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Healix Health Services Limited manages, on behalf of its clients, the healthcare needs of individuals; this requires engaging with various providers to arrange medical and related services for such individuals. As one of our providers, you would be engaged for the provision of medical, surgical, and diagnostic services.
These terms and conditions apply to your Provider Recognition Application (“Application”) with Healix. You are able to submit an Application:
By completing and submitting an Electronic Application or Paper-Based Application, you will be deemed to have accepted these terms and conditions.
In these terms and conditions, “Healix”, “HHS”, “we”, “us” and “our” shall mean Healix Health Services Limited. References to “you” and “your” shall mean the consultant, medical practice, company or other business named on your Application. Each may be referred to as a “party”, or together “the parties”.
Please ensure that you read these terms and conditions carefully before completing your Application.
Your completed Application will be reviewed by our Provider Network Team and you will be notified if your registration has been successful. If your Application is successful these terms and conditions shall become legally binding.
Completion of an Application does not guarantee you will be accepted to join the provider network and we retain the right to reject your Application, complete or incomplete, without reason.
Healix will not be liable for any costs incurred by you in the completion of this Application.
By completing this Application, you agree that all information provided is, and will remain, accurate for the duration of your registration with Healix by agreeing to notify us via the Healthcode Private Practice Register if completing an Electronic Application or in writing if completing a Paper-Based Application of any changes to the information provided.
Healix is under no obligation to pay you if you do not become one of our registered providers.
When Healix confirms cover to a patient, we will issue a Treatment Authorisation (TA) which will include the treatment we have authorised, the amount authorised and, if applicable, the remaining amount and any excess (“Shortfall”) that is not covered by us and which must be recovered from the patient directly. You agree to obtain the TA from Healix prior to carrying out treatment. If you have queries as to whether planned treatment is eligible, you can discuss this with us by calling 020 3376 3905.
It is your responsibility to ensure that the recipient of the treatment is the individual named in the TA.
If the case is an emergency, you should treat the patient as the situation requires and seek authorisation as soon as is reasonable thereafter.
You agree to provide medical evidence (or other such information as we request) within 72 hours of the request, to allow us to provide authorisation for treatment or pay invoices. Failure to do so may result in delay or withholding of payment.
We recommend you charge in line with the Healix Schedule of Procedures and Fees (“Fee Schedule”), available to view at hsp.healix.com/hfs. The Fee Schedule contains codes and professional fees for procedures based on work undertaken by the Clinical Coding and Schedule Development group (CCSD). This Schedule is therefore constantly updated and we recommend that you check it regularly to take into account any changes.
If you do not agree to charge in line with the Fee Schedule, Healix will settle payments up to the amount authorised in the issued TA, which will be in line with our Fee Schedule. The Shortfall, if any, should be charged to the patient directly. For more information, please view our Fee Schedule Guidelines at hsp.healix.com/hfs/Guideline or visit healix.com/healthcare-providers/uk-healthcare-providers-network.
The inclusion of a code in our Fee Schedule does not necessarily mean that for the treatment is covered. Please contact us by calling 020 3376 3905 if you are unsure as to whether treatment will be eligible.
You agree to submit invoices to Healix which should contain the following information:
If you are completing an Electronic Application, and therefore intend to submit invoices via Healthcode, they must be submitted in accordance with the Healthcode mandatory fields to avoid processing delays. If you need assistance with electronic billing, you can visit www.healthcode.co.uk/medical-billing/electronic-billing, contact the customer service desk at Healthcode by phone (01784 263150) or email (firstname.lastname@example.org).
If you are submitting a Paper-Based Application, and intend to issue paper invoices to Healix, they should be emailed to Healix at email@example.com or sent by post to:
Healix Health Services,
Esher, Surrey, KT10 8AB
You may submit invoices only for eligible treatment which has been carried out by you. Invoices must be submitted promptly. Invoices submitted after 6 months will not be paid. In such circumstances, you also agree not to approach the patient for payment.
If the patient is required to pay an excess, we will advise you either in the Treatment Authorisation or by communicating with you following the submission of your invoice should the excess not be known at the time of writing the Treatment Authorisation. You will be responsible for charging the patient directly and collecting the excess.
If you do not agree to our Fee Schedule, you agree to:
Payment will be made by BACS in accordance with the terms set out in section 3 (Billing) of these terms and conditions and to the bank account supplied in your Application, unless you have provided a change of details. We will only make payments to UK business bank accounts in your name or a nominated third party agency or provider that has been agreed with us.
Healix shall make payment of invoices correctly rendered by you less any patient liabilities within 60 calendar days.
In exceptional circumstances, you may need to contact Healix for information on an unpaid invoice; we request that you do not do so before 60 calendar days has elapsed.
By completing the Application, you agree that you will seek to provide a high quality of care to each patient and always act in accordance with good clinical practice.
You agree to refer the patient back to Healix if you are unable to provide the required treatment.
You confirm that you hold the appropriate professional indemnity insurance cover and can supply evidence to Healix upon request. Failure to do so may result in the termination this or any other agreement between us.
You must ensure that you (and the staff within your practice, where applicable), are:
You agree that you will notify Healix immediately if there is:
You agree to ensure that your facility (i.e. the location, owned by you, where the treatment takes place e.g. clinic, therapy studio) is appropriately maintained for the purposes of carrying out treatment and has a full and current registration with the Care Quality Commission.
If a disagreement should arise between us, you agree that in the first instance you will discuss this with us via the Provider Helpline on 020 3376 3905. If we are unable to resolve a disagreement via the provider Helpline, an appropriate escalation of the dispute will be undertaken.
This section addresses the following matters:
The following definitions and interpretation shall apply:
As a Healix Provider, both you and Healix will be acting as Data Controllers for Personal Data and Sensitive Personal Data collected and processed when providing services.
In the course of the provision of services there is a requirement to share Personal Data between us. When sharing and processing personal data the following obligations will apply:
Both you and Healix agree to comply at all times with the Data Protection Legislation and not perform any obligations in such a way as to cause the other party to breach any of its obligations under the Data Protection Legislation and shall in particular:
On an ongoing basis, both you and Healix shall ensure that the Personal Data is:
In the event of a Personal Data breach both parties agree to take immediate action and manage the data breach in accordance with best practice, taking into account the interests of both parties, and in accordance with the Data Protection Legislation. Both parties agree to inform each other of a relevant Personal Data breach without undue delay and no later than 24 hours after becoming aware of the breach.
The notification must include sufficient information about the breach, including:
If required and reasonable, the parties will work together in order to minimise the impact, perform mitigating actions and put in place controls as soon as possible.
Each party shall fully indemnify and hold the other party harmless from and against any and all losses, damages, claims, costs and expenses suffered or incurred by, or awarded against, the non-breaching party as a result of, or in connection with, the other party’s breach.
The parties shall deal with all enquiries, requests or complaints from Data Subjects or any regulators in relation to the Personal Data that has been shared.
Should any such enquiry be received by either party, where appropriate to do so, they shall without undue delay (and no later than 3 working days) forward that enquiry to the other party. The other party shall provide all necessary support in addressing the request.
The parties shall provide sufficient and adequate protection of the Personal Data in respect of technical and organisational security measures. The parties must ensure that the security measures are appropriate to protect Personal Data against accidental or unlawful destruction, accidental loss, unauthorised alteration, disclosure or access and any other unlawful forms of processing and that these measures ensure a level of security appropriate to the risks presented by the processing and the nature of the data to be protected.
In the event that you sub-contract any processing of Personal Data you warrant that the processing activity is carried out by a sub-contractor, acting on the instructions of the Data Controller of such Personal Data and in accordance with Data Protection Legislation providing at least the same level of protection for such Personal Data and the rights of the data subject as the Data Controller.
Where either party intends to export Personal Data outside the European Economic Area, the data exporter shall procure that third parties acting on the data exporter’s behalf, comply at all times with the Data Protection Legislation do not perform their obligations in any way that would cause either Healix or the provider to breach any of their respective obligations under the Data Protection Legislation.
Healix will act as Data Controller when dealing with your request for registration. Please see the Provider Privacy Notice: healix.com/provider-privacy-notice/ for further information on how we protect your personal data. Healix will collect and process your name, your specialisms and capabilities, your hospital practice rights/admission rights, appointment booking contact details and consultation and treatment information.
By completing our registration form for application recognition and/or adherence to our Fee Schedule, you are agreeing that Healix will process your personal data for the purposes outlined in the Provider Privacy Notice. You have the right to withdraw your consent to this processing by contacting Healix using the contact details listed below. This will however impact our ability to maintain your recognised provider status.
If you do not agree to the outlined processing activities then you should not continue with this application for recognized provider status.
For any questions or to exercise your privacy rights please email firstname.lastname@example.org.
Healix reserves the right to withdraw recognition of you as one of our providers at any time and without reason.
If your recognised provider status ends, you will not be eligible to claim payment from us for treating patients, unless the treatment is ongoing or received approval from us prior to the termination of our agreement.
You may request to end your status as a provider for Healix at any time by giving us at least one (1) month’s written notice.
Please submit any amendments to your details through Healthcode’s Private Practice Register (www.theppr.org.uk) if you are completing an online Application, or by emailing HHSUKProviderNetworkTeam@healix.com if you are completing a paper-based Application.
Healix may amend, add to, or remove any of these terms and conditions at any time. It is the responsibility of the provider to keep up to date with any changes. The most recent version of this document is available at healix.com/healthcare-providers/uk-healthcare-providers-network/
It is the express understanding of the parties that this agreement is not exclusive and there is no minimum commitment by Healix to you.
The parties shall not commit, authorise or permit any action in connection with the negotiation, conclusion or the performance of this agreement which would cause the parties to be in violation of any applicable anti-corruption or anti-bribery laws or regulations.
Each party agrees that it will not either offer, or give, or agree to give, to any employee, representative or third party acting on behalf of the other party or accept, or agree to accept from any employee, representative or third party acting on behalf of the other party, any gift or benefit, be it monetary or other, with regard to the negotiation, conclusion or the performance of this agreement.
Healix is committed to preventing fraud, and to co-operating with other organisations to reduce opportunities for fraud. We will fully investigate and may be required to report any incident of suspected fraud or misrepresentation.
Healix monitors claims regularly and has a zero tolerance policy of fraud and misrepresentation. Examples of fraudulent activity may include but are not limited to:
Submissions of fraudulent claims, or misrepresentations of details in a claim, will result in the termination of our agreement.
Nothing in these terms and conditions is intended to or shall operate to create a relationship of principal and agent or a partnership or joint venture of any kind between us.
You shall indemnify Healix against any and all liabilities, costs, expenses, damages and losses (including any direct, indirect or consequential losses, loss of profit, loss of reputation and all interest, penalties and legal and other reasonable professional costs and expenses) suffered or incurred by Healix arising out of or in connection with any claim made against Healix by a third party arising out of breach of these terms and conditions or in connection with the provision of treatment or care to a patient.
These terms and conditions constitute the entire understanding and agreement between us and supersede all previous negotiations and understandings between us with respect to their subject matter.
A person who is not a contracting party hereunder has no rights under the Contracts (Rights of Third Parties) Act 1999 to enforce, or to enjoy the benefit of, any provision of these terms and conditions The rights of the parties to terminate, rescind or agree any variation, waiver or settlement under these terms are not subject to the consent of any other person.
These terms and conditions shall be governed by and interpreted in accordance with the laws of England and Wales. Both you and Healix submit irrevocably to the jurisdiction of the courts of England and Wales should any claim or matter arise in connection with these terms and conditions.
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