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Financial Agreement For Medical Office
"I need a Financial Agreement For Medical Office for my new dermatology clinic in Manila, opening March 2025, that includes provisions for both cosmetic and medical procedures, with specific sections on installment payment plans and credit card processing."
1. Parties: Identification of the medical office/provider and the patient/guarantor
2. Background: Context of the agreement and relationship between parties
3. Definitions: Key terms used throughout the agreement
4. Services and Charges: Description of medical services covered and associated fee structure
5. Payment Terms: Payment schedules, methods, and conditions
6. Insurance and Claims: Procedures for insurance claims and coordination of benefits
7. Patient Responsibilities: Financial obligations and required patient cooperation
8. Provider Responsibilities: Medical office obligations and service commitments
9. Confidentiality and Data Protection: Handling of patient information under Data Privacy Act
10. Default and Remedies: Consequences of non-payment and available remedies
11. Term and Termination: Duration of agreement and termination conditions
12. General Provisions: Standard legal clauses including governing law and notices
1. Third-Party Guarantor: Used when someone other than the patient is financially responsible
2. Payment Plans: Include when offering installment payment options
3. Emergency Services: Required for facilities offering emergency care
4. Government Insurance Coverage: Include when PhilHealth or other government insurance is accepted
5. Charity Care Policy: Required for facilities offering indigent care programs
6. Medical Records Access: Detailed procedures for requesting and charging for medical records
7. Telehealth Services: Include if offering remote healthcare services
1. Schedule A - Fee Schedule: Detailed list of services and corresponding fees
2. Schedule B - Payment Plan Options: Available payment plans and their terms
3. Schedule C - Insurance Partners: List of accepted insurance providers and coverage terms
4. Appendix 1 - Patient Rights: Statement of patient rights under Philippine law
5. Appendix 2 - Privacy Policy: Detailed privacy practices and data protection procedures
6. Appendix 3 - Required Forms: Standard forms for insurance, consent, and financial responsibility
Authors
Healthcare
Medical Services
Healthcare Administration
Financial Services
Insurance
Medical Practice Management
Private Healthcare
Ambulatory Care
Primary Care
Specialty Medical Services
Legal
Finance
Compliance
Operations
Patient Services
Billing
Risk Management
Administration
Accounts Receivable
Medical Records
Front Office
Practice Management
Medical Director
Practice Manager
Financial Controller
Healthcare Administrator
Billing Manager
Compliance Officer
Medical Office Manager
Finance Director
Legal Counsel
Operations Manager
Patient Services Coordinator
Accounts Receivable Manager
Healthcare Finance Specialist
Medical Practice Administrator
Risk Management Officer
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