PartAgreementForm

 Medical Access Corporation Terms of Use for Participants

Medical Access Corporation (“Medical Access USA” or “MAC”) facilitates connections between  participants (“Participants”) and certain healthcare providers and certain other healthcare services, which may include healthcare providers who provide primary care (collectively, “Treating Providers”). These connections our Participants access to and payment for primary care medical and healthcare services (“Services”).  By becoming a Participant or accessing and using MAC’s Website (the “Site”) or by signing and returning a printed copy of this Agreement to MAC you agree to be bound by these Terms of Use and all other terms and policies that may appear on the Site from time to time during your use of the Site or while you are otherwise a Participant.  Do not become a Participant or use the Site or sign and return to us a printed copy of these Terms of Use, if you do not agree to be bound by these Terms of Use. Using the Site or otherwise becoming a Participant or by signing and returning these Terms of Use indicates your agreement to be bound by the following Terms of Use:

  1. You acknowledge and understand that by using the Site or by signing and returning a copy of these Terms of Use to MAC you are voluntarily becoming a Participant; that this agreement is non-transferable; and that you agree to be bound by these Terms of Use and any other terms you may be required to agree to in connection with obtaining services that you and/or your family may obtain from time to time.
  2. You understand these Terms of Use will replace and make void any previous Participant Terms of Use with MAC, if any.
  3. You understand that you are entitled to a copy of these Terms of Use should you request one.
  4. You understand that Treating Providers provide only a limited set of health care services in the field of primary care (general Family Medicine, general Internal Medicine, and general Pediatrics) and the Treating Providers’ ability to provide Services may be limited by training, experience, equipment, supplies, outside facilities (i.e. hospitals) and other unforeseen situations.
  5. YOU UNDERSTAND AND ACKNOWLEDGE THAT TREATING PROVIDERS WILL PROVIDE ONLY PRIMARY CARE AND WILL NOT PROVIDE EMERGENCY OR CATASTROPHIC HEALTHCARE SERVICES AND THAT YOU WILL NEED TO SEEK OTHER PHYSICIANS FOR THIS CARE AND OBTAIN CATASTROPHIC HEALTHCARE INSURANCE COVERAGE  TO PAY FOR ALL CARE NOT DEEMED TO BE PRIMARY CARE PROVIDED THROUGH TREATING PROVIDERS. MAC does not limit your choice of catastrophic healthcare insurance coverage and does not recommend any particular provider for this insurance. MAC can however, upon your request, facilitate your ability to obtain catastrophic healthcare coverage through Custom Medical Plans, should you choose Custom Medical Plans for this catastrophic healthcare coverage.
  6. You understand and agree that you will be solely responsible for who you choose to provide Services for you or your family.
  7. You also understand and agree you or your family may require health care and related goods beyond what Treating Providers offer (the “Additional Services”) and that Treating Providers may recommend Additional Services (outside care or services) for some health issues and that you will be solely and financially responsible for payment for the Additional Services.
  8. You understand that you and the Treating Providers have the ultimate right to decide what Services you receive; provided that, MAC may add or discontinue facilitation of any Services at anytime and Treating Providers may stop providing certain Services as well.
  9. You recognize and agree that Treating Providers may be unavailable by phone or in-person at times due to vacations, illness, technical malfunctions or other unforeseen situations.
  10. You understand that should your  Treating Provider become unavailable, you will need to arrange alternative coverage with another Treating Provider and this alternative coverage is not guaranteed at all times.
  11. You understand and agree that being a Participant  requires payment of an ongoing, recurring monthly Participant fee and that the Participant (and/or a sponsoring employer) must continue to pay Participant fees to receive Services and remain a Participant.
  12. You acknowledge and understand that if under an employer-sponsored plan, the employer and you, the employee, are entirely responsible for managing any payroll deductions that may be related to  and your becoming a Participant.
  13. You understand that as a Participant you will be provided a limited set of Services at no charge, including basic communications with the Treating Provider you select, unlimited nurse and doctor visits at the Treating Provider’s clinic during regular business hours, coordination of care and referrals to other providers, annual flu shot, crutches, splints, slings, and the following lab and diagnostic testing: rapid strep test, cholesterol panel, chemistry panel, CBC, basic Pap smear, hemoglobin A1c, EKG, urine dipstick analysis, and urine pregnancy test.
  14. You understand that the Services included for Participants are at the full judgment and discretion of MAC and these Services may change without notice.
  15. You understand that some Services, including but not limited to after-hours visits (not during regular business hours), house calls, some labs, procedures, medications, and Teleheath Services will require payment of an additional fee.
  16. You understand, acknowledge, and agree that if your Participant’s monthly fees are not paid within 60 days of the due date, the Participant’s participation and access to the Site and Treating Providers will be end.
  17. You acknowledge and agree MAC or a Treating Provider may change the amount of its fees at anytime in the future, but will endeavor to notify you in writing of any change at least 90 days prior to the effective date of this change.
  18. You understand and agree an initial membership fee must be paid upon joining MAC as a Participant and that this payment is non-refundable.
  19. You acknowledge and agree a one-time registration fee is required upon joining MAC and this fee is non-refundable.
  20. If joining as an individual (not sponsored by an employer), you understand that upon cancellation of your participation with MAC, you will be refunded any pre-paid membership fees remaining on your account calculated on a pro-rated basis from the date of cancellation. Any refund due will be issued within 30 days from the date of cancellation.
  21. You understand that some Treating Provider Services, including but not limited to after-hours visits (not during regular business hours), some labs, procedures, and medications, may require payment of an additional fee. These fees are subject to change without notice, but Treating Providers will always disclose any charges prior to rendering service.
  22. You understand that you are entirely responsible for any charges you as a Participant may incur related to health care services received outside of MAC including, but not limited to, other physicians, emergency rooms, hospitalization, diagnostic testing, specialty services and prescription medications.
  23. You acknowledge that MAC will not reimburse you for any charges you as a Participant  incur for any care received from a provider that is not a Treating Provider defined herein.
  24. You acknowledge, understand and agree that MAC IS NOT a health insurance plan, nor a substitute for health insurance.
  25. You acknowledge that Treating Providers and MAC encourages, but not requires, all Participants to have some type of health insurance plan to help pay for health care services obtained apart from a Treating Provider facilitated by MAC.
  26. You acknowledge and agree MAC DOES NOT participate in, or accept payment from, any health insurance plans; including but not limited to Medicare, Medicare Advantage plans, Medicaid, PPOs, HMOs or TriCare.
  27. You understand MAC cannot guarantee reimbursement for any services and resultant charges from any third-party health plans, including insurance plans and savings accounts (health savings or flexible spending).
  28. You acknowledge that if you elect to receive Additional Services including, but not limited to, diagnostic tests, labs, other physicians, medications, outside of a Treating Provider facilitated by MAC using a health insurance plan, including services that are ordered by a Treating Provider, you assume full responsibility for properly submitting appropriate insurance information and to pay for any associated costs.
  29. You hereby confirm that the Participant IS NOT currently enrolled in traditional Medicare (Parts A or B) plans.
  30. You understand that individuals enrolled in traditional Medicare (Parts A or B) ARE NOT eligible to become MAC Participants.
  31. You agree to notify MAC immediately if Participant becomes enrolled in traditional Medicare for any reason, including but not limited to age, disease or disability.
  32. You acknowledge and agree a Medicare beneficiary, or a legal representative during a time when the Medicare beneficiary, requires emergency care services or urgent care services cannot become a Participant or bind MAC to these Terms of Use
  33. You acknowledge and agree MAC or any Treating Provider IS NOT a contracted provider for any Medicare Advantage Plans and Services will not be covered by these plans.
  34. You agree to never seek reimbursement for payments made to MAC from Medicare or Medicare Advantage health plans and you agree to indemnify, defend and hold MAC harmless from and against any claim made against MAC as a result of your actions as a Participant.
  35. You acknowledge that that the Treating Provider, MAC, and you have an absolute and unconditional right to cancel your Participation  at any time for any reason.
  36. You understand if your participation fees are unpaid 60 days after scheduled payment or billing date, your participation as a Participant may be cancelled.
  37. You must provide MAC a written or verbal notice of cancellation and you understand that MAC participation fees will continue to be billed our auto-paid, if available, until MAC receives your notice of cancellation.
  38. In addition, you understand that your participation may be terminated at the sole discretion of a Treating Provider by providing you with written notice of cancellation. However, MAC will not terminate your membership  on the basis of health status or medical conditions.
  39. You understand that if your participation with MAC is cancelled by you or MAC or a Treating Provider, you will still be responsible for any past-due balances owed – including participation fees or fess for Services.
  40. You acknowledge if you re-join MAC after a cancellation (actively or by lack of payment), you may be required to pay an additional “Re-Enrollment” fee in addition to other standard charges.
  41. You understand that under the Health Insurance Portability & Accountability Act of 1996 (“HIPAA”) and it’s subsequent regulations you have certain rights to privacy regarding your “protected health information” (herein referred to as “PHI).
  42. You have reviewed and understand MAC ’s Notice of Privacy Practices and you acknowledge it is available in printed form by request or for review online at: http://medicalaccessusa.com/privacy-policy/.
  43. You acknowledge and agree that MAC will not receive or maintain any of your PHI and that the Treating Provider will keep your (the Participant’s) “PHI” confidential and private and in conformity with HIPAA.
  44. You understand that the Participant’s “PHI” can and will be used by Treating Providers to (i) conduct, plan and direct medical treatments and follow-up among the multiple healthcare providers who may be involved in that treatment directly and indirectly, and (ii) conduct normal healthcare operations such as quality assessments and physician certifications.
  45. You understand that any and all methods of correspondence may be used by the Treating Provider to generate information for the Participant’s medical records.
  46. You understand that MAC offers, but does not require, some forms of communication in discussion of  “PHI” that cannot reasonably be guaranteed to be fully secure.
  47. You acknowledge MAC will only use your contact information (phone numbers, email address, usernames, etc.) provided by you upon registration, “Authorization for Communications” form or in subsequent updates.
  48. You acknowledge that MAC advises the Participant against using employer owned or operated computers or email in communications with MAC and that MAC will not assume any responsibility or consequences created from use of employer-owned computers or email.
  49. You acknowledge MAC recommends Participants NOT communicate health information about sensitive health topics (such as sexually related activities, HIV/AIDS or substance abuse issues) through unsecured (internet-based or otherwise) means.
  50. You acknowledge when using electronic methods (email, website, etc.) the Participant should reasonably expect to hear a response within 24 hours during regular business hours. If the Participant has not received a response, the Participant should contact the Treating Provider by phone or another means of communication.
  51. You hereby agree not to hold MAC or the Treating Provider liable or accountable for any loss, injury, damages, costs, or expenses which are sustained or the result of any technical failures with respect to email or electronic services including, but not limited to, (i) technical failures attributable to any internet service provider, (ii) power outages, failure of any electronic messaging software, or failure to properly address e-mail messages, (iii) failure of MAC’s or the Treating Provider’s computers or computer network, or faulty telephone or cable data transmission, (iv) any interception of e-mail communications by a third party; or (v) Participant’s failure to comply with the MAC ’s guidelines regarding use of electronic communications set forth in this agreement.
  52. You acknowledge that email and other forms of online communication are not an appropriate means to discuss any potentially urgent or emergency medical needs or other time-sensitive issues and you should call 911 or visit nearest emergency room should you reasonably suspect a medical emergency.
  53. You acknowledge you have had an opportunity to have this Agreement reviewed by an attorney prior to signing this Agreement reviewed by an attorney or you have waived your right to this review by an attorney.

Your  signature below or your use of the Site indicates your  acceptance of and agreement with the foregoing Terms of Use.

________________________________________ ­­________________________________________

Participant Date

X

Forgot Password?

Join Us

Password Reset

Please enter your e-mail address. You will receive a new password via e-mail.