A sample Business Associate agreement is presented here  for illustration purposes only. Actual contract language may vary depending on the client and the nature of work contracted for. Scribernet takes pride in clearly specifying the responsibilities of both parties and adhering to it.

SAMPLE AGREEMENT   

DEFINITION OF PARTIES. This document delineates the working relationship between Scribernet (referred to as "Business Associate") , a medical transcription and electronic patient record service based in _______(town), ______(state), and, _____________________ hereinafter referred to as "Client."   



LENGTH OF CONTRACT.
The terms of this contract will be in force beginning on the date signed by both parties with the following exception: The prices for services rendered are guaranteed for one year from the date this contract is signed by the Client. These prices are subject to re-negotiation on each anniversary of the signing of this contract. This contract may be terminated by either party after giving 30 days' written notice of its intent to do so.  At the time of termination materials belonging to the client must be returned, and any and all completed transcription by the Business Associate must be paid for, in full. Contract will be considered still in effect until all monies owed to Business Associate are paid in full.

RESPONSIBILITIES OF EACH PARTY. Business Associate will work with the Client to develop a set of templates in order to standardize report formats. Business Associate will not be responsible for printing envelopes, providing extra copies of a document, or including graphics in a report. For standard delivery rates, transcribed documents will be transmitted electronically within 48 hours of the time of dictation. For priority delivery rates, transcribed documents will be transmitted electronically as soon as possible, but no later than 24 hours after the time of dictation..  Business Associate also provides for  4 hour STAT turnaround time, if required, with a different rate schedule (see payment schedule). Business Associate will train the Client in the proper procedures for using its dictation equipment, dictation transmission procedures, as necessary. Client will inform  Business Associate of the minimum and maximum workload expected per day, weekend assignments, etc. so that Business Associate can organize its resources properly to meet the work load.

Business Associate will electronically archive all transcribed reports indefinitely, unless instructed otherwise by Client. Business Associate will instruct Client on how to use the Electronic Patient Record System, which is offered as a part of the transcription service.

The Client will be responsible for correctly entering the proper ID codes, patient, and report codes into the dictation system. If the Client codes a document as a priority item, he will be responsible for paying the priority billing rate (see payment schedule) on the final transcribed document. In order to ensure a high-quality recorded dictation, thus reducing the amount of time spent on corrections, the Client will, whenever possible, organize his/her thoughts prior to commencing dictation; speak clearly into the telephone; carefully spell out all names of patients, doctors, new drugs, etc., and include all pertinent pieces of identification (dates, patient numbers, addresses, etc.) in his or her dictation. If the client is receiving documents via electronic transmission, the Client will make only reasonable corrections in-house.

FEES AND PAYMENT SCHEDULE

The Client shall reimburse the Business Associate in accordance with the following schedule:

a)                 Medical transcription services shall be billed at __ cents per line standard rate for a 48 hour standard turnaround, for the first one year of this contract.

b)                 Priority services shall be defined as any work requested by the Client to be completed in less than 24 hours from the time of receipt of materials by the Business Associate and will be billed at ___cents per line. .  Rush or STAT services (defined as a  4 hour turnaround ) shall be billed at __ cents per line by the Business Associate.

c)                 Special work, including transcription of meetings, designing forms, any non-transcription work or any irregular transcription work (i.e. not patient reports, unscheduled clinics, etc.) requested by the Client shall be contracted on a per project basis at a rate agreed to by both parties. Special work shall be undertaken solely at the discretion of the Business Associate.

d)                 Business Associate will bill the Client on the 1st day of each month. Invoices will be mailed on the first day of the month. Terms are net 30 days. The Client is entitled to a "5% Early-Bird discount" if payment is received by 5 p.m. on the 10th day of the same month as the invoice date. However, it is the Client’s responsibility to determine the amount of the discount and submit a check corresponding to the discounted amount.  

e)                 Client who is  delinquent beyond the 30-day payment deadline will be assessed a re-billing fee of an additional $___per month above the dictation charges. If the Client is delinquent on payment 60 days or more, Business Associate reserves the right to withhold transcribed material until payment is made in full. 

ERRORS AND OMISSIONS 

Due to the many variables involved in the process of converting dictation from voice to text, there will be times when a patch of unclear dictation needs to be filled in or certain terms may need to be corrected. In such instances blank spaces will be left in the transcribed document. The dictator is ultimately responsible for proofreading each document. When information such as the patient's medical record number, the date of a procedure, etc., has not been provided by the dictator, it will be the Client's responsibility to manually enter such data into the transcribed document.  If a dictator wishes to make extensive editorial revisions to a document there will be a $___service charge for word processing. The final responsibility for all text rests with the dictator. In the event of a malpractice claim or lawsuit, Business Associate cannot and will not be held liable for any errors and/or omissions.

LIABILITY

Business Associate's liability under this service agreement shall be limited solely and exclusively to the correction of typographical errors. The Client agrees to submit requests for changes due to typographical errors within ___ day(s) of delivery of final document.  

CONFIDENTIALITY

The Business Associate agrees not to violate any confidence of the patient or their family through indiscriminate discussion pertaining to the patient, their treatment, diagnosis, or prognosis.  The Business Associate agrees that all patient records and patient information are strictly confidential and shall not make any disclosures.

GOVERNING LAW

Enforcement of rights and responsibilities under this contract shall be governed by the laws of the State of Massachusetts.

MATTERS NOT INCLUDED

This document represents the entire agreement between the parties.  No other terms or conditions shall be implied or inferred from the text or otherwise.  Any changes or amendments to this agreement shall be in writing and shall be agreed to by both parties.  

   

 

_____________________, 
Client                                      

_____________________, 
Business Associate

______________________
Date