This contract is made and
entered into on __________________ (date) by_________________________(herein
called the client) whose address is __________________________________ and _______________________,
(herein called the contractor) whose address is
________________________________________________. In consideration of the
mutual promises in this contract, the parties agree to abide by all the terms
of this contract. It is understood that the contractor is an independent
contractor and not an employee of the client and therefore will be
responsible for all taxes and withholdings.
CONTRACT FOR MEDICAL TRANSCRIPTION SERVICE
JANE SMITH MEDICAL TRANSCRIPTION SERVICE
PHONE: 1-234-567-8910 FAX: 1-000-123-4567
This agreement entered into on (DATE)____________________, by and between the Transcriptionist, known as: Jane Smith, whose address is __________________, and telephone number is_________________________, and the Professional client
___________________________and telephone number is _____________Whereas Transcriptionist desires to contract with the Professional client to perform said work and/or service, and
Whereas the parties desire to set forth their contractual and business arrangement(s)
Therefore, this agreement constitutes the said contractual and business arrangements, and the parities contract and agree as follows:
The Transcriptionist agrees to perform, abide by and follow the stipulations listed in the remainder of this contract.
The transcriptionist is responsible for providing all equipment and supplies necessary for any work done, other than supplies given by the professional client (i.e. stationery indigenous to the professional client). These supplies provided by the transcriptionist, but not limited to, office equipment (i.e. typewriter, computer, transcription equipment, etc.) paper, dictionaries and manuals, tools, etc. The transcriptionist is also responsible for all repairs on her own equipment.
Any supplies that are necessary from the professional client must be requested well in advance by the transcriptionist and the transcriptionist is responsible for keeping adequate supply on hand at all times. This supply must be returned to the professional client should this contract ever cease.
Any equipment or supplies loaned by the Professional client to the Transcriptionist must be returned to the Professional client at the termination of this contract, or final payment of any payment due will be withheld until said items are returned.
Each professional client’s pricing is set separately, according to the individual client. Pricing is by each piece and/or line as set forth in the WORK SCOPE.
Payment for services rendered is on ______________. (This may be determined by the Professional Client’s present staff practice). If the Transcriptionist does not turn in invoices by the dates specified, the Professional client is not responsible to pay by any set date and pay may be late.
The Transcriptionist must give a separate billing for each professional client to the Professional client. Each billing must be typewritten or computer generated and include the name of the client, the dates of the billing, the pages and specific dates of work completed and, if applicable, a description of each piece of work completed, and individual pricing, as well as total. The Transcriptionist must be prepared to back up each billing with copies of work completed should the Professional client request any information regarding the services rendered.
Professional client will pay for any work containing errors. Transcriptionist is responsible to redo all work containing errors without charge to the professional client or agency. If the professional client should request a redo of the transcription with minor editing changes that were not the fault of the Transcriptionist then the Transcriptionist will provide redo at ½ of the original cost. Fax charge remains the same for each page faxed each time it is faxed.
Professional client is not responsible to pay for redo work in the case of power outages or faulty equipment. It is the responsibility of Transcriptionist to keep equipment in working order and to provide backup emergency services should a technical problem occur.
Transcriptionist may not communicate with Professional client directly regarding billing or pricing structure or anything other than a question directly applying to the transcription or work procedures, such as terminology, spelling, etc. unless it is the policy of the professional client to do so. When communicating with the Professional client on the above matters, transcriptionist must identify herself as being the Proprietor of Jane Smith Medical Transcription Service.
The Transcriptionist is responsible for keeping a complete Work Scope on each client. This Work Scope is to be given to the Professional Client upon termination originated either by the Transcriptionist or the Professional Client. The Work Scope must be typewritten or computer generated, include the Professional client’s name, address, telephone number, names of contact personnel, list of specific terminology used by that professional client, and any specialized instructions for that professional client.
The Transcriptionist is responsible for keeping one month of work for each client on file for reference for billing purposes, termination or request of the client for any particular piece of work. The transcriptionist will also save the work on floppy disc and on request will supply this to the professional client.
The Transcriptionist is responsible to make specific arrangements with the management of the Professional client for the delivery of the workload.
The Transcriptionist is responsible for providing services for the assigned client at all times during the duration of this contract. The Transcriptionist is responsible for notification of any time needed for illness or vacation when this will greatly affect the operation of the Professional client’s work. There is no back up coverage with this contract.
The Professional client expects loyalty, enthusiasm and total support verbally, in action and in deed from the Transcriptionist at all times.
Professional client understands that transcriptionist as a disabled person and works on a part-time basis.
The logo, name, promotional material, and advertising associated with the Professional client are exclusively the property of the Professional client. Unauthorized usage of any stationery or materials or authorized representation of the Professional client is strictly prohibited. The Transcriptionist cannot use any name similar to or representing in any way, shape or form the name, advertising methods and appearances or practices of the Professional client.
The Transcriptionist must give no less that a 7-day notice to the Professional client in writing for termination of this contract. Anything less than a 7 day notice will result in 50% penalty fee payable to the Professional Client and subtracted from the final payment due to the Transcriptionist.
Before the termination is effective, Transcriptionist must return all supplies and/or equipment belonging to or loaned or borrowed from the Professional Client. The Transcriptionist is also responsible for supplying the Professional client with a copy of all complete and detailed work scope as specified previously in this contract. Failure to comply with any portion of this termination stipulation or any portion of this termination contract may result in withholding of final payment.
Violation of any part of this contract can result in immediate termination by the Professional client without notice. All termination terms other than the 7-day notice would then be applicable for the Transcriptionist and final check would be held until terms are complied with.
Professional Client reserves the right to remove from the Transcriptionist (in the case of a multiple practice) without any notice. Transcriptionist also agrees that Professional clients can be dropped at any time due to termination from the client.
The Transcriptionist hereby agrees to abide by all of the terms and stipulations set forth in pages one through 5 of this contract and understand each item fully, as signified by signing below.
The contract will be in effect from date of the agreement and continue for 6 months at which time a review will be made.
SOCIAL SECURITY NUMBER OF TRANSCRIPTIONIST: ___________________
PROFESSIONAL CLIENT: ________________________ DATE_______________
Professional client will compensate Transcriptionist $0.___ per line defined as 65 keystroke or characters for office or hospital reports transcribed plus any additional transmittal (fax) fees required to transmit the reports.
LOST REPORTS: ½ the original cost.
STAT WORK: STAT work is defined as anything requested in 12 hours or less: $.20 per line
TURNAROUND TIME shall be 24 hours unless special arrangements are made.
FAXED REPORTS: No charge if faxing is done evenings or weekends and is within regional telephone area. Fee for generating report is same as above.
COPIES: $.25 per copy.
SPECIAL DELIVERY: $10.00 for the delivery *negotiable.
ANY PERSONAL TYPING, such as curriculum vitae form, medical manuscripts negotiable.
EXHIBIT B- ERRORS AND OMISSIONS:
I DO NOT CARRY ERRORS AND OMISSIONS INSURANCE. THAT I DO NOT ENDORSE COMPUTER-AUTHENTICATED OR ARTIFICIAL SIGNATURES GENERATED BY MEANS OTHER THAN ACTUAL DICTATING PHYSICIAN’S SIGNATURES. THEREFORE, THE DOCTORS SHOULD PROOFREAD THE TRANSCRIPTION FOR DOCUMENT CONTENT, ACCURACY AND QUALITY CONTROL. THIS MEANS THAT THEY WILL ACCEPT THE LIABILITY OF THE TRANSCRIPTION AND I WILL NOT PURCHASE ERRORS AND OMISSIONS LIABILITY INSURANCE.
By signing this Nondisclosure Agreement, I indicate my understanding that:
Patients, physicians and other health care providers furnish confidential information to obtain or carry out medical services, and medical service information and records are confidential.
Patients depend on the providers of medical services to keep patient information confidential. The provider’s reputation depends on this confidentiality.
If medical information has been used or disclosed inappropriately, patients or providers who have suffered loss or injury may seek legal action to recover damages from the person who used or disclosed the information. Specific violations of patient confidentiality resulting in economic loss or personal injury to a patient may be punishable by law.
Any breach of confidentiality will be considered serious and subject to investigation and possible discipline, including immediate termination of services. Therefore as a Transcriptionist contract service provider, I agree that I will not at any time:
Disclose services given or information about patients.
Allow anyone else to examine or copy any records or documents having to do with patients, physicians, or other health care providers and services.
Independent Contractor ______________________ Date:________________
Transcriptionist’s Social Security Number: 123-45-6789
EIN : 12-3456789_________________