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Single Case Agreement 101. What is a Single Case Agreement? 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.
What is a case agreement?
A Single Case Agreement (SCA) is a one-time contract between an insurance company and an out-of-network provider so the patient can see that provider using their in-network benefits.
What is the difference between a gap exception and a single case agreement?
Single Case Agreement: This is a one-time contract your insurance will set up with an out-of-network provider so you can see this provider at your in-network benefit level. The difference between this and a Gap Exception is a negotiation process that takes place between your insurance and the out-of-network provider.
How do you negotiate a single case agreement?
What to Consider When Approving Single Cases Agreements Make sure you have all the documentation regarding an SCA, including the details of your. patients condition and treatment. Focus on the services included in the contract. Once the insurance company fixes the rates of an SCA, make sure the charges are immediately.
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