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ST. LUKE’S MEDICAL CENTER
HOSPITAL SERVICE AGREEMENT
KNOW ALL MEN BY THESE PRESENTS :
This pa rei sere peement de and entre ito hit ast _ day of
‘by and between
ity represented in
IENT-FINANCE & CFO MS. EDITHA M. SIMEON leteinair refered to
and =
as the COMPANY.
\WITNESSETH
WHEREAS, the COMPANY desires to engage the services of the HOSPITAL forthe
hospitalization needs of all its fiers and employees.
hospitalization services to the Patients and
juipment and experienced / trained
and the
)MPANY agreed to send Patients tothe HOST
HOSPITAL agrees to manage the Patients referred by the under
conditions
A. HOSPITALIZATION SERVICES
Letter of Authorizati
submited upon the
‘To ensure tha ll hos
and approved by the o
LOA and ther specimen signatures will be provided by the COMPANY to the
HOSPITAL as reference,c r=
‘Ad. In-Patient Services :
> ‘The HOSPITAL shall admit the Patient without requiring the
FY ID ear for purposes of admission, provided, however that the
the COMPANY'S representative shall preset fo the HOSPITAL,
24 HOURS, the LOA with 100% payment guarantee from the
COMPANY. In ase of flue to present the LOA, the Patint’s account willbe
considered as NON-CORPORATE account subject tothe HOSPITAL'S regular
policies on such account.
A2 OutPatient Services:
- > The HOSPITAL shal ender out-patint services tothe Patent provided a LOA
“wih 100% payment guarantee is submitted prior to availment ofthe examinations
or procedures.
For emergency treatment and consultation only not requiring admission,
tment Change Of
v
care and will not be placed inthe Patient
HOSPITAL will ot be aocepted by any nursing or medi
‘medical records as we cannot guarantee
1B, SETTLEMENT OF BILLS
BA In-Patient Services
> The HOSPITAL"
LOA with 100%
> The HOSPITAL shal subi
of ills theofficial & detailed statement of Patient's account supported by
- the LOA.A
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HOSPITAL may submit the progres billings and demand immediate
for confinement of patent who accurnulat bills amounting to
Pp 200,000.00 and above.
B2_OutPatient Services :
> The HOSPITAL shall submit tothe COMPANY as their basis of settlement,
the oficial charge invoices for out-patient availmens ofthe Patients
supported by the LOA,
fifteen (15) days credit period to the
ays from receipt of|
{questions tothe Account Services’ officer of the HOSPITAL. If there are no
{uestions beyond this period, the bills received by the COMPANY are
v
summary to support the claim of the Patients, Non-sub
quirements by the HOSPITAL shall not delay payment of HOSPITAL
billings by the COMPANY.
€._ MISCELLANEOUS PROVISIONS :
smooth and proper implementation ofthis agreement, and such guidelines when signed
by the duly authorized representatives of both partes, shal const
spar of this agreement
“The HOSPITAL shall have the right to pr-terminate this apreement on any ofthe
following grounds by serving the COMPANY thirty (30) day written notice.
> Violation of any provisions ofthe agreement.Cc “
‘The COMPANY shal also have the right to pre-terminate this agreement by serving the
HOSPITAL thy (30) day writen notice onthe ground of violation of any provision of
this agreement.
‘This Agreement shall be governed by and construed in accordance with che Philippine
Law. The parties hereby agree tht any action ari is Agreement shall be
Insttted before the proper courts of Quezon Cit
‘ST. LUKE'S MEDICAL CENTER MAKATI DEVELOPMENT
‘CORPORATION
B
» Of
som Aeon
yANTE Mi, ABANDO
Sr. Viee President-Finance t
——
SIGNED IN THE PRESENCE OFACKNOWLEDGMENT
‘gr UE MTP? SS.
APR yeathe, «Nor Pir and in rear this
NAME IDNUMBER ISSUED ON/ AT
EDITHAM. SIMEON 1NOS.81-002806 03/17/09 -ox/1s72012
DANTE M. ABANDO BBI745370
corporation represented.
WITNESS MY HAND AND NOT ARIAL SEAL on the date and place first
Notary Public
MA,THERESA 8 VENERACION