PROVIDER INFORMATION & REQUIREMENTS

The Utah FOP Foundation uses primarily member dues to fund this program. As such, the rules governing this program are as follows:

1) Any therapist on the plan asserts they are "culturally competent" in treating police officers and/or spouses/family.

2) Any therapist on the plan agrees that they will verify eligibility for the program, being that any police officer in the state of Utah is granted 4 visits to a listed provider. This offer is limited to just those 4 visits. If the patient is an FOP member, then additional visits or programs may be authorized.

3) Provider agrees to submit an invoice to the Utah FOP Foundation no later than 60 days after the visit unless prior arrangements are made.

4) Provider agrees that the Utah FOP Foundation is ONLY a third party payer, and that the Utah FOP Foundation is absolved of any liability stemming from treatment or information provided to the patient.

5) Provider agrees to collect the name and agency of the patient and agrees to explain to the patient that the information is needed to have the Utah FOP Foundation pay for the visits. The patient agrees that by having the Utah FOP Foundation pay for the visits, they release the Utah FOP Foundation as well as the selected provider from any action resulting from that agreement and waive any claims associated with that disclosure.

6) The Utah FOP Foundation agrees that any information transmitted from the provider will be held confidential and will NOT release the information collected to anyone not authorized by the patient to have. We further agree to destroy the records of visit upon completion of our internal audits.