Terms of Service
Primary Care Concierge
This Terms of Service (“Agreement”) constitutes a legally binding agreement between the undersigned patient or member (“Patient/Member”) and Primary Care Concierge (“Clinic”). By signing this Agreement, the Patient/Member agrees to the terms and conditions set forth below.
Introduction
- General Provisions
1.1 Non-Discrimination Policy: The Clinic provides services without regard to race, color, religion, gender, sexual orientation, national origin, or other protected classes, in compliance with applicable laws.
1.2 Services Offered: The Clinic provides medical services to its members, including but not limited to:
– In-person consultations
– Telemedicine consultations
– At-home services for VIP members (included) and Premium members (additional charges apply)
– Wellness exams
– Chronic and acute disease management (e.g., hypertension, hyperlipidemia, diabetes mellitus)
– Weight management
– Smoking cessation
– Women’s and men’s health
– Other services typically categorized as primary care
– Coordination and collaboration with specialists when needed, including referrals to ensure comprehensive patient care
1.3 Service Limitations: The Clinic reserves the right to limit the scope of services provided based on medical necessity, operational capacity, or other considerations. The Patient/Member will be notified in advance of any limitations.1.4 Notice of Non-Coverage: Certain services may not be covered under membership plans and will be billed separately. The Patient/Member will be informed of any additional charges prior to service delivery.
- Patient and Clinic Responsibilities
2.1 Patient Responsibilities:
– Provide accurate and complete medical history and information to the Clinic.
– Notify the Clinic promptly of any changes in health or contact information.
– Follow medical advice and prescribed treatment plans to the best of their ability.
– Ensure timely payment of all fees and charges associated with their membership and services.
2.2 Appointment Policies:
– No-Show Policy: The first no-show appointment will be forgiven. Each subsequent no-show appointment will result in a $250 fee. After three no-shows, the Patient/Member will be discharged from the Clinic without refund.
– Cancellation Policy: Appointments canceled with at least 24 hours’ notice will not incur a fee. Cancellations made within 24 hours of the scheduled appointment will result in a $250 fee.
2.3 Communication Channels:
– Text messaging and phone calls may be subject to the Patient/Member’s carrier fees. The Clinic is not liable for any such charges incurred by the Patient/Member.
– Text messaging is not a secure form of communication and should not be used for transmitting confidential or sensitive information. Secure communication must be conducted through the Tebra patient portal.
– The Clinic is not liable for any communication delays, message failures, or other issues arising from the use of third-party applications, telecommunication networks, or similar services.
– Messaging frequency may vary.
– Message and data rates may apply.
– To opt out at any time, text STOP.
– For assistance, text HELP or visit our website at www.primarycareconcierge.com.
– SMS Terms of Service
By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from Primary Care Concierge. This includes SMS messages for appointment scheduling, appointment reminders, post-visit instructions, lab notifications, and billing notifications. Message frequency varies. Message and data rates may apply. See privacy policy at https://primarycareconcierge.com/private-policy/. Message HELP for help. Reply STOP to any message to opt out. -
SMS Terms & Conditions
1- SMS Consent Communication:
The information (Phone Numbers) obtained as part of the SMS consent process will not be shared with third parties for marketing purposes.
2- Types of SMS Communications:
If you have consented to receive text messages from Primary Care Concierge, you may receive messages related to the following:
Appointment reminders
Follow-up messages
Example: “Hello, this is a friendly reminder of your upcoming appointment with Dr. Lyle Miyashiro at Primary Care Concierge on [Date] at [Time]. Reply STOP to opt out of SMS messaging at any time.”
3- Message Frequency:
Message frequency may vary depending on the type of communication. For example, you may receive up to 1 SMS message per week related to your [appointments/billing, etc.].Example:
“Message frequency may vary. You may receive up to 1 SMS message per week regarding your appointments or account status.”4- Potential Fees for SMS Messaging:
Please note that standard message and data rates may apply, depending on your carrier’s pricing plan. These fees may vary if the message is sent domestically or internationally.
5- Opt-In Method:
You may opt-in to receive SMS messages from Primary Care Concierge in the following ways:
- By submitting an online form
6- Opt-Out Method:
You can opt out of receiving SMS messages at any time. To do so, simply reply “STOP” to any SMS message you receive. Alternatively, you can contact us directly to request removal from our messaging list.
7- Help:
If you are experiencing any issues, you can reply with the keyword HELP. Or, you can get help directly from us at www.PrimaryCareConcierge.com
Additional Options:
If you do not wish to receive SMS messages, you can choose not to check the SMS consent box on our forms.
8- Standard Messaging Disclosures:
Message and data rates may apply.
You can opt out at any time by texting “STOP.”
For assistance, text “HELP” or visit our [Privacy Policy] and [Terms and Conditions] pages.
Message frequency may vary
2.4 Privacy of At-Home Services: The Patient/Member agrees to provide a safe and private environment for at-home services. The Clinic reserves the right to refuse or discontinue at-home services if these conditions are not met
- Membership Terms
3.1 Fees and Payment: The Patient/Member is responsible for all fees associated with services rendered, as outlined in their membership agreement. Any additional charges for services, such as at-home visits for Premium members, will be disclosed prior to service delivery.
3.2 Refund Policy: Membership fees and pre-paid service fees are non-refundable. Exceptions may be considered on a case-by-case basis at the sole discretion of the Clinic.
3.3 Termination of Membership:
– Membership may be terminated for repeated no-show appointments exceeding three occurrences, abusive behavior, or non-payment of fees.
– Membership may also be terminated if fraud, dishonesty, or failure to adhere to Clinic policies is discovered. Such termination will be communicated in writing to the Patient/Member.
3.4 Cancellation of Membership by Patient: Patients/Members may terminate their membership by providing written notice to the Clinic. Refunds for pre-paid services are subject to the Clinic’s Refund Policy. - Legal and Compliance
4.1 HIPAA Compliance: The Clinic complies with all applicable Federal and State laws, including the Health Insurance Portability and Accountability Act (HIPAA), to protect the privacy and security of Patient/Member health information.
4.2 Indemnification: The Patient/Member agrees to indemnify and hold the Clinic, its providers, and staff harmless against any claims, damages, or liabilities arising from the Patient/Member’s actions, omissions, or non-compliance with this Agreement.
4.3 Arbitration Clause: Any disputes arising under this Agreement shall be resolved through binding arbitration in accordance with the applicable laws of the State of Arizona.
4.4 Governing Law: This Agreement shall be governed by the laws of the State of Arizona. Disputes not resolved through arbitration shall be subject to Arizona law. - Technology and Third-Party Services
5.1 Technology Use and Disclaimer: The Clinic utilizes technology to enhance patient care. The Patient/Member acknowledges that limitations or failures of such technology may occur, and the Clinic is not liable for adverse outcomes related to technology use.
5.2 Third-Party Services: The Clinic may refer patients to third-party providers for diagnostic tests, labs, or treatments. The Clinic is not liable for the actions or outcomes of these third-party services - Medical Records and Practice Limitations
6.1 Scope of Practice and Limitations: The Clinic provides services within the scope of primary care and does not offer emergency medical services or specialist care unless explicitly stated.
6.2 Ownership of Medical Records: The Clinic retains ownership of all medical records. Patients/Members have the right to access their medical records upon request, in compliance with Federal and State laws.
6.3 Conflict of Interest Disclosure: The Clinic may have financial relationships with certain specialists or service providers. Such relationships will be disclosed to Patients/Members when relevant to their care. - Additional Terms
7.1 Telemedicine Specifics: The Patient/Member acknowledges the risks and limitations of telemedicine, including potential technology failures and limitations in remote evaluations.
7.2 Additional Terms for Minors: For patients under the age of 18, a parent or legal guardian must sign this Agreement on their behalf.7.3 Severability: If any provision of this Agreement is deemed invalid or unenforceable, the remaining provisions shall remain in full force and effect.
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Acknowledgment and Agreement By signing this Agreement, the Patient/Member acknowledges that they have read, understood, and agreed to these terms. They accept full responsibility for compliance with these terms and any associated fees or liabilities.