Please review the Qs and As below prior to enrolling! Thank you so much for your consideration and patience with the website.
TERMS OF SERVICE
*Clicking the button below will open a new window that walks you through the enrollment process. At the end, you will have to check a box that states "I agree with the Terms of Service" with the "terms of service" being a hyperlink. I know it is typical when one sees this on almost any website to just ignore it and check the box to get where you want to go (I do it too). PLEASE understand that this link will allow you to view or download the Patient agreement and Medicare Opt Out forms. You are fully agreeing to all terms in the agreement document (for all patients) and the Medicare Opt Out document (for Medicare recipients) whether you read through them or not! If you choose to read them, which I recommend, and have any questions, please email me firstname.lastname@example.org. I want you to feel comfortable with what you are agreeing to and have peace about it. I am happy to help with any questions!
PAYMENT INFORMATION AND OPTIONS
Payments for membership or (for a limited time, see Fees and Benefits Page) fees for service will be accepted through credit card (including those that double as debit cards), cash, check, or automatic withdrawal from your bank account. However, the online enrollment process will only allow a patient to set up billing through a credit card at this time. Because some of you may prefer a non-credit card method of payment, I have made the entry of credit card information OPTIONAL when you enroll. However, before or on the last day of the month in which you enroll, you will be required to provide a valid method of payment. This can be done quickly and easily either by phone call to the office or email to email@example.com, or in person at the office. If valid payment information is not provided by the final day of your first month of enrollment (grace periods given if you sign up less than 2 days before end of a month), you will be disenrolled from the practice.
Remember that the practice size is limited to 600 patients at this time. Other patients wishing membership who are able to provide payment infomation immediately will be given preference over patients just "holding" a spot but making no payments whatsoever. I have enabled automatic billing in the EMR at this time. It is IMPORTANT that you carefully review auto-bill date options when you enroll. If you choose to pay manually each month, you may, but do not select an auto-bill date at the time of enrollment to prevent unexpected charges.
If you choose to enter a cc now and are given the option of automatic billing, you may choose any date from the options given and change that date at any time. Your first month is ALWAYS prorated, so unless you join on the 1st of a month, you will pay less than full fee for that month. Full monthly fees will begin on your 2nd month of membership. Should you terminate membership less than 1 mo after enrollment date, you will still be responsible for 1 full month of fees regardless of enrollment date. Please email me with any questions regarding payments.
CAN I QUIT AND REJOIN AT ANY TIME? Wouldn’t that be convenient? Obviously, allowing this would lead to widespread abuse of the practice model, not to mention its bankruptcy. There is never a financial commitment to the practice longer than 1 month. The agreement is for 1 month but automatically renews if not terminated by either party. Patients may terminate their agreement at any time. However, except for very rare exceptions – i.e. military deployment – patients may not rejoin the practice without penalty until 2 full years have elapsed since the final day of their most recent paid month of membership. For example, if you quit the practice in November 2017, your first eligible rejoin date, without penalty, is December 1, 2019. If a patient wishes to rejoin sooner than the stated 2 years, he/she may do so by paying, in lump sum, the product of the monthly membership fee (at the time those months were missed), multiplied by the number of months “missed” between their termination date and their rejoin date.
CAN I BE TERMINATED FROM THE PRACTICE MEMBERSHIP OTHER THAN BY MY OWN CHOICE? As with any physician, I reserve the right to terminate my provision of care to any patient with a 30 day written notice. Care will continue to be provided within that 30 day period, though may be as indirect as an ER referral for any and all requests by the patient. It is rare that this action ever needs to be taken, but the right is reserved by me in the case that a drug seeking, overly demanding, highly disrespectful, dishonest, or other inappropriately behaved patient requires termination.