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Sometimes referred to as SCA, Single Case Agreement is essentially a contract between an insurance company and an out-of-network provider to ensure that a client doesnt have to change providers. Its especially important for clients who need extended long-term treatment or therapy.
Single-Case Agreement Approval Process The insurer conducts an initial assessment to determine whether in-network services are available and the medical necessity of the treatment. The insurance company then reviews the patients diagnosis and treatment plan documentation. The insurer negotiates terms with the provider.
It allows for customized payment terms and reimbursed rates for particular medical cases so the patient can receive care they might not otherwise have access to from a provider in their network.
The healthcare provider initiates a single-case agreement request by contacting the patients insurance company and discussing the possibility of covering services at an out-of-network rate. A single-case agreement letter can initiate the request or formalize the agreement once its negotiated.
How to write an agreement letter Title your document. Provide your personal information and the date. Include the recipients information. Address the recipient and write your introductory paragraph. Write a detailed body. Conclude your letter with a paragraph, closing remarks, and a signature. Sign your letter.

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Also known as SCAs, Single Case Agreements are contracts between an insurance company and an out-of-network provider. These types of contracts typically cover a specific client receiving a service for a designated length of time at an agreed-upon rate.
The individual making the offer is referred to as the offeror. When initiating a contract, the offeror presents specific terms to the offeree. These terms include the following elements: Expression of Intent: The offeror declares their intention to enter into a contract with the offeree.

single case agreement