Common use of Statement of Earnings to be Provided Clause in Contracts

Statement of Earnings to be Provided. (a) The practitioner shall provide to the hospital by 30 September each year a statement for the year to 30 June prepared and certified by a Certified Practising Accountant or Chartered Accountant in the following form together with cheques for the amounts to be paid to the hospital and into the approved special purpose account respectively: (i) Total amount of accounts (exclusive of GST) rendered during the year $ (ii) Total amount of accounts (exclusive of GST) collected $ (iii) Less: (A) 17½% (exclusive of GST) for administration and collection costs $ (B) Medical defence premium (exclusive of GST) for the year in question in accordance with subclause 26(2)(b) $ (iv) NETT amount for distribution in the following order: $ (A) To the hospital – payment (exclusive of GST) for the use of hospital facilities in accordance with subclause. 24(8) $ (B) Retained by the practitioner being up to an amount equal to the amount payable under subclause 26 (6) 16% or 25% of the practitioner's salary $ (C) To approved Special Purpose Account (exclusive of GST) for hospital / departmental purposes in accordance with subclause 26(3)(b) or (c) $ (D) To the practitioner (exclusive of GST) in accordance with subclause 26(3)(b) or (c) $ (b) The practitioner shall include the following certification at the end of the statement: "I certify that all monies due to the hospital have been accounted for." ............................................................. Signature ............................................................. Date (c) Example of Statement of Earnings to be Provided (example assumes all accounts rendered are for services for which a facilities fee is payable, in practice they may apply to none or only a proportion of services provided). (i) Total amount (exclusive of GST) of accounts Rendered for the year ended 30 June XX $100,000 (ii) Total amount (exclusive of GST) of accounts collected $ 80,000 LESS (iii) (A) 17.5% for admin and collection costs $ 14,000

Statement of Earnings to be Provided. (a) The practitioner shall will provide to the hospital by 30 September each year a statement for the year to 30 June prepared and certified by a Certified Practising Accountant or Chartered Accountant in the following form together with cheques for the amounts to be paid to the hospital and into the approved special purpose account externally restricted cost centre respectively: (i) Total amount of accounts (exclusive of GST) rendered during the year $year. (ii) Total Less adjustments and write backs. (iii) Less value of outstanding patient accounts as at 30 June XX. (iv) Subtotal amount of accounts (exclusive of GST) collected $collected. (iiiv) Less: (A) 17½% (exclusive of GST) for administration and collection costs $costs. (B) Medical defence premium (exclusive of GST) for the year in question in accordance with subclause 26(2)(b) $question. (ivvi) NETT Nett amount for distribution in the following order: $: (A) To the hospital – payment (exclusive of GST) for the use of hospital facilities in accordance with subclause. 24(8) $facilities. (B) Retained by the practitioner being up to an amount equal to the amount payable under subclause 26 (6) 16% or 25% of the practitioner's salary $as the case requires. (C) To approved Special Purpose Account externally restricted cost centre (exclusive of GST) for hospital / departmental the purposes specified in accordance with subclause 26(3)(b) or (c) $the Agreement. (D) To the practitioner (exclusive of GST) in accordance with subclause 26(3)(b) or (c) $). (b) The practitioner shall statement will include the following certification at the end of the statement: "Accountants Certification I certify that the above statement is correct in all relevant particulars and associated records have been checked to ensure all monies due to the hospital have been accurately and correctly calculated and accounted for." for in accordance with the applicable Australian Accounting Standards for the financial year ending 30 June xxxx. At the date of signing I am not aware of any circumstances which would render the particulars misleading or inaccurate. ............................................................. Signature ............................................................. Date (c) Example Date Practitioner’s Certification “I certify that this statement is submitted in compliance with the Private Practice provisions of Statement the Industrial Agreement. At the date of Earnings to be Provided (example assumes all accounts rendered are for services for signing I am not aware of any circumstances which a facilities fee is payable, in practice they may apply to none would render the particulars misleading or only a proportion of services provided)inaccurate. (i) Total amount (exclusive of GST) of accounts Rendered for the year ended 30 June XX $100,000 (ii) Total amount (exclusive of GST) of accounts collected $ 80,000 LESS (iii) (A) 17.5% for admin and collection costs $ 14,000” ............................................................. Signature

Statement of Earnings to be Provided. (a) The practitioner shall provide to the hospital by 30 September each year a statement for the year to 30 June prepared and certified by a Certified Practising Accountant or Chartered Accountant in the following form together with cheques for the amounts to be paid to the hospital and into the approved special purpose account respectively: (i) Total amount of accounts (exclusive of GST) rendered during the year $ (ii) Total amount of accounts (exclusive of GST) collected $ (iii) Less: (A) 17½% (exclusive of GST) for administration and collection costs $ (B) Medical defence premium (exclusive of GST) for the year in question in accordance with subclause 26(2)(b) $ (iv) NETT amount for distribution in the following order: $ (A) To the hospital – payment (exclusive of GST) for the use of hospital facilities in accordance with subclause. 24(8) $ (B) Retained by the practitioner being up to an amount equal to the amount payable under subclause 26 (6) 16% or 25% of the practitioner's salary $ (C) To approved Special Purpose Account (exclusive of GST) for hospital / departmental purposes in accordance with subclause 26(3)(b) or (c) $ (D) To the practitioner (exclusive of GST) in accordance with subclause 26(3)(b) or (c) $ (b) The practitioner shall include the following certification at the end of the statement: "I certify that all monies due to the hospital have been accounted for." ............................................................. Signature ............................................................. Date (c) Example of Statement of Earnings to be Provided (example assumes all accounts rendered are for services for which a facilities fee is payable, in practice they may apply to none or only a proportion of services provided). (i) Total amount (exclusive of GST) of accounts Rendered for the year ended 30 June XX $100,000 100,000 (ii) Total amount (exclusive of GST) of accounts collected $ 80,000 LESS (iii) (A) 17.5% for admin and collection costs $ 14,000

Statement of Earnings to be Provided. (a) The practitioner shall provide to the hospital by 30 September each year a statement for the year to 30 June prepared and certified by a Certified Practising Accountant or Chartered Accountant in the following form together with cheques for the amounts to be paid to the hospital and into the approved special purpose account respectively: (i) Total amount of accounts (exclusive of GST) rendered during the year $ (ii) Total amount of accounts (exclusive of GST) collected $ (iii) Less: (A) 17½% (exclusive of GST) for administration and collection costs $ (B) Medical defence premium (exclusive of GST) for the year in question in accordance with subclause 26(2)(b) $ (iv) NETT amount for distribution in the following order: $ (A) To the hospital – payment (exclusive of GST) for the use of hospital facilities in accordance with subclause. 24(8) $ (B) Retained by the practitioner being up to an amount equal to the amount payable under subclause 26 (6) 16% or 25% of the practitioner's salary $ (C) To approved Special Purpose Account (exclusive of GST) for hospital / departmental purposes in accordance with subclause 26(3)(b) or (c) $ (D) To the practitioner (exclusive of GST) in accordance with subclause 26(3)(b) or (c) $ (b) The practitioner shall include the following certification at the end of the statement: "I certify that all monies due to the hospital have been accounted for." ............................................................. Signature ............................................................. Date (c) Example of Statement of Earnings to be Provided (example assumes all accounts rendered are for services for which a facilities fee is payable, in practice they may apply to none or only a proportion of services provided). (i) Total amount (exclusive of GST) of accounts Rendered for the year ended 30 June XX $100,000 (ii) Total amount (exclusive of GST) of accounts collected $ 80,000 LESS LESS (iii) (A) 17.5% for admin and collection costs $ 14,000