Indiana Application Service Provider Agreement

State:
Multi-State
Control #:
US-CP1027-AM
Format:
Word; 
Rich Text
Instant download

Description

This sample form, a detailed Application Service Provider Agreement document, is for use in the computer, internet and/or software industries. Adapt to fit your circumstances. Available in Word format.

The Indiana Application Service Provider Agreement is a legally binding contract that outlines the terms and conditions between a service provider and a client for the provision of application services in the state of Indiana. This agreement is specifically designed to govern the relationship between the service provider and the client, ensuring that both parties are aware of their respective roles, responsibilities, and obligations. Keywords: 1. Indiana: Indicates that the agreement is specific to the state of Indiana, highlighting the jurisdiction under which the agreement operates. 2. Application Service Provider (ASP): Refers to a company or entity that provides application services, such as software licensing, maintenance, support, and hosting services, to clients. 3. Agreement: Signifies a legally binding contract that establishes the terms and conditions for the provision of application services. 4. Service Provider: Denotes the company or entity that offers application services to clients. 6. Client: Refers to the individual or organization that receives application services from the service provider. 7. Terms and Conditions: Refers to the rules, obligations, rights, and responsibilities that both the service provider and the client must abide by during the term of the agreement. 8. Roles and Responsibilities: Specifies the tasks, duties, and obligations that each party must fulfill to ensure the proper provision and utilization of application services. 9. Obligations: Indicates the legal or contractual duties that the service provider and the client need to fulfill. 10. Jurisdiction: Relates to the specific geographical area or legal jurisdiction in which the agreement is valid and enforceable. Types of Indiana Application Service Provider Agreements: 1. Software Licensing Agreement: This type of agreement specifically focuses on the licensing of software applications by the service provider to the client, outlining the terms and conditions for the use, payment, and maintenance of the licensed software. 2. Software Maintenance and Support Agreement: In this agreement, the service provider commits to providing ongoing maintenance, updates, and technical support for the software applications being provided to the client to ensure proper functionality and troubleshooting. 3. Software Hosting Agreement: This agreement emphasizes the service provider's responsibility to host the client's software applications on their servers or cloud infrastructure, enabling the client to access and utilize the applications remotely. 4. Service Level Agreement (SLA): This type of agreement sets out the specific performance metrics, uptime guarantees, and response times that the service provider must adhere to when providing application services to the client. An SLA ensures that both parties have clear expectations regarding the quality and reliability of the service being delivered. It is important to consult with legal professionals or attorneys when drafting or entering into an Indiana Application Service Provider Agreement to ensure compliance with relevant state laws and regulations.

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FAQ

Enroll as an IHCP provider for the first time ? When you enroll as a provider with the IHCP, you will need to enroll online through the portal or complete and submit the appropriate IHCP provider packet in its entirety.

Indiana Medicaid Members Home Healthy Indiana Plan. Hoosier Care Connect. Traditional Medicaid.

Anyone covered by Indiana Medicaid should make sure the Indiana Family and Social Service Administration (FSSA) has their correct address. They can update their information on the benefits portal ( ) or by calling 800-403-0864.

Change of Ownership The following must be submitted along with the enrollment application: Appropriate licensure or other supporting documentation. A copy of a purchase agreement, bill of sale, or other documentation to verify the CHOW.

Enroll as an IHCP provider for the first time ? When you enroll as a provider with the IHCP, you will need to enroll online through the portal or complete and submit the appropriate IHCP provider packet in its entirety.

Visit the Provider Portal. Click on the ?Register Now? button and complete the three-step registration process. You will need your Tax ID number and your CareSource Provider Number, located in your welcome letter. Click the ?Continue? button.

How Do Indiana Medicaid Transportation Providers Apply for Enrollment? Step 1 ? Determined the Enrollment Specialty. ... Step 2 ? Purchase a Surety Bond. ... Step 3 ? Purchase Insurance. ... Step 4 ? Complete the Application.

More info

As an enrolled Provider in ISDH Programs, the undersigned entity agrees to provide ISDH Program-covered services and/or supplies to ISDH participants. As a ... This agreement must be completed, signed, and returned to the IHCP for processing. By execution of this Agreement, the undersigned entity (“Provider”) requests ...When the application appears on the screen, you may print it. For convenience, a Provider Agreement is included with the application. 6. Retrieve a W-9 Form ... Dec 28, 2022 — Step by Step Guide when completing a network participation request via MHS Website · Go to our For Providers Tab. · Select Enrollments and Updates ... THE APPLICATION PROCESS. Step 1: To enroll in the IHCP please refer to the “TYPE and SPECIALTY MATRIX” to determine what best fits the. (2) Include the following disclosures: (A) The name and address of: (i) the provider; (ii) any administrator of the service contract, if different from the ... Fill out the New Health Partner Contract Form to get started. If you offer ... Click on the “Register for an account” button and complete the three-step ... Sep 6, 2023 — Simply log onto the National Plan and Provider Enumeration System (NPPES) and apply on line (see 'Apply Now' link under the Related Links ... 7 days ago — Enroll as a Medicare provider or supplier; Review information currently on file; Upload your supporting documents; Electronically sign and ... To apply for a Provider Healthcare Portal user ID and password, complete the Provider. Healthcare Portal registration at https://portal.indianamedicaid.com.

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Indiana Application Service Provider Agreement