These Terms of Use govern your use of the website located at www.ezcareclinic.io (the “Website”), which is operated by Spartacus Management, Inc. and EzCare Medical Clinic, Inc., P.C. (“EzCare”) (Spartacus Management, Inc. and EzCare Medical Clinic, Inc., P.C., collectively, the “Companies”) and related services. The Website is a service for clients to manage their health using email, telephone and telecommunications-enabled care from physicians and other health care professionals employed by or contracted with EzCare (“Providers”). By using the Website you agree to be bound by these Terms of Use (this “Agreement”), whether or not you register as a member of EzCare (“Member”). If you wish to become a Member and make use of the EzCare service (the “Service”), please read this Agreement.
CAREFULLY READ THE TERMS AND CONDITIONS OF THIS AGREEMENT BEFORE USING THE WEBSITE OR SERVICE. USING THE WEBSITE OR SERVICE INDICATES YOUR ACCEPTANCE OF THESE TERMS AND CONDITIONS. THE SITE IS NOT INTENDED FOR USE IN A MEDICAL EMERGENCY OR IN CASE OF AN URGENT HEALTHCARE NEED.
(b) Format of Agreement. By accessing the Website or becoming a Member, you consent to have this Agreement provided to you in electronic form. You may request a non-electronic copy of this Agreement at any time. To receive a non-electronic copy of this Agreement, please send an e-mail to [email protected] or a letter and self-addressed stamped envelope to: EzCare Clinic, 1884 market Street , San Francisco, CA 94102.
(c) Withdrawing Your Consent. You have the right at any time to withdraw your consent to have this Agreement provided to you in electronic form. To withdraw your consent, please send an email to [email protected] or a letter and self-addressed stamped envelope to: EzCare Clinic, 1884 market Street , San Francisco, CA 94102. Should you choose to withdraw your consent to have this Agreement provided to you in electronic form, we will discontinue your then-current username and password, and you will not have the right to use the Service unless, and until, we issue you a new username and password. Your withdrawal of consent will not affect the legal validity or enforceability of the Agreement provided to, and electronically signed by, you prior to the effective date of your withdrawal.
(a) General. EzCare bills you through an online account (your “Billing Account”) for use of the Service. You agree to pay EzCare all charges at the prices then in effect for any use of the Service by you or other persons (including your agents) using your Billing Account, and you authorize EzCare to charge your chosen payment provider (your “Payment Method”) for the Service. You agree to make payment using that selected Payment Method. EzCare reserves the right to correct any errors or mistakes that it makes even if it has already requested or received payment. The payment might be divided into two parts. First part charges at the moment of the appointment booking. The rest charges just before the appointment starts.
(b) Current Information Required. You must provide current, complete and accurate information for your Billing Account. You must promptly update all information to keep your Billing Account current, complete and accurate (such as a change in billing address, credit card number, or credit card expiration date), and you must promptly notify EzCare if your payment method is canceled (e.g., for loss or theft) or if you become aware of a potential breach of security, such as the unauthorized disclosure of your user name or password.
(c) Payment Method. The terms of your payment will be based on your Payment Method and may be determined by agreements between you and the financial institution, credit card issuer or other provider of your chosen Payment Method (the “Payment Method Provider”). If EzCare does not receive payment from your Payment Method Provider, you agree to pay all amounts due on your Billing Account upon demand.
In addition to the preceding paragraph and other provisions of this Agreement, any advice that may be posted on the Website is for informational purposes only and is not intended to replace or substitute for any professional financial, medical, legal, or other advice. EzCare makes no representations or warranties and expressly disclaims any and all liability concerning any treatment, action by, or effect on any person following the information offered or provided within or through the Website.
(a) It is understood that any dispute as to medical malpractice, that is as to whether any medical services rendered under this Agreement were unnecessary or unauthorized or were improperly, negligently, or incompetently rendered, will be determined by submission to arbitration as provided by California law, and not by a lawsuit or resort to court process except as California law provides for judicial review of arbitration proceedings. Both parties to this contract, by entering into it, are giving up their constitutional right to have such dispute decided in a court of law before a jury, and instead are accepting the use of arbitration.
(b) You understand and agree that this agreement to arbitrate binds you and anyone else who may have a claim arising out of or related to all treatment or services provided by EzCare or physicians employed or engaged by EzCare, including a spouse or heirs and any children, whether born or unborn at the time of the occurrence giving rise to any claim. This includes, but is not limited to, all claims for monetary damages exceeding the jurisdictional limit of the small claims court, including, without limitation, suits for loss of consortium, wrongful death, emotional distress or punitive damages. You further understand and agree that if you sign this Agreement on behalf of some other person for whom you have responsibility, then, in addition to myself, such person(s) will also be bound by this agreement to arbitrate, along with anyone else who may have a claim arising out of the treatment or services rendered to that person. You also understand and agree that this agreement to arbitrate relates to claims against EzCare or physicians employed or engaged by EzCare and any consenting substitute physician, as well as the physician’s partners, associates, association, corporation or partnership, and the employees, agents, and estates of any of them. You also hereby consent to the intervention or joinder in the arbitration proceeding of all parties relevant to a full and complete settlement of any dispute arbitrated under this Agreement, as set forth in the Medical Arbitration Rules of the California Medical Associations and the California Hospital Associations (the “Rules”).
(c) You agree that the arbitrators have the same immunity from civil liability as that of a judicial officer when acting in the capacity of arbitrator under this agreement to arbitrate. This immunity shall supplement, not supplant, any other applicable statutory or common law.
(d) YOU UNDERSTAND THAT YOU DO NOT HAVE TO SIGN THIS AGREEMENT TO ARBITRATE IN ORDER TO RECEIVE THE SERVICES OF EZCARE OR ITS EMPLOYED OR ENGAGED PHYSICIANS, AND THAT IF YOU DO SIGN THIS AGREEMENT TO ARBITRATE AND CHANGE YOUR MIND WITHIN 30 DAYS OF TODAY, THEN YOU MAY CANCEL THIS AGREEMENT ARBITRATE BY GIVING WRITTEN NOTICE TO EZCARE WITHIN 30 DAYS OF THE DATE OF YOUR SIGNATURE BELOW STATING THAT YOU WANT TO WITHDRAW FROM THE ARBITRATION PROVISIONS OF THIS AGREEMENT. SHOULD YOU CHOOSE TO WITHDRAW FROM THE ARBITRATION PROVISIONS OF THIS AGREEMENT, ALL OTHER PROVISIONS OF THIS AGREEMENT WILL REMAIN IN FULL FORCE AND EFFECT.
(e) On behalf of yourself and all others bound by this agreement to arbitrate as set forth in Paragraph 19(b), agreement is hereby given to be bound by the Medical Arbitration Rules of the California Medical Associations and the California Hospital Associations, as they may be amended from time to time, which Rules are hereby incorporated into this Agreement.
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I agree to comply with this Agreement, on behalf of myself and on behalf of any other person on whose behalf I am seeking medical care. I understand and agree that if I fail to comply with the terms of the Agreement, I may be prohibited from using the Service, and I will hold EzCare harmless from any liability arising from my failure to comply.
I hereby certify that I am at least 18 years of age and possess the legal right and ability to enter into this Agreement under the name in which I have registered to use the Service. I further certify that I am physically present in a state which EzCare operates at the time that I am accessing the Service. I understand and acknowledge that my ability to access the Service is conditional upon the above mentioned criteria of my certification of age, legal authority, and physical presence in a state which EzCare operates at the time that I access the Service, and that the Providers rely upon this certification in order to interact and facilitate health care services with me.
NOTICE: BY SIGNING THIS AGREEMENT I AM AGREEING TO HAVE ANY ISSUE OF MEDICAL MALPRACTICE DECIDED BY NEUTRAL ARBITRATION AND I AM ARE GIVING UP MY RIGHT TO A JURY OR COURT TRIAL. SEE PARAGRAPH 19 OF THIS AGREEMENT.
I HAVE READ THIS AGREEMENT AND AGREE TO ALL OF THE PROVISIONS CONTAINED ABOVE.
Consent For Medical Care: I consent to medical testing, care and treatment by MEDvidi Medical and its affiliated providers.
Consent for Telemedicine: I agree to care using Telemedicine. This is care done by sending video images or other transmitted information to a Provider who is in a different place from me. There are some advantages to care by Telemedicine. Advantages include being able to get faster care, and more immediate response by a Provider. There are also possible problems. These include interruptions, unauthorized access and technical difficulties. An exam, consultation or service by Telemedicine may miss information that a direct exam might provide. At any time, I may refuse or stop an exam, consultation or service done by Telemedicine. Technical assistants may also be present during the exam, consultation or service to help with the process. There may be charges for Providers and the facility for Telemedicine services.
Assignment of Benefits: I hereby irrevocably assign payment to MEDvidi Medical and its affiliated providers accepting this assignment. Where benefits are applicable, I certify that the information given by me in applying for payment, under Title XVIII or XIX of the Social Security Act, is correct and request that payment of authorized benefits be made to MHS on my behalf.
Release of Information for Payment Purposes: I hereby authorize and consent MEDvidi Medical and its affiliated providers’ release of medical information to obtain payment as described in the MEDvidi Medical and its affiliated providers Privacy Notice. This consent includes, without limitation, present and future HIV test results and mental health records.
Obligation for Payment: I understand I am financially responsible to MHS and physicians for charges for all services provided by MEDvidi Medical and its affiliated providers to me, which my insurance carrier does not cover (which includes all commercial and government third-party payors). I understand that it is my responsibility to comply with all requirements for insurance out-of-network coverage. I further understand and agree that any credit balance resulting from payment may be applied to any other accounts owed by me to MEDvidi Medical and its affiliated providers. In the event that I fail to fulfill any of the payment obligations in this section, I agree to pay any and all attorney fees and/or collection costs incurred by MEDvidi Medical and its affiliated providers in the enforcement of my payment obligations or any other obligations as specified herein.
Release of Liability for Loss of Personal Property: I fully understand that the staff of MEDvidi Medical and its affiliated providers cannot give attention to any item of personal property, regardless of value. In the event of the loss of such items, I will not hold MEDvidi Medical and its affiliated offices responsible, but will personally assume any cost and expense incurred because of such loss.
Communications: I authorize MEDvidi Medical and its affiliated providers to contact me by the use of any automatic dialing system or by pre-recorded forms of voice/messaging system. I also authorize MEDvidi Medical and its affiliated providers or other providers or their agents or affiliates to contact me on my home phone, cell phone (by either voice call or text message), and/or electronic mail owned or used by me. If I request medical or financial information be sent by e-mail, fax, or other electronic means I understand there is a risk of misdirection disclosure, or interception by unauthorized parties. If I make such a request, I assume that risk. I further authorize MEDvidi Medical and entities contracted with MEDvidi to contact me for the purpose of inquiring about my patient experience at any MEDvidi facility.
Professional Billing: Charges for physicians who provided your care and interpreted your tests are not included in your hospital bill. You will receive separate bills from the emergency room physician, radiologist, pathologist, anaesthesiologist, surgical assistants, specialty consults, and your attending physician outside of this medical group.
Consent For Medical Care: I consent to medical testing, care and treatment by MEDvidi Medical and its affiliated providers.
Consent for Telemedicine: I agree to care using Telemedicine. This is care done by sending video images or other transmitted information to a Provider who is in a different place from me. There are some advantages to care by Telemedicine. Advantages include being able to get faster care, and more immediate response by a Provider. There are also possible problems. These include interruptions, unauthorized access and technical difficulties. An exam, consultation or service by Telemedicine may miss information that a direct exam might provide. At any time, I may refuse or stop an exam, consultation or service done by Telemedicine. Technical assistants may also be present during the exam, consultation or service to help with the process. There may be charges for Providers and the facility for Telemedicine services.
Assignment of Benefits: I hereby irrevocably assign payment to MEDvidi Medical and its affiliated providers accepting this assignment. Where Medicare and Medicaid benefits are applicable, I certify that the information given by me in applying for payment, under Title XVIII or XIX of the Social Security Act, is correct and request that payment of authorized benefits be made to MHS on my behalf.
Release of Information for Payment Purposes: I hereby authorize and consent MEDvidi Medical and its affiliated providers’ release of medical information to obtain payment as described in the MEDvidi Medical and its affiliated providers Privacy Notice. This consent includes, without limitation, present and future HIV test results and mental health records.
Obligation for Payment: I understand I am financially responsible to MHS and physicians for charges for all services provided by MEDvidi Medical and its affiliated providers to me, which my insurance carrier does not cover (which includes all commercial and government third-party payors). I understand that it is my responsibility to comply with all requirements for insurance out-of-network coverage. I further understand and agree that any credit balance resulting from payment may be applied to any other accounts owed by me to MEDvidi Medical and its affiliated providers. In the event that I fail to fulfill any of the payment obligations in this section, I agree to pay any and all attorney fees and/or collection costs incurred by MEDvidi Medical and its affiliated providers in the enforcement of my payment obligations or any other obligations as specified herein.
Release of Liability for Loss of Personal Property: I fully understand that the staff of MEDvidi Medical and its affiliated providers cannot give attention to any item of personal property, regardless of value. In the event of the loss of such items, I will not hold MEDvidi Medical and its affiliated offices responsible, but will personally assume any cost and expense incurred because of such loss.
Communications: I authorize MEDvidi Medical and its affiliated providers to contact me by the use of any automatic dialing system or by pre-recorded forms of voice/messaging system. I also authorize MEDvidi Medical and its affiliated providers or other providers or their agents or affiliates to contact me on my home phone, cell phone (by either voice call or text message), and/or electronic mail owned or used by me. If I request medical or financial information be sent by e-mail, fax, or other electronic means I understand there is a risk of misdirection disclosure, or interception by unauthorized parties. If I make such a request, I assume that risk. I further authorize MEDvidi Medical and entities contracted with MEDvidi to contact me for the purpose of inquiring about my patient experience at any MEDvidi facility.
Professional Billing: Charges for physicians who provided your care and interpreted your tests are not included in your hospital bill. You will receive separate bills from the emergency room physician, radiologist, pathologist, anaesthesiologist, surgical assistants, specialty consults, and your attending physician outside of this medical group.