recipient which result from the use of a vehicle by a Pathways employee, unless the injuries were the direct result of the Pathways employee’s intentional or negligent acts or failures to act. This limitation on Pathways’ liability shall apply regardless of whether the vehicle is owned by the Care Recipient, the Client/Authorized Representative, a third party, or by Pathways, its employees or agents.
Service Parameters. Pathways does not provide 24-hour emergency coverage. We monitor our phones and email after hours, and utilize an answering service on weekends and holidays, but cannot guarantee a timely response outside of business hours Monday through Friday, excluding holidays. We encourage clients and families to have phone numbers on hand for emergency and other service providers.
Email Communication. Pathways includes clients and designated family care team members on email newsletters. There is an option to unsubscribe at the bottom of the newsletter.
Term and Termination. The nature of this Agreement shall be ongoing until terminated by Client or Pathways. Termination is effective upon receipt of written notice by either party. Termination can be initiated by Pathways for the following reasons:
Pathways is unable to provide appropriate services to meet Client’s needs
Client has achieved his or her goals and services are no longer needed
Client is unwilling to participate appropriately in the Care Plan, creating an unsafe living situation
Client is unwilling to pay fees
In the event Pathways finds cause to terminate services as described above there will be an allowance for sufficient time and support to transition Client to alternative services.
Entire Agreement. The Agreement constitutes the entire agreement of the Parties, and supersedes any and all previous understanding, agreements, arrangements or discussions, written or oral, between the Parties relating hereto. There are no collateral agreements, representations or guarantees, oral or otherwise unless attached hereto.
Arbitration. Any and all disputes, claims or controversies arising out of or relating to this Agreement, and any and all other disputes, claims or controversies by and between Client, on the one hand, and Pathways, and/or its/their respective employees, agents, clients, customers, and vendors (collectively, the “Pathway Parties”), on the other hand, shall be resolved exclusively through final and binding arbitration, and not by way of a court or jury trial. This agreement to arbitrate shall be governed, construed and enforced pursuant to the Federal Arbitration Act; however, any claims submitted to arbitration regarding other terms of this Agreement shall be governed by the laws of the State of Virginia or Washington. In arbitration, each party shall pay the fees for his, her or its own attorneys, subject to applicable law and/or any remedies to which that party may later be entitled under applicable law. By signing this Agreement, both Pathway Parties and Client waive any rights to have such disputes tried by a judge or jury, or to appeal any findings of the arbitrator except as may be vacated under the Federal Arbitration Act.
Fee Schedule for Core Billable Services
Monthly Administrative Fee $69/month Billed monthly to all hourly care management clients who occupy a slot on a care manager’s caseload.
Care Management Services $195/hr (billed in 6-minute increments) Care management services include all time spent by the Care Manager on behalf of the Client and Care Recipient and are detailed in Billable Services attached hereto and made part of this Agreement. While the amount of time needed may differ from one client to another, Client understands that a minimum of one hour per month of personal contact with Client and/or Care Recipient is necessary to have current information allowing Care Manager to be able to provide quality care management services and to reduce the likelihood of a crisis.
Assistant Care Manager Services $80/hr (billed in 6-minute increments, when available)
Mileage Charged at $0.75 per mile for all travel associated with Care Management services.
After Hours Services $250/hr (billed in 15 minute increments)
Service hours are Mon-Fri, 8:30am–5:30pm. All services provided on weekends, holidays or between the hours of 5:30m and 8:30am are billed at the rate of $250/hr.
Unplanned phone calls, crisis intervention, and client contact on weekends, holidays or between the hours of 5:30pm and 8:30am will be charged a minimum of 15 minutes.
Fee Schedule for a la carte Billable Services
Mini Virtual Consultation $150 for up to 1 hour for an hour of consultation by phone or video conference.
Comprehensive Assessment $850 for an in-home visit and assessment including a formal written report of assessment findings and targeted recommendations.
Plan Ahead with Pathways $500 for the initial interview (in office or virtual). Biannual or quarterly interviews to maintain our records are required for this service, and billed at the Care Management rate. Any Care Management Services requested between biannual interviews are also billed at the Care Management rate.
Invoicing and Payment
All Care Management services are billed at an hourly rate in 6-minute increments.
Monthly invoices will include all reasonable out-of-pocket expenses incurred on behalf of the Client.
Services are billed monthly with payment due and payable upon receipt. We accept payment by check or credit card.
Invoices that are not paid within thirty days are subject to a late fee of 1.5% per month, and may result in cessation of all Care Management services pending satisfactory financial arrangements.
Client will be charged for a canceled appointment unless canceled at least 24 hours in advance.
If Client terminates this Agreement, all payments are due immediately.
Fees may be updated from time to time by Pathways in Aging at its discretion. Clients will be provided notice of any fee changes thirty (30) days in advance of the effective date and a revised Fee Schedule will be deemed to be incorporated into this Agreement.
Examples of Billable Care Management Services
Information Gathering and Research Time spent researching potential resources, as well as contact with current care providers. This includes gathering information from doctors, lawyers, non-family caregivers, homecare agencies, community agencies, residential facilities and other community resources.
Care Management Direct care to include assessment, recommendations, arranging and monitoring of services; re- applications and continuation of eligibility requirements for programs identified; contact with clients, family, caregivers, healthcare providers and community agencies involved with the client, whether face-to-face or by telephone, text, email or letter; errands, shopping, travel time, reports to involved parties and any administrative support.
Medical or Behavioral Health Visits Attending Client medical or behavioral health appointments, communicating with the provider, and any necessary follow-up.
Consulting Specialists and Advocates Medical education and advocacy for complex diagnoses and ethical dilemmas.
Coaching and Counseling Education and support for caregivers, family members and friends about effective communication, disease specific care, preventing caregiver burnout, conflict management and other topics as needed.