Patient Financing Program Agreement
Whereas Credit Medical Corporation provides financing to selected persons (Borrower). And whereas the Provider desires to obtain payment, upon the terms and conditions set forth in this Agreement, for providing medical or related services or surgery (Procedure) to patients, who may or may not be the same person as the Borrower. Accordingly, the parties agree as follows:
1. Financing Authorization: Before carrying out a procedure, which requires Credit Medical Corporation's financing, the Provider shall obtain a Financing Confirmation and Funds Request Form from Credit Medical Corporation; The Provider may rely on a properly obtained Financing Confirmation & Funds Request form as Credit Medical Corporation's assurance of payment in accordance with and subject to the terms of this Agreement.
2. Payment of Funds: Upon receipt of the signed Financing Confirmation & Funds Request Form from the Provider, Credit Medical Corporation shall pay to the Provider the financing amount set out on the Funds Request Form for payment on the indicated date. If mailed, shall be deemed to have been received within five days after mailing, except in case of postal service interruption. If by electronic funds transfer - payment shall be deposited within two working days.
3. Representations and Warranties: As to each Funds Request Form signed and delivered to Credit Medical Corporation, the Provider represents and warrants to Credit Medical Corporation that: It represents a bona fide proper procedure; The Provider has no knowledge or notice that would impair enforceability or collection thereof as against the named Borrower.
4. Indemnity: The provider shall indemnify Credit Medical Corporation and hold it harmless from any and all claims whatsoever made against Credit Medical Corporation by the Borrower (or person who receives the Procedure if different from the Borrower) which arises or is alleged to arise out of any procedure involving the Provider; however, Credit Medical Corporation shall indemnify the Provider and hold it harmless from any and all claims whatsoever made against the Provider by the Borrower (or person who receives the Procedure if different from the borrower) which arises or is alleged to arise out of any financing involving Credit Medical Corporation.
5. Other Agreements and Amendments: This Agreement supersedes all representations, agreements, arrangements and understandings between the parties, whether oral or written, in respect to all matters governed by this Agreement. Credit Medical Corporation may amend this Agreement by furnishing the Provider with 30 days written notice of amendment and this agreement shall be amended effective on the date specified therein unless the Provider by notice in writing to Credit Medical Corporation within a 30 day period objects to the amendment.
6. Termination: This Agreement may be terminated by either party at any time, provided there are no outstanding obligations of either party.