MyPracticeCares Patient Compassion Fund Management Agreement
This Patient Compassion Fund Management Agreement (the “Agreement”) is made between MyPracticeCares, a League Network PBC brand, (MyPracticeCares”) located at 211 Warren Street, Newark, NJ 07103, and your dental practice (“the Practice”). By using the MyPracticeCares service, the Practice assumes all the rights and responsibilities specified in this Agreement, and agrees to be bound by its terms without exception.
WHEREAS MyPracticeCares is a technology platform run by staff experts in raising and running Patient Compassion Funds (the “Fund” or “Funds”) on behalf of physician practices;
WHEREAS the Practice desires to hire MyPracticeCares to raise and manage its Patient Compassion Fund to fund services for patients-in-need in its service area (the “Services”) as identified in the Qualified Patient Bill Definition (the “Definition"), as shown in 2. below.
THEREFORE, based on the foregoing and in consideration of the mutual covenants and promises contained in this Agreement, it is agreed as follows:
- A. MyPracticeCares Obligations.
- Using its proprietary MyPracticeCares technology platform and expert staff, MyPracticeCares will use best efforts to set up, raise and administer payments of a Patient Compassion Fund on behalf of the Practice.
- MyPracticeCares will provide Practice access to a portal for viewing real time Fund activities, periodic reporting, and internal communications.
- At its sole expense, MyPracticeCares shall comply with all laws applicable to the services hereunder, and when performing work on Practice premises, shall comply with applicable Practice rules and procedures.
- MyPracticeCares agrees to regularly communicate with Practice on the progress of the services and inform Practice of delays or problems encountered in fulfilling its obligations hereunder.
- B. Practice Obligations.
- Practice will provide MyPracticeCares with one or more contact persons within the Practice to provide timely approvals of patient payments, actions and requests.
- Practice will support marketing of the Fund to its patients and the surrounding community by providing MyPracticeCares with all available electronic contact lists of patients and potential patients within its service area, Practice promotional text, artwork and video, and access to all Practice-associated online and social media pages and presences. Practice agrees to cooperate with one or more local human services charities jointly identified by MyPracticeCares and Practice for the purpose of identifying Qualified Patients who are otherwise unable to afford care.
- Practice and its patients may make voluntary donations into its Patient Compassion Fund (the “Donation”). Donations are non-recourse. Patient Compassion Funds may only be used by the Practice to pay Qualified Patient Bills via the Practice's MyPracticeCares prepaid Mastercard.
- Practice agrees to notify MyPracticeCares within 15 days of its support for a competing fundraising platform.
- C. Termination.
- MyPracticeCares or Practice can terminate for any reason by providing thirty (30) days written notice to the other in writing.
- If funds remain in the Practice Fund at time of termination, MyPracticeCares and Practice will jointly determine the disposition of the proceeds, with the caveat that remaining proceeds cannot be unilaterally annexed by the Practice.
- A. MyPracticeCares Obligations.
- Patient Compassion Fund Qualified Patient Bill Definition.
- Practices may only use Patient Compassion Funds to pay Qualified Patient Bills, defined as: Balances due for Practice services billed according to prevailing prices schedules as incurred by patients otherwise unable to afford care. Inability to pay shall be determined by the Practice or the Practice's revenue cycle management provider based on his/her judgment as to the patient's inability to pay.
- Practice pays MyPracticeCares no fees for setup, which includes being assigned a MyPracticeCares fundraising Captain and Campaign Manager, campaign page setup on the MyPracticeCares platform, use of the League Network Foundation bank account, Fund setup including branded virtual MyPracticeCares Mastercard debit account and setup of related bank payment services.
- At time of donation payment, MyPracticeCares.com charges a 17.1% fee on money raised into the Practice’s Patient Compassion Fund, in addition to bank charges of approximately 2.9%. At time of transfer of net proceeds from a Practice's Patient Compassion Fund into the Practice's virtual MyPracticeCares Mastercard debit account, MyPracticeCares financial partners charge a 5% fee. Net proceeds into the Patient Compassion Fund from all donations into the Fund will total approximately 76% of donated funds.
- When Practice requests services (the “Other Services”) in writing other than Fund setup, fundraising and payment, MyPracticeCares may invoice Practice separately. Other Services typically include online advertising on Google, Facebook, LinkedIn, Instagram or other online properties, purchase of email lists, trade show or event presence, and travel to events on behalf of Practice.
- Privacy, Compliance.
- MyPracticeCares was established to provide support to dental practices and a sustainable, vibrant and inclusive ecosystem of impact-focused partners. We believe in inclusiveness, respect, non-discrimination, freedom of religion and equal opportunity. As such, while we do not post position on our stakeholders’ mission, personal or organizational beliefs, we ask that you do not seek to do business with us if you disagree with those principles. We also reserve the right to investigate complaints or concerns and terminate our relationship with you. This includes promoting violence, hatred or discrimination by any means available (online or offline). We occasionally offer services from third party partners to the general public and parents via our website or newsletters. For some of our offerings we will need to share certain information with outside parties. While we maintain the highest levels of data security and use best efforts to protect data, we are not liable in the case of deliberate theft, hack or inadvertent release of information associated with an act of terrorism or force majeure.
- We expect high standards of conduct from our employees in dealing with our customers, data and processes. We also ask that our customers respect our code of conduct, which includes in part refraining from:
- Using deceptive information and false representation as to your identity, organization mandate or purpose.
- Interfering with another User’s rights to privacy, personal information or access to our services.
- Hateful, unlawful, drugs, guns or sexuality related, deceptive, harassing, libelous or misleading comments, emails or posts in any of your interactions with our staff, partners or users.
- Unsolicited or unauthorized gaming, advertising, promotional or recruitment offers.
- Dissemination of software viruses, spying or harvesting programs, or programs intended to steal, damage or interfere with our sites, data, hardware or telecommunication equipment.
- Infringement on our patents, trademarks, copyrights or any of our other property.
- Use of our trademark, logos, copyrighted material and other intellectual property without prior authorization (unless specifically authorized in our agreement with you).
- We pledge that our team will work to help resolve any concern with diligence and honesty and we ask that you reach out directly to us at firstname.lastname@example.org to solve any issue, prior to using social media or forums.
- In order to properly operate our sites, we - or our business partners and service providers - may use certain automated electronics means such as cookies, browser analysis tools, and web server logs. Usage of our sites expressly indicates your consent. Use of anti-tracking and/or ad-blocker software may impair our ability to serve you properly, and your ability to see content or complete tasks. If the settings on your device are set to allow Geo-tagging, (location information), we may collect this information to direct pertinent offers and information to you or allow you proper operations of some of our features.