Terms and Conditions
Complete Healthcare of Oklahoma, L.L.C. ("Complete Healthcare") provides the services described in the Monthly Consultation Membership Agreement. By noting that you are agreeing to the terms and conditions during your electronic registration, you acknowledge that you have read and agree to the terms, conditions, limitations, and fee schedule and that you authorize Complete Healthcare to receive recurrent payments as set forth below. Services not included in the monthly membership fee, including any tests, treatments, or procedures administered by a specialist physician or hospital will be billed separately by those providers/institutions. Complete Healthcare is not responsible for any fees of specialist physicians or hospitals.
Participation in Complete Healthcare's program is continuous. Complete Healthcare is authorized to withdraw membership fees as set forth in the Monthly Consultation Membership Agreement.
The Member(s) and the company have executed this Membership Agreement on the Effective Date.
Monthly Consultation Membership Agreement
The Monthly Consultation Membership Agreement (the "Membership Agreement") is entered into and effective on the first of the month(the "Effective Date") following full payment of the monthly Membership Fee by and between the person agreeing to terms and conditions and making the payment (referred to herein as the "Member")and Complete Healthcare of Oklahoma, LLC, and Oklahoma limited liability company, with a mailing address of 3440 RC Luttrell Dr., Suite 100, Norman, OK 73072 (the "Company").
Recitals
The Company desires to offer the Member medical consultation services (the "Consultation Services") from its current roster of contracted physicians, urgent care centers, and other medical services on a monthly basis for a monthly fee.
The Member desires to receive the Consultation Services from the Company and its physicians, urgent care centers, and other medical services. according to the terms and conditions provided in this Membership Agreement.
Therefore, the Company and the Member agree as follows:
Terms and Conditions
1. Consultation Services. Upon execution of this Agreement by both parties, the Member will select a physician from a roster of physicians that is provided by the Company and the Company will assign the physician selected by the Member as appropriate for the Member's needs (the "Assigned Physician") to the Member. The Assigned Physician will provide the Consultation Services more specifically described in Schedule 1 - Description of Services.
2. Membership Fee. The current fee for the Primary Care Consutation Services (the "Membership Fee") is as follows:
Individual Adult (Ages 18 and above): $68/month
Children (Ages birth -17): $15/month /child if combined with at least one adult individual membership
Other Services from the Company can be obtained from the Company at additonal cost per month.
Payment. The Member may choose to pay monthly by Electronic Funds Transfer or Credit Card. The Membership Fee is due on the first day of each month. The Consultation Services will not be rendered for Members with past due accounts. In the event that a Membership Fee is declined due to insufficient funds or and expired credit card, the Company may charge an additional fee of $25.00 to your account. Failure to comply with payment terms may result in the termination of this Agreement and a denial of Consultation Services. Complete Healthcare of Oklahoma, L. L. C. ("Complete Healthcare") provides the services described in the Monthly Consultation Membership Agreement. By signing below, you acknowledge that you have read the terms, conditions, limitations, and fee schedule and that you authorize Complete Healthcare to receive recurrent payments as set forth above. Services not included in the monthly membership fee, including any tests, treatements, or procedures administered by a specialist physician or hospital will be billed seperately by those providers/institutions. Complete Healthcare is not responsible for any fees of specialist physicians or hospitals. Participation in Complete Healthcare's program is continuous. Complete Healthcare is authorized to withdraw membership fees as set forth above until notice of termination is received as set forth in the Monthly Consultation Membership Agreement.
3.Termination. The Member may terminate this Agreement at any time for any reason by providing the Company with at least 24 hour written notice (mail or email) or phone conversation prior to the next scheduled payment date (which is the first of each month). The Member will no longer receive the Consultation Services upon 5 days prior written notice (mail or email) to the Member if any of the following occur: (i) the Member fails to pay the Membership Fee when due; (ii) the Member fails to abide by the Company's policies or this Membership agreement; (iii) the member's Assigned Physician ceases to provide the Consultation Services and the Member and the Company are unable to find an agreeable replacement physician; or (iv) the Assigned Physician refuses to provide the Consultation Services to the Member "for cause."
4. Modification of Consultation Services or Discontinuation of Consultation Sevices. The Company may modify the Consultation Services at any time and may change the Member's Assigned Physician at any time, without prior notice to or consent from the Member. The Member may terminate this Membership Agreement in accordance with Section 4 above in the event that any change is not agreeable. The Company may discontinue the Consultation Services entirely and terminate this Membership Agreement at any time with 60 days advance notice.
5. Insurance Regulations. The Member acknowledges that:
(i) the Company and the Consultation Services provided under this Membership Agreement are not an insurance plan, nor is this Membership Agreement a contract for insurance;
(ii) the Member further acknowledges that the Company and its physicians and staff must abide by all patient privacy rules and regulation mandated by the Health Insurance Portability and Accountability Act("HIPAA");
(iii) due to regulatory restrictions, individuals enrolled in or eligible for Medicare, Medicaid, and other government programs are disqualified from becoming a Member under this Membership Agreement.
6. Electronic Communications. The Member may request to receive communications form the Company or its physicians or staff by e-mail. By executing this Membership Agreement and by providing your email during the registration process, the Member acknowledges that email and texting are not secure methods for sending and receiving potentially sensitive personal health information. Although communication between the Member and his/her physician are subject to confidentiality requirements under the Company's policies and that of applicable law, the Company cannot assure the protection of confidential information with respect to email and text communications. The Member further acknowledges that email and text communications are not a good medium for urgent or time-sensitive information and telephone or in-person communication are more appropriate for urgent or time-sensitive information. The Member acknowledges that, at the discretion of his/her physician, email or text communications may become part of his/her permanent medical records. (The Member may revoke this consent to electronic communication at any time by written notice to the Company.)
7. No Assignment. This Membership Agreement may not be assigned or transferred by the Member.
8. Severability. If for any reason any provision of this Membership Agreement is deemed by a court of competent jurisdiction to be legally invalid or unenforceable, the validity of the remainder of this Membership Agreement shall not be affected, and that provision shall be deemed modified to the minimum extent necessary to make that provision consistent with applicable law.
9. Amendment. Any amendment to this Agreement shall be in writing and signed by both parties. Notwithstanding the foregoing, th Company may unilaterally amend this Agreement to the extent required by federal, state, or local law or regulation ("Applicable Law") upon 30 days' prior written notice to the Member. Any changes required by Applicable Law may be incorporated herein by reference without the need for signature by the parties. The Company may also amend Schedule 1 - Description of the Consultation Services from time to time in its sole discretion.
10. Notices. All written notices required by this Membership Agreement are deemed served upon mailing by first-class U.S. mail to the address of the Member provided during internet registration or by e-mail notice transmitted electronically to the e-mail address of the Member during internet registration.
11. Governing Law. This Membership Agreement shall be construed in accordance with and governed by the laws of the State of Oklahoma, without regard to its principles of conflict of laws. The parties agree that any action arising out of this Membership Agreement shall be litigated under the laws of the State of Oklahoma in a court of competent jurisdiction in Oklahoma County, Oklahoma. If any action or proceeding involving such questions arises under the Constitution, laws, or treaties of the United States of America, or if there is a diversity of citizenship between the parties thereto, so that it is to be brought in a United States District Court, it shall be brought in the United States District Court for the Western District of Oklahoma. In any event, the prevailing party shall be entitled to all reasonable attorney's fees and costs incurred in the enforcement of this Membership Agreement.
Schedule 1
Description of the Consultation Services
The Member will be allowed to consult with the Assigned Physician at the Assigned Physician's office a maximum of two times each month for the Membership Fee. During each consultation, the Assigned Physician will take the health history of the Member and if necessary conduct a physical exam. If the Assigned Physician is able to render a medical diagnosis upon completing the health history, the Assigned Physician will provide the diagnosis to the Member, together with a prescription for medication or other therapy, if necessary. No other services will be offered to the Member for the Membership Fee.
If, after taking the Member's health history and completing a physical exam, if necessary, the Assigned Physician cannot render a diagnosis because additional diagnostic tests or procedures are required, the Assigned Physician will notify the Member. If the Assigned Physician is able to conduct the required diagnostic test or procedure the Assigned Physician and the Member will pay the Assigned Physician directly for that diagnostic test or procedure.
If the Assigned Physician does not provide the diagnostic test or procedure, the Assigned Physician will use his/her best efforts to refer the Member to at least one medical facility that does provide the diagnostic test or procedure. If the Member desires to have the diagnostic test or procedure conducted, the Member will be required to pay the medical facility directly for the cost of that diagnostic or procedure. Upon receiving the results of any diagnostic test or procedure, the Assigned Physician will make a diagnosis and provide the Member with a prescription for medication or other therapy, if necessary.
In no event will the Company or the Assigned Physician be required to provide or pay for any medical service, test, procedure, medication, or other therapy which is not otherwise expressly provided for in this Membership Agreement.
Participation in Complete Healthcare's program is continuous. Complete Healthcare is authorized to withdraw membership fees as set forth in the Monthly Consultation Membership Agreement.
The Member(s) and the company have executed this Membership Agreement on the Effective Date.
Monthly Consultation Membership Agreement
The Monthly Consultation Membership Agreement (the "Membership Agreement") is entered into and effective on the first of the month(the "Effective Date") following full payment of the monthly Membership Fee by and between the person agreeing to terms and conditions and making the payment (referred to herein as the "Member")and Complete Healthcare of Oklahoma, LLC, and Oklahoma limited liability company, with a mailing address of 3440 RC Luttrell Dr., Suite 100, Norman, OK 73072 (the "Company").
Recitals
The Company desires to offer the Member medical consultation services (the "Consultation Services") from its current roster of contracted physicians, urgent care centers, and other medical services on a monthly basis for a monthly fee.
The Member desires to receive the Consultation Services from the Company and its physicians, urgent care centers, and other medical services. according to the terms and conditions provided in this Membership Agreement.
Therefore, the Company and the Member agree as follows:
Terms and Conditions
1. Consultation Services. Upon execution of this Agreement by both parties, the Member will select a physician from a roster of physicians that is provided by the Company and the Company will assign the physician selected by the Member as appropriate for the Member's needs (the "Assigned Physician") to the Member. The Assigned Physician will provide the Consultation Services more specifically described in Schedule 1 - Description of Services.
2. Membership Fee. The current fee for the Primary Care Consutation Services (the "Membership Fee") is as follows:
Individual Adult (Ages 18 and above): $68/month
Children (Ages birth -17): $15/month /child if combined with at least one adult individual membership
Other Services from the Company can be obtained from the Company at additonal cost per month.
Payment. The Member may choose to pay monthly by Electronic Funds Transfer or Credit Card. The Membership Fee is due on the first day of each month. The Consultation Services will not be rendered for Members with past due accounts. In the event that a Membership Fee is declined due to insufficient funds or and expired credit card, the Company may charge an additional fee of $25.00 to your account. Failure to comply with payment terms may result in the termination of this Agreement and a denial of Consultation Services. Complete Healthcare of Oklahoma, L. L. C. ("Complete Healthcare") provides the services described in the Monthly Consultation Membership Agreement. By signing below, you acknowledge that you have read the terms, conditions, limitations, and fee schedule and that you authorize Complete Healthcare to receive recurrent payments as set forth above. Services not included in the monthly membership fee, including any tests, treatements, or procedures administered by a specialist physician or hospital will be billed seperately by those providers/institutions. Complete Healthcare is not responsible for any fees of specialist physicians or hospitals. Participation in Complete Healthcare's program is continuous. Complete Healthcare is authorized to withdraw membership fees as set forth above until notice of termination is received as set forth in the Monthly Consultation Membership Agreement.
3.Termination. The Member may terminate this Agreement at any time for any reason by providing the Company with at least 24 hour written notice (mail or email) or phone conversation prior to the next scheduled payment date (which is the first of each month). The Member will no longer receive the Consultation Services upon 5 days prior written notice (mail or email) to the Member if any of the following occur: (i) the Member fails to pay the Membership Fee when due; (ii) the Member fails to abide by the Company's policies or this Membership agreement; (iii) the member's Assigned Physician ceases to provide the Consultation Services and the Member and the Company are unable to find an agreeable replacement physician; or (iv) the Assigned Physician refuses to provide the Consultation Services to the Member "for cause."
4. Modification of Consultation Services or Discontinuation of Consultation Sevices. The Company may modify the Consultation Services at any time and may change the Member's Assigned Physician at any time, without prior notice to or consent from the Member. The Member may terminate this Membership Agreement in accordance with Section 4 above in the event that any change is not agreeable. The Company may discontinue the Consultation Services entirely and terminate this Membership Agreement at any time with 60 days advance notice.
5. Insurance Regulations. The Member acknowledges that:
(i) the Company and the Consultation Services provided under this Membership Agreement are not an insurance plan, nor is this Membership Agreement a contract for insurance;
(ii) the Member further acknowledges that the Company and its physicians and staff must abide by all patient privacy rules and regulation mandated by the Health Insurance Portability and Accountability Act("HIPAA");
(iii) due to regulatory restrictions, individuals enrolled in or eligible for Medicare, Medicaid, and other government programs are disqualified from becoming a Member under this Membership Agreement.
6. Electronic Communications. The Member may request to receive communications form the Company or its physicians or staff by e-mail. By executing this Membership Agreement and by providing your email during the registration process, the Member acknowledges that email and texting are not secure methods for sending and receiving potentially sensitive personal health information. Although communication between the Member and his/her physician are subject to confidentiality requirements under the Company's policies and that of applicable law, the Company cannot assure the protection of confidential information with respect to email and text communications. The Member further acknowledges that email and text communications are not a good medium for urgent or time-sensitive information and telephone or in-person communication are more appropriate for urgent or time-sensitive information. The Member acknowledges that, at the discretion of his/her physician, email or text communications may become part of his/her permanent medical records. (The Member may revoke this consent to electronic communication at any time by written notice to the Company.)
7. No Assignment. This Membership Agreement may not be assigned or transferred by the Member.
8. Severability. If for any reason any provision of this Membership Agreement is deemed by a court of competent jurisdiction to be legally invalid or unenforceable, the validity of the remainder of this Membership Agreement shall not be affected, and that provision shall be deemed modified to the minimum extent necessary to make that provision consistent with applicable law.
9. Amendment. Any amendment to this Agreement shall be in writing and signed by both parties. Notwithstanding the foregoing, th Company may unilaterally amend this Agreement to the extent required by federal, state, or local law or regulation ("Applicable Law") upon 30 days' prior written notice to the Member. Any changes required by Applicable Law may be incorporated herein by reference without the need for signature by the parties. The Company may also amend Schedule 1 - Description of the Consultation Services from time to time in its sole discretion.
10. Notices. All written notices required by this Membership Agreement are deemed served upon mailing by first-class U.S. mail to the address of the Member provided during internet registration or by e-mail notice transmitted electronically to the e-mail address of the Member during internet registration.
11. Governing Law. This Membership Agreement shall be construed in accordance with and governed by the laws of the State of Oklahoma, without regard to its principles of conflict of laws. The parties agree that any action arising out of this Membership Agreement shall be litigated under the laws of the State of Oklahoma in a court of competent jurisdiction in Oklahoma County, Oklahoma. If any action or proceeding involving such questions arises under the Constitution, laws, or treaties of the United States of America, or if there is a diversity of citizenship between the parties thereto, so that it is to be brought in a United States District Court, it shall be brought in the United States District Court for the Western District of Oklahoma. In any event, the prevailing party shall be entitled to all reasonable attorney's fees and costs incurred in the enforcement of this Membership Agreement.
Schedule 1
Description of the Consultation Services
The Member will be allowed to consult with the Assigned Physician at the Assigned Physician's office a maximum of two times each month for the Membership Fee. During each consultation, the Assigned Physician will take the health history of the Member and if necessary conduct a physical exam. If the Assigned Physician is able to render a medical diagnosis upon completing the health history, the Assigned Physician will provide the diagnosis to the Member, together with a prescription for medication or other therapy, if necessary. No other services will be offered to the Member for the Membership Fee.
If, after taking the Member's health history and completing a physical exam, if necessary, the Assigned Physician cannot render a diagnosis because additional diagnostic tests or procedures are required, the Assigned Physician will notify the Member. If the Assigned Physician is able to conduct the required diagnostic test or procedure the Assigned Physician and the Member will pay the Assigned Physician directly for that diagnostic test or procedure.
If the Assigned Physician does not provide the diagnostic test or procedure, the Assigned Physician will use his/her best efforts to refer the Member to at least one medical facility that does provide the diagnostic test or procedure. If the Member desires to have the diagnostic test or procedure conducted, the Member will be required to pay the medical facility directly for the cost of that diagnostic or procedure. Upon receiving the results of any diagnostic test or procedure, the Assigned Physician will make a diagnosis and provide the Member with a prescription for medication or other therapy, if necessary.
In no event will the Company or the Assigned Physician be required to provide or pay for any medical service, test, procedure, medication, or other therapy which is not otherwise expressly provided for in this Membership Agreement.