XXXX
YYYY,
XXXX
YYYY
XXXX
XXXX
[ADDRESS]
RE: REQUEST FOR SINGLE CASE AGREEMENT
Dear _____,
This letter serves as a formal request for a Single Case Agreement for _________with UHC member ID number _________.
We understand that SCAs make up for the lack of availability when an in-network provider is no longer available within reasonable time from the patient.
Our request is necessitated by the fact that we are going out-of-network on XXX. Therefore, the aforesaid patient is at a risk of missing out on services in the event we do not have the SCA. The SCA should therefore be issued, unless the patient gets access to immediate care. While we understand that continuity of care is not currently a legal right, the Affordable Care Act (ACA) did create payment incentives for organizations in order to promote continuity of care. Patient rights established by the ACA are distributed across 45 CFR § 146, 147, 148, 153, 155, 156, and 158. These rights include: the right to insurance, the right to preventive care for free, the right to essential health benefits, the right to maintain health insurance, and the right to have some choice as to a health provider.
It follows; to ensure continuity of care for our patient, we request you grant us a Single Case Agreement. We are looking forward to negotiate the terms of the SCA.
Thank you for considering this request.
Yours sincerely,
_________________
XXXX
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