Hospital Services Corporation

Hospital Services Corporation

Business Partner Application

Introduction

Hospital Services Corporation (HSC), a wholly-owned subsidiary of the New Mexico Hospital Association (NMHA), was established in 1985 to provide cost-effective programs and services to the New Mexico healthcare community. If you are interested in working with HSC as a Business Partner, please complete this application and return it to .

All applications will be evaluated by HSC within thirty (30) days of receipt. Applications must be complete and concise, and follow the format of the Business Partner Profile to allow for a fair evaluation of the services to be provided. Each application must be signed and dated by an authorized representative of the Business Partner organization.

Corporate Profile

1.  Provide a complete description of the services you are proposing to offer, along with how your service will benefit HSC’s members and customers.

2.  Provide an executive summary of your organization, including the following:

a.  History of organization,

b.  Listing of all current services,

c.  Listing and description of all wholly-owned subsidiaries and/or any parent/subsidiary/affiliate relationships as well as any joint ventures.

2.  Identify the locations of the following:

a.  Corporate headquarters

b.  Field support offices.

3.  Provide the name, title, address, email, fax and phone numbers for the primary contact on this application.

4.  Identify and provide qualifications of the individuals who would be primarily responsible for delivering the services proposed.

Proposed Services and Pricing

1.  Describe your pricing model, including all potential charges, transaction and processing fees that will be applicable to HSC’s Customers. Please specify the unique and tangible discounts, and other incentives you will make available to HSC’s Customers as a result of this endorsement. If you can provide a guarantee that the fees and charges to HSC’s Customers will be no less favorable than you would make available under other comparable agreements, please indicate so.

2.  If applicable, please include any tools or case studies that are used by your organization to demonstrate the Return on Investment (ROI) for your solutions.

3.  List your top three competitors and describe why your services are the best solution for HSC’s customers.

4.  Please itemize the marketing activities that you would expect from HSC to make this program successful in New Mexico. Be as specific as possible. Examples may include introductions to key HSC Customer staff, newsletter articles, website descriptions and links, and other similar benefits and activities.

5.  Please describe the marketing activities your organization will be performing in New Mexico, including how these activities will be performed, and the frequency of such.

6.  List the typical decision makers for your services, and provide information regarding the average sales-cycle time from initial contact to executed contract.

7.  Describe how you address customer issues and complaints.

8.  Explain any additional benefits that HSC should consider that are pertinent to the evaluation and selection process of this RFI.

Additional Information and Requirements

1.  In order to compensate HSC for its endorsement and marketing assistance, a minimum monthly marketing fee is required. HSC will utilize its relationships with hospitals and healthcare organizations in New Mexico to assist the Endorsed Vendor with its marketing and sales. Please describe any incentive-based marketing fees your organization will propose based upon the usage of your Services by HSC’s Customers.

2.  Please provide a list of any marketing relationships, endorsements, or affiliations that you have with other state hospital or healthcare trade associations.

3.  Provide a current list of all hospitals or healthcare organizations that you serve in New Mexico, Texas, Colorado, and Arizona.

The following conditions will be incorporated into the contract for services between HSC and Business Partner (Endorsed Vendor):

·  Governing Law: The validity, interpretation, construction and performance of the Agreement shall be governed by the laws of the State of New Mexico.

·  Indemnification: The Endorsed Vendor agrees to indemnify, defend and hold harmless HSC and its affiliated organizations for acts, omissions, and violations in connection with the Endorsed Vendor’s performance under the Agreement. These obligations do not extend to any liability caused by the sole negligence of HSC.

·  Insurance: The Endorsed Vendor agrees to provide proof of acceptable insurance that may be necessary or appropriate to accomplish the purpose and scope of this RFI.

·  Medicare/Medicaid Exclusion: The Endorsed Vendor represents and warrants that it is not and at no time has been, excluded from participation in any federal health care program, including Medicare and Medicaid (Federal Programs), and no person or entity affiliated with the Endorsed Vendor is or has been excluded from participation in any Federal Program as a result of actions by the Endorsed Vendor.

·  Marketing Fees: The Endorsed Vendor agrees to pay HSC the greater of (i) a monthly marketing fee during the term of the Agreement, or (ii) a negotiated percentage of the fees paid to Endorsed Vendor for the services provided to HSC Customers.

·  Termination: Should the Endorsed Vendor terminate the Agreement with HSC, the Endorsed Vendor will continue to pay marketing fees to HSC for a period of twelve (12) months after the effective date of the termination for agreements entered into with HSC’s Customers during the term of the Agreement with HSC.

Business Partner Application Page 2