HomeMy WebLinkAboutOur Lady of Lourdes Hospital - Medical Fee AgmtMEDICAL FEE AGREEMENT
BETWEEN
CITY OF PASCO AND OUR LADY OF LOURDES HOSPITAL
THIS MEDICAL FEE AGREEMENT is entered into on this day of January,
2007, by and between the City of Pasco, Washington, a Municipal Corporation, hereinafter
referred to as "City" and Our Lady of Lourdes Hospital, a nonprofit Corporation, hereinafter
referred to as "Lourdes. " The Parties to this Agreement, in consideration of mutual covenants
and stipulations set out herein agree as follows:
1. Purpose
The City desires to utilize Lourdes' services for the care and well being of City
prisoners /arrestees, hereinafter referred to as "patients."
2. Admission of Patient - Inmate
City of Pasco Police Officers presenting patients under police custody will present City
of Pasco billing forms to registration clerk upon admission. These Pasco billing forms
will be provided by the Lourdes' registration clerk. Patients admitted to Lourdes while
under City of Pasco Police custody will register using City of Pasco as patient guarantor.
The City of Pasco shall provide an officer at bedside during treatment and/or admission.
3. Medical Care
Medical care furnished by Lourdes will be the same level of care that is provided all other
non - inmate patients admitted to Lourdes.
4. Medical Costs
The City shall not be responsible for payment of costs covered by the Washington State
Department of Social and Health Services, private medical insurances or any other
federal or state funded medical programs. Lourdes shall process the appropriate forms to
obtain payment from any other agency, insurance company, and shall exhaust all
available sources of payment, including the patient, insurance, or other private or
governmental agency that may be obligated to pay for such services.
5. Crediting of Amendments
Any such payments so paid from any federal, state, or private source shall be first applied
to the balance due for such services provided by Lourdes. Any payments received in
excess of the balance shall be paid to the patient.
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6. Fees
In the event there is insufficient payments received from the patient, insurance or other
responsible parties, the balance of charges remaining, after exhaustion of collection
efforts, shall be home equally between Lourdes and the City. Upon completion of its
collection efforts, Lourdes shall provide the City an invoice for services and the City shall
pay Lourdes the sum equal to fifty percent (50 1/o) of the balance of charges due in full
satisfaction of all obligations relating to medical costs and services provided to City
patients related to that admission and constitute a waiver of any medical liens which may
be assessed against the City.
Relationship
The Parties intend that an independent contractor relationship will be created by this
Agreement. The City is interested only in the results to be achieved and the conduct and
control of the work will lie solely with Lourdes. Lourdes is not to be considered an agent
or employee of the City for any purposes and the employees of Lourdes are not entitled to
any benefits that the City provides for City employees. It is understood that the City does
not agree to use Lourdes exclusively.
8. Liabili
Medical care to be performed at Lourdes Health Network will be performed entirely at
Lourdes' risk and Lourdes assumes responsibility.
9. Duration
The duration of this Agreement shall be for one (1) year from the date of this Agreement
and shall automatically be renewed thereafter for one (1) year terms. However, either
party may terminate this Agreement without cause by giving written notice to the other
thirty (30) days before such termination shall take effect.
10. General Provisions
For the purpose of this Agreement, time is of the essence. Should any dispute arise
concerning the enforcement, breach or interpretation of this Agreement, venue shall be
placed in Franklin County, Washington, the laws of the State of Washington shall apply,
and the prevailing parties shall be entitled to its reasonable attorney fees and costs.
11. Entire Agreement
This section completes the entire Agreement between the Parties and no statements,
promises or inducements made by either party or agent or other party that is not
contained in this written Agreement, shall be void or binding and this Agreement may not
be enlarged, modified, or altered except in writing signed by the Parties and endorsed
hereon.
Medical Fee Agreement - City/Lourdes
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IN WITNESS WHEREOF, the Parties have signed this Agreement on the date set forth
above.
STATE OF WASHINGTON )
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County of Franklin
OUR LADY OF ZES OSPITAL
On this day personally appeared before me GARY CRUTCHFIELD, City Manager of the City of
Pasco, to be known to be individual described in and who executed the within and foregoing instrument,
and acknowledged that he signed the same as his free and voluntary act and deed for the uses and
purposes therein mentioned.
GIVEN under my hand and official seal this f U day of
NOTARY PUB IC in and
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STATE OF WASHINGTON )
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County of Franklin
2007 X00 L. 1V\
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On this day personally appeared before me John Syr-le--, (2ED of Our Lady
Lourdes Hospital, to be known to be individual described in and who executed the within and foregoing
instrument, and acknowledged that he signed the same as his free and voluntary act and deed for the uses
and purposes therein mentioned.
GIVEN under my hand and officio} seal this Q8 day of FtJ n� ne 2007.
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Medical Fee Agreement - City/Lourdes
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