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Legal Contract Medical Services Powered By Docstoc
					         Proposal for Radiology Services


                 Table of Contents


I.   Company Background

II. Capabilities and Experience

III. Financial

IV. References

V.   Service Plan and Fee Schedule

VI. Company Organization

VII. Contract Administrator

VIII. Current Clients

IX. Licenses

X.   Distinguishing Features of Poland Hospital
I.   Company Background
II.   Capabilities and Experience
                                     III.    Financial




Insert Copy of:

   1. State of New Jersey incorporation with filed date

   2. Certificate of good Standing for the State of New Jersey

   3. Bank of America proof of service. (this letter will have to be requested) This

        should list the checking account number.

   4. Federal SS4 (I think) listing the tax ID number

   5.
IV.   References
                          V.     Service Plan / Fee Schedule




                               SERVICES CONTRACT

      THIS AGREEMENT dated June 30, 2006 is entered into by and between
Poland Hospital, a New Jersey professional corporation and Commonwealth
Health Center (CHC), the (“Client”) a legal entity of the Commonwealth of the
Just For You Corporation.

                                WITNESSETH

      WHEREAS, POLAND HOSPITAL office is at 321 N. Girade Ave.,
Philadelphia, PA 19122

                                         And

      WHEREAS, Client office is at, Commonwealth Health Center, P.O. Box
100, Detroit, MI 12254.

      WHEREAS, POLAND HOSPITAL will perform physician services within
the specialty of diagnostic radiology and nuclear medicine to interpret medical
examinations for the Client; and

       WHEREAS, the parties desire to enter into this agreement whereby
POLAND HOSPITAL will be employed by and will render services to the Client
on the terms and conditions hereinafter set forth.

      NOW, THEREFORE, intending to be legally bound hereby, the parties
agree as follows:

Employment and Term
This agreement shall remain in force for a period of one (1) year from the date of
signature. This agreement will be automatically renewable, unless either party
receives termination as defined in the section on Termination.
Interpretation

The POLAND HOSPITAL will perform exclusive Telemedicine diagnostic
interpretations of medical imaging studies for the Client. This will include all
medical imaging studies in the defined medical specialties of diagnostic radiology
and nuclear medicine and defined on Schedule A. It is understood by the Client
that POLAND HOSPITAL will not perform mammography interpretations or
supervision.     The examinations for interpretation will include MRI (magnetic
resonance imaging), CT (computed tomography), plain x-ray, nuclear medicine
and ultrasonography (this will include general, obstetrical, gynecological, and
vascular). POLAND HOSPITAL or its physicians will not perform the duties of
nor should they be considered as the medical director of the Client or the medical
imaging (diagnostic radiology) department of the hospital, medical facility and
ancillary facilities.


Reporting
POLAND HOSPITAL will provide transcription service to Client. The cost per
examination report is $2.80. Reports will be sent to the Client via encrypted
electronic mail, phone or fax.    The Client server can be interfaced with the
appropriate Client provided hardware and software interface.


A physician will be available for consultation 24 hours per day for 7 days per
week.


STAT interpretations will be performed and reports given within 1 (one) hour after
the receipt of the medical images for review.


Non-emergent interpretations will be performed and reports given within 12
(twelve) hours after the receipt of the medical images for review.


Routine interpretations will be performed and reports given within 24 (twenty
four) hours after the receipt of the medical images for review.
All routine studies received after 1600 hours Eastern Standard Time on Friday to
include all day Saturday and Sunday will receive written reports the following
Monday, with the exception of stat reports and those requested for less than 24
hour reporting. Holidays will extend the reporting period by the number of days
in the holiday.


The receipt of typed patient reports from POLAND HOSPITAL is ultimately
dependent on the efficiency of the Client once they are received.




Compensation and Fees

POLAND HOSPITAL will charge Client a fee per patient examination in accordance
with Schedule A and this section of the Agreement. POLAND HOSPITAL will bill
the Client monthly for service.


Fees billed by POLAND HOSPITAL to Client for services are payable by the
Client within ten (10) business days after receipt of bill. A compounded late fee
of 1.5% per 30 day period from billing date will be assessed on unpaid bills.




Conditions of Contract


The POLAND HOSPITAL and Client shall during the life of the Agreement
observe and conform to all applicable federal, state and local laws and
regulations relating to licensure, the practice of medicine and regulation of
physicians and medical facilities to include guidelines defined by the American
College of Radiology.




Staffing
The physicians of the POLAND HOSPITAL performing Client services will have
active licensure in the state of service. The POLAND HOSPITAL physicians
providing service to the Client will maintain malpractice insurance with minimum
coverage of one million dollars per claim and total of 3 million dollars in
aggregate.       Client will pay for any and all cost associated of hospital privileges,
credentialing, and medical staff dues.


Confidentiality
Client will not at any time, in any form or manner, either directly or indirectly,
divulge, disclose, and/or communicate to any person, firm, entity, or corporation,
any information of any kind, nature or description concerning any matters
affecting or relating to the business of the POLAND HOSPITAL.


This will include for POLAND HOSPITAL any information regarding any financial,
trade secrets, operations, plans, or processes of the business, and any other
information concerning any aspect of the business of the POLAND HOSPITAL.
POLAND HOSPITAL and Client stipulates that the above information, and any
aspect thereof, is confidential, material, important, and gravely affects the
effective and successful conduct of the business of the POLAND HOSPITAL,
and its good will, and any breach of this covenant is a material breach of this
Agreement. This confidentiality section survives the termination or expiration of
this contract.


POLAND HOSPITAL will not at any time, in any form or manner, either directly or
indirectly, divulge, disclose, and/or communicate to any person, firm, entity, or
corporation, any information of any kind, nature or description concerning any
matters affecting or relating to the business of the Client. POLAND HOSPITAL
has the right to provide this contract to financial institutions and governmental or
licensing agencies.




Liabilities
It is understood and agreed that except as expressly provided in the Agreement,
the POLAND HOSPITAL shall not assume any liabilities, duties or obligations of
the Client of any kind or nature.


The Client shall assume all cost to maintain the required equipment for patient
examinations in working condition acceptable for patient examinations and will be
responsible for all maintenance, equipment replacement and upgrades as
required during the term of this contract. POLAND HOSPITAL will not be held
liable for a failure to perform under the conditions and terms of the agreement
due to equipment failure, equipment limitations for the performance of
examinations as determined by POLAND HOSPITAL and personnel problems.
The equipment includes but is not limited to the hardware, software, and
telecommunications. Client assumes all liability and responsibility for the actions
and training of its staff.


POLAND HOSPITAL shall not be liable for errors, omissions, or illegal billing
practices by the Client. Client will warrant the accuracy of billing information
given to POLAND HOSPITAL as part of its billing process. This includes the
accuracy of patient demographic information and Common Procedural
Terminology (CPT) codes. The Client assumes total responsibility and will pay for
the defense of POLAND HOSPITAL to include all legal and consultants as
required by POLAND HOSPITAL for its defense.            The Client assumes total
responsibility for any monetary claims arising from billing, to include but not
limited to, refunds, and penalties. Client will assume total liability for required
record keeping and documentation as required by law and healthcare payers.
Client agrees at its cost to pay for all required electronic interface required by
POLAND HOSPITAL for patient billing and examination reporting.               Patient
demographic information will include the minimum of, patient name, patient
address, complete patient health insurance information, examination pre-
certification, name of referring physician, date of examination and patient history.




Indemnify and Warranty
The parties agree to indemnify and hold harmless each other from any and all
claims and losses of whatsoever nature arising out of this agreement, with the
exception of those stated in this Agreement.


Breech
The POLAND HOSPITAL will have 30 days to cure any breech of this contract
upon written notification by Client.




Termination
Either party can terminate this Agreement with cause with 90 day’s notice. The
date of termination will be the date 90 days following certified or express mail
submission by POLAND HOSPITAL or Client for delivery to POLAND HOSPITAL
or Client.
Cause for immediate termination of POLAND HOSPITAL.
          Loss of medical licensure
          Conviction
          Failure to comply with the terms of this Agreement


Cause for termination of Client.
          Failure to comply with the terms of this Agreement.
          Conviction of company or principal members.


Survivorship Assigns
Any of the terms and covenants contained in this Agreement, which require the
performance of either party after the Closing shall survive this Agreement. This
Agreement shall be binding upon the heirs, executors, administrators,
successors and assigns of the parties hereto. This Agreement shall supersede
and replace any and all prior agreements, whether written or oral, between the
parties hereto as well as with any affiliated companies of POLAND HOSPITAL or
Client.
Records and Files
All files, documents and records pertaining to patients of the Client shall remain
the property of and in the possession of the Client. Files may be paper, film and
electronic. The Client shall be responsible for the maintenance of all patient
records in accordance with Federal and State laws, to include rules and
regulations of any applicable regulatory agencies. It is understood by the Client
that patient file transfers may be performed by electronic, telecommunications
and courier services to include but not limited to patient records and medical
images for diagnostic interpretation, billing and consultation. The Client will be
solely responsible for the cost of the required hardware and software to connect
to POLAND HOSPITAL computer system and its vendor and as required
maintenance agreements. The Client will be solely responsible for the cost to
maintain electronic, telecommunication and courier services to and from
POLAND HOSPITAL. Client will maintain a secure telecommunications network
to include encryption and digital signature of patient records. The Client will be
solely responsible for the cost to maintain all patient files, documents and
records.     Client will perform all duties in accordance with the Federal
Government Health Insurance Portability and Accountability Act (HIPAA).


POLAND HOSPITAL assumes no liability for failure of the Client to deliver to
POLAND HOSPITAL patient exams to include associated files and materials for
interpretation, correlation or consultation. Client will maintain tracking system for
verification and tracking of patient files.


General Terms
   1. Client will not solicit POLAND HOSPITAL physicians or staff for
       employment during the term of this Agreement and for a period of 5 years
       after its termination.


   2. Changes to this Agreement shall be of no force of effect except by
       subsequent modification in writing, signed by both parties.
3. Neither party hereto may transfer or assign this Agreement without the
   prior written consent of the other party.


4. This Agreement shall be governed by and construed in accordance with
   the laws of the State of New Jersey.


5. The parties to this Agreement agree that any action on this Agreement
   shall be brought in a court of competent jurisdiction located in Burlington
   County, New Jersey.


6. In the event a suit or other action is brought by any party under this
   Agreement to enforce any of its terms, or in any appeal there from, it is
   agreed that the prevailing party shall be entitled to reasonable attorneys'
   fees to be fixed by the arbitrator, trial court and/or appellate court.


7. This Agreement or any section thereof shall not be construed against any
   party due to the fact that said Agreement or any section thereof was
   drafted by said party.


8. This Agreement may be executed in several counterparts and all so
   executed shall constitute one Agreement, binding on all the parties hereto
   even though all the parties are not signatories to the original or the same
   counterpart.


9. If any provision of this Agreement, or the application of such provision to
   any person or circumstance, shall be held invalid, the remainder of this
   Agreement, or the application of such provision to persons or
   circumstances other than those as to which it is held invalid, shall not be
   affected thereby.


10. All notifications to either POLAND HOSPITAL or Client will be to the
   address of record on this Agreement.
   11. Client certifies that it is a facility licensed and credentialed as required by
      their State, the Federal Government, agencies and health care
      companies.


   12. It is understood that POLAND HOSPITAL and its physicians are not the
      medical director of the imaging services (radiology and nuclear medicine
      departments) section of the Client’s facility(s).


   13. It is understood and agreed that the party whose signature appears below
      is signing this Agreement as the duly authorized representative or agent of
      the Client.


   14. It is understood that the Client will be solely responsible for any contract
      agreements with other agencies for the placement and recruitment of
      physician medical services.




IN WITNESS WHEREOF, the parties have caused this, Agreement to be
executed and delivered by their proper and duly authorized officers.

Poland Hospital                                Commonwealth Health Center (Client)



By: ________________________                     By: _______________________

Joseph R. Jones, MD
Title: President                                 Title:


Date ______June 2006                             Date: ______June 2006
                            Schedule A




                    Fee Schedule per Examination


MRI                         $79.00

CT                          $67.00

X-ray                       $24.50

Ultrasound                  $45.00

Bone Densitometry           $42.00

Nuclear Medicine            $50.00
                VI.   Poland Hospital Executive Staff/ Consultants



Joseph R. Jones, MD                          President and Medical Director


                                             Administrative / Contract Manager


                                             Physician Liaison Coordinator
                                             *Professional Relations Liaison




                                             Information Technology Consultant
                                             Brit Systems, Dallas, TX


                                             Network Systems Consultant
                                             Selekture, Mt. Laurel, NJ


                                             Siemens Medical USA
                                             Malvern, PA


                                             Bank of America
                                             Princeton, NJ
                             VII.   Contractor Administrators


Joseph R. Jones, MD, President and Medical Director of Poland Hospital will be

responsible for all contract negotiations, modifications and issues relating to the contract

and the basic servicing of the Department of Public Health for the Commonwealth Health

Center.




Jane Jones, Administrative / Contract Manager for Poland Hospital, will be responsible

for the day to day and routine compliance of the contract terms and conditions. She will

be the initial direct contact person for the basic servicing of the contract and any issues

that may arise during its term with the Department of Public Health for the

Commonwealth Health Center.
VIII. Current Clients
                                     IX.     Licenses



Name of Doc


Use CV and Executive Summary
Listing of all states of licensure




Note:

Add copy of the following for each doctor.
   1.     Medical School Diploma
   2.     Residency Certificate
   3.     Board Certificate
   4.
               X.     Distinguishing Features of Poland Hospital


1. Dr. Jones, has over 12 years of experience in the performance of

   Teleradiology. While in training at Walter Reed Army Medical Center, Dr.

   Jones was trained and gained experience on some of the first Teleradiology

   equipment in the country. He has continued to maintain his expertise in the

   field as a member of the Society of Computer Applications in Radiology

   (SCAR) and ongoing work with Poland Hospital.



2. Dr. Jones has received formal training in tropical diseases which will be

   needed by your health care facility.



3. Poland Hospital has a proven record of successfully working with hospitals

   such as Commonwealth Health Center, as demonstrated with our success

   with remote, rural and Critical Access hospital communities in the

   continental USA.



4. Poland Hospital has an extraordinarily talented and in depth staff to include

   consultants to provide a complete solution to your current and unanticipated

   future needs.



5. Poland Hospital is developing a national show site in conjunction with

   Siemens Medical USA that is currently being called by the Siemens personnel

   as the Cleveland Clinic East. This is because of the leading technology that
will be used in the facility. This technology can and will be used to assist

your facility when feasible.

				
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Description: Employment Contract