LA1527: PRO-OWNER RADIOLOGY CLINIC AGREEMENT FOR PROFESSIONAL SERVICES PROVIDED BY PHYSICIAN GROUP $99.95
|Agreement Type||Professional Services Agreement For Medical Services Relating To Radiation Oncology Clinic|
|Parties||Clinic Owner and Doctor Group Specializing in Radiology|
|Compensation Arrangement||Quarterly Percentage Fee Payable By Clinic to the Medical Doctor Group|
|Term of Agreement||Month to Month Until Termination Pursuant to the Agreement|
|Covenant Not To Complete||Included for Specified Service Area|
|Nonsolicitation||Doctor Group Cannot Hire Clinic Personnel During Specified Period|
|Status of Medical Doctor Group||Independent Contractors|
|Number of Pages||13|
THIS PROFESSIONAL SERVICES AGREEMENT (the “Agreement”) is made this __ day of ________, 20__ between Modern Radiation Clinic LLC, a _______ limited liability company (the “Clinic”) and Specialty Physician Group PA, a _______ professional association (the “Group”).
1. Clinic operates a radiation oncology office at _________________, _______ (the “Practice”) and renders medical treatment to such members of the general public as the Clinic from time to time accepts as patients (the “Patients”).
2. Group provides professional radiation oncology services through its owners and affiliated physicians who are authorized and licensed to engage in the practice of medicine in the State of _______.
3. Clinic and the Group have agreed that the Clinic would employ the Group to provide professional medical services to its Patients, upon the terms and conditions more particularly set forth in this Agreement.
NOW, THEREFORE, the parties agree as follows:
1. Employment. Subject to the terms and conditions of this Agreement, Group shall be contracted by the Clinic to render professional medical services to the Clinic’s Patients.
2. Term. The Group’s engagement hereunder shall commence on the date hereof and shall continue on a month-to-month basis, unless terminated earlier as provided herein (the “Term”).
3.1 Group shall receive a quarterly amount equal to one hundred percent (100%) of the quarterly Professional Collections received by Clinic from services rendered by or under the supervision of Group’s owner and physicians at the Practice. For these purposes Practice Professional Collections shall mean _____ percent (___%) of the net fees billed and collected by Clinic for services provided to patients at Clinic’s Practice. Net fees shall be calculated as global fees billed and collected by Clinic for services provided to patients at Clinic’s Practice for each three months of this Agreement less refunds and overpayments for the Practice in the same three-month period.
3.2 Compensation shall be payable quarterly and the amount due to Group shall be settled within 30 days of the end of each quarterly period.
4. Representations, Warranties, and Covenants of the Group. Group represents and warrants to Clinic that the following statements are true, correct and complete as of the date hereof and shall be true, correct, and complete at all times during the Term:
4.1 This Agreement constitutes a legal, valid, and binding agreement and obligation of the Group, enforceable against the Group in accordance with its terms;
4.2 Group’s owners and physicians are duly licensed and registered and in good standing under the laws of the State of _______ to practice medicine, and such licenses and registrations have not been suspended, revoked, or restricted in any manner;
4.3 Group’s owners and physicians are duly licensed and authorized to practice medicine in the State of _______, and have obtained Board Certification in the area of radiation oncology;
4.4 Group’s owner and physicians participate in, and have agreed to accept assignment for payment under, the Medicare and Medicaid programs and such other third party payor or managed care programs, including, without limitation, health maintenance programs and preferred provider organizations, with respect to which Clinic is then a participant;
4.5 Group’s owners and physicians have valid U.S. Drug Enforcement Administration numbers;
4.6 Group’s owners and physicians have licenses or rights to practice medicine or to dispense or prescribe drugs in any state of the United States and have never been suspended, revoked, or canceled for any reason;
4.7 The admitting and hospital staff privileges of Group's owners and physicians have never been suspended, revoked, or canceled for any reason at any hospital at which the Group owners and physicians ever had such privileges; and
4.8 Group’s owners and physicians have never been denied medical malpractice insurance coverage with respect to any application therefor or under any policy thereof for any reason, and Group knows of no fact, condition, circumstance, or event that has caused or would cause Group to be denied or uninsurable for medical malpractice insurance coverage.
5. Duties and Responsibilities.
5.1 Area of Responsibility. The principal areas of responsibility of Group's owners and physicians shall be predominantly within the specialty of radiation oncology. The Clinic agrees that the Group’s owners and physicians shall have such authority as may be reasonably required by Group in order to discharge such responsibilities in an efficient and proper manner.
6. Clinic’s Patients. Clinic shall determine who shall be accepted as its Patients, and Group recognizes that such Patients accepted are Patients of Clinic and not the Group. Clinic shall designate, or establish a procedure for designating, which of its engaged professional Groups shall treat each such Patient. Group shall be free to exercise Group’s professional judgment in connection with the diagnosis and treatment of Patients and in fulfilling Group’s responsibilities for Clinic; however, Group agrees to observe and comply with the policies, standards, and procedures of Clinic as the same shall exist and be modified from time to time by Clinic, provided they are reasonable and do not violate any applicable statute, law, rule, or regulation, of any governmental body. Upon the request of the Clinic in connection with a claim, action, or specific Patient question, whether made during the term of this Agreement or following its expiration or other termination, Group shall provide in writing a true and complete account of all procedures relating to the rendering of professional services by Group in connection with such claim, action, or Patient question.
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