As the healthcare industry becomes more complex, health insurance providers are looking for ways to control costs without compromising the quality of care for their members. One way they achieve this is through Moda Single Case Agreements (SCAs).

An SCA is an agreement between an insurance provider and a healthcare provider for a single patient`s care. It is an exception to the provider`s network, allowing them to cover services from an out-of-network provider for a specific patient`s care.

Moda Health is an insurance provider that offers SCAs to its members. They understand that specific medical conditions may require specialized care that is not available within their network. By partnering with out-of-network providers, Moda can offer its members access to the best healthcare options available.

Moda SCAs are typically offered for patients who require unique treatments, experimental procedures, or rare medical conditions that require specialized care. The healthcare provider must demonstrate that they are the best option for the patient, and that the treatment is necessary for the patient`s health.

To obtain a Moda SCA, the healthcare provider must submit a request to Moda. The request must include detailed information about the patient`s condition, the proposed treatment, and why the provider is the best option for the patient. The insurance provider will review the request and determine if the SCA is necessary for the patient`s care.

Moda SCAs are beneficial to both the insurance provider and the patient. For the patient, it offers access to specialized care that may not be available within the network. For the insurance provider, it allows them to control costs while ensuring that their members receive the best possible care.

In conclusion, Moda Single Case Agreements are a viable option for patients who need specialized care that is not available within the provider`s network. It is an exception to the network, allowing the insurance provider to cover the cost of services from an out-of-network provider for a specific patient`s care. By partnering with out-of-network providers, Moda Health can offer its members access to the best healthcare options available.