Provider Network Participation Policy
Credentialing, professional independence, patient-safety, privacy, compliance, and participation standards for external clinicians using Sleep Balance Academy services.
- Published by
- Sleep Balance Academy PC
- Effective date
- Last updated
Contents
Scope and Relationship
This Policy applies to external licensed clinicians approved to participate in SBA's provider network or use provider-facing clinical functions. Participation does not by itself create an employment relationship, partnership, joint venture, or guarantee of referrals, patient volume, compensation, or continued participation. Separate written agreements govern compensation or other commercial terms when applicable.
Credentialing and Ongoing Eligibility
A participating clinician must maintain every license, registration, certification, prescriptive authority, and professional qualification required for the services the clinician performs and for each jurisdiction in which the clinician practices. The clinician must provide accurate credentialing information and cooperate with reasonable initial and periodic reverification. A clinician must notify SBA promptly of any material restriction, lapse, suspension, surrender, revocation, board investigation or order, exclusion or debarment, loss of required professional liability coverage, or other event that may materially affect legal authority, competence, or eligibility to provide services through the network.
Patient Location and Scope of Practice
The clinician is responsible for determining the patient's physical location at the time care is provided and for ensuring that the clinician is legally authorized to practice in that jurisdiction. Participation in SBA or availability of a service in a provider interface is not legal advice and does not expand a clinician's scope of practice or prescribing authority.
Professional Independence
Clinical decisions must be based on the patient's interests, accepted professional standards, and the clinician's independent judgment. SBA does not require a clinician to order a product, prescribe a treatment, make a referral, or reach a particular clinical conclusion. No compensation arrangement may lawfully reward or penalize a clinician for making a clinically inappropriate decision.
Fraud, Abuse, and Referral Compliance
Participants must comply with applicable federal and state fraud-and-abuse, fee-splitting, self-referral, anti-kickback, false-claims, and patient-inducement laws. No participant may offer, solicit, pay, or receive remuneration in return for referrals or for the volume or value of business reimbursable by a federal health care program or otherwise prohibited by law. Any financial interest relevant to a clinical recommendation must be handled in accordance with applicable law and professional ethics.
Privacy, Security, and Confidentiality
Participants must comply with HIPAA, applicable state confidentiality law, SBA privacy and security requirements, and any Business Associate Agreement, data-use agreement, or other privacy agreement that applies to the relationship. Where law requires a Business Associate Agreement or other written arrangement before a particular function is performed, the required agreement must be in place for that function. Access patient information only for an authorized treatment, payment, operations, or other lawful purpose. Do not share credentials or permit staff to use a clinician's identity to access patient information or perform an action that must be attributable to the clinician.
Documentation and Records
Maintain timely, accurate, clinically sufficient documentation for services, orders, recommendations, communications, and informed-consent decisions as required by law and professional standards. Records created in SBA systems remain subject to SBA's legal record-retention duties and patient access rights even after a participant leaves the network.
Patient Safety and Quality
Participants must respond appropriately to safety concerns, adverse events, abnormal findings, care-transition needs, and urgent communications within the scope of their professional responsibilities. Participants must cooperate with reasonable quality, safety, peer-review, compliance, and incident-review activities to the extent permitted by law.
Commercial and Educational Activities
Wholesale purchasing, educational programs, and non-clinical commercial activities are separate from a clinician's duty to exercise independent clinical judgment. A discounted product, commercial relationship, or educational affiliation is not a clinical indication and must not be presented to a patient as one.
Suspension or Termination
SBA may suspend, restrict, recredential, or terminate participation when reasonably necessary for patient safety, credentialing, compliance, security, fraud prevention, breach of an applicable agreement, or legal requirements. When immediate action is not necessary to protect patients or information, SBA will ordinarily provide notice of the concern and an opportunity to respond. Ending network participation does not eliminate professional duties to existing patients, legal recordkeeping duties, or appropriate continuity-of-care obligations.
Contact
Provider participation and credentialing questions: support@sleepbalanceacademy.com. Do not send patient clinical details to ordinary support email unless expressly instructed through an approved secure method.
