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Concierge Program 

Services and Payment Terms

1. Medical Services. As used in this Agreement, the term Medical Services shall mean those medical services that the Nurse Practitioner is permitted to perform under the laws of the State of Florida and that are consistent with her training and experience as a family nurse practitioner, as the case may be. Patient shall also be entitled to an annual in-depth “wellness examination and evaluation,”.

The Physician may from time to time, due to vacations, sick days, and other similar situations, not be available to provide the services referred to above in this paragraph 1. During such times, Patient’s calls to the ARNP, or to the office or visits may be carried out by covering healthcare providers. 

2. Non-Medical, Personalized Services.
 

(a) 24/7 Access. Patient shall have access to the ARNP via instant messaging and video chat. Patient shall also have direct telephone access to the ARNP on a twenty-four hour per day, seven day per week basis. Patient shall be given a phone number where patient may reach the ARNP directly around the clock. During the ARNP’s absence for vacations, continuing medical education, illness, emergencies, or days off, Mobile Medical Associates will provide the services of an appropriate licensed healthcare provider for assistance in obtaining medical services. Patient shall be given instructions as to how to contact such healthcare providers. Such provider shall be available to Patient to the same extent as would the ARNP, however provider may be contacted through an answering service rather than through a direct phone line.
 

(b) E-Mail Access. Patient shall be given the ARNPs e-mail address to which non-urgent communications can be addressed. Such communications shall be dealt with by the ARNP or staff member of the Practice in a timely manner. Patient understands and agrees that email and the internet should never be used to access medical care in the event of an emergency, or any situation that Patient could reasonably expect may develop into an emergency. Patient agrees that in such situations, when a Patient cannot speak to ARNP immediately in person or by telephone, that Patient shall call 911 or the nearest emergency medical assistance provider, and follow the directions of emergency medical personnel.
 

(c) No Wait or Minimal wait Appointments. Every effort shall be made to assure that Patient is seen by the ARNP immediately upon arriving for a scheduled office visit or after only a minimal wait. If ARNP foresees a minimal wait time, Patient shall be contacted and advised of the projected wait time.
 

 (d) Same Day/Next Day Appointments. When Patient calls or e-mails the ARNP prior to noon on a normal office day (Monday through Friday) to schedule an appointment, every reasonable effort shall be made to schedule an appointment with the ARNP on the same day. If the patient calls or e- mails the ARNP after noon on a normal office day (Monday through Friday) to schedule an appointment, every reasonable effort shall be made to schedule Patient’s appointment with the ARNP on the following normal office day.  
 

(e) Home or Office Visits. Patient may request that the ARNP see Patient in Patient’s home or office, and in situations where the ARNP considers such a visit reasonably necessary and appropriate, he will make every reasonable effort to comply with Patient’s request.

 

 

Communications. You acknowledge that communications with the ARNP using e-mail, facsimile, video chat, instant messaging, and cell phone are not guaranteed to be secure or confidential methods of communications. As such, You expressly waive the Physician’s obligation to guarantee confidentiality with respect to correspondence using such means of communication. You acknowledge that all such communications may become a part of your medical records.
 

By providing Patient’s e-mail address on the attached document gives permission for the ARNP to communicate with Patient by e-mail regarding Patient’s “protected health information” (PHI) (as that term is defined in the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and it’s implementing regulations) By inserting Patient’s e-mail address below, Patient acknowledges that:
 

(a)  E-mail is not necessarily a secure medium for sending or receiving PHI and, there is always a possibility that a third party may gain access;
 

(b)  Although the ARNP will make all reasonable efforts to keep e-mail communications confidential and secure, neither Mobile Medical Associates nor the ARNP can assure or guarantee the absolute confidentiality of e-mail communications;
 

(c)  In the discretion of the ARNP, e-mail communications may be made a part of Patient’s permanent medical record; and,
 

(d)  Patient understands and agrees that E-mail is not an appropriate means of communication regarding emergency or other time-sensitive issues or for inquiries regarding sensitive information. In the event of an emergency, or a situation in which the member could reasonably expect to develop into an emergency, Member shall call 911 or the nearest Emergency room, and follow the directions of emergency personnel. If Patient does not receive a response to an e-mail message within one day, Patient agrees to use another means of communication to contact the ARNP. Neither Mobile Medical Associates or the ARNP will be liable to Patient for any loss, cost, injury, or expense caused by, or resulting from, a delay in responding to Patient as a result of technical failures, 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 the Practice’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) your failure to comply with the guidelines regarding use of e-mail communications set forth in this paragraph.

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