YOUR INDEPENDENT CONTRACTOR PHYSICIAN:
In order to provide you with the best service possible, America’s ER* (“AER”) has entered into arrangements with numerous medical companies and healthcare practitioners. These companies and medical personnel are separate and distinct legal entities that provide their services to America’s ER and its clients/patients as independent contractors. As a result, the Physicians providing services at America’s ER are independent contractors and not employees, agents or representatives of America’s ER or its affiliates and, therefore, are not authorized to make representations on behalf of America’s ER. While America’s ER schedules, coordinates and provides the medical support staff necessary to facilitate your care, as an independent contractor, your physician is directly responsible for rendering his services to you as well as for overseeing and managing your continuing care and treatment relative to those procedures performed and services provided by him. America’s ER exercises no control or influence over your physicians’ medical decision-making regarding any of the medical care and treatment recommended and/or provided to you. The manner and method by which your physician provides his professional services and functions to you are governed solely by him.
FINANCIAL RESPONSIBILITY:
In most cases, the fees for services render in the emergency room at AER have two components. One component is the physician fee, which is separate from the facility fee component. In contrast, fees in AER’s urgent care center have only a single component. The fees for services rendered, whatever they may be, are charged to all patients and are due at the time of service, unless other advance arrangements have been made with AER’s business office. Secondary procedures and or additional treatments will result in additional fees. To that end, the financially responsible party is obligated for all charges for services provided to the patient, specifically including those portions of the charges which are either not covered by a Health Insurance Plan or that is the obligation of the financially responsible party pursuant to the terms of the respective Health Insurance Plan (e.g., copayments and or coinsurance among others). To the extent no coverage exists under a Health Insurance Plan, the financially responsible party shall be liable for all charges for services provided. To the extent permissible by law, the financially responsible party shall reimburse AER for all costs, expenses and attorney’s fees that may be incurred by AER to collect those charges.
PAYMENT OF FEES, COSTS AND FINANCING:
For your convenience, America’s ER accepts a number of different payment methods. In addition to traditional private healthcare insurance and credit cards such as Visa, MasterCard and American Express, AER has made various third party financing companies available to our patients to help defray the immediate out of pocket costs increasingly demanded by traditional healthcare insurance plans. These financing programs can be used individual or in combination with insurance and other forms of credit. Because these companies provide virtually instant crediting decisions, qualified patients can, in many cases, defer immediate out of pocket expenses thereby potentially making required copays and coinsurance more manageable. Qualified patients can choose the financing plan that best suits their particular needs from the programs that are available. In the event a patient chooses to utilize third party financing companies to fund their services and or treatment, they should understand that said third party financing companies are separate business entities with their own rules, policies and procedures over which AER exercises no influence or control. Accordingly, while AER is always happy to help to the extent that it can, questions regarding a patient’s credit account status should be directed to their chosen financing company. Notwithstanding the foregoing, the decision to apply for, and if approved, utilize third party financing to pay either in whole or in part for the services and or treatment rendered to a patient personally or for someone for whom they are financially responsible, is solely and exclusively the patient’s decision and neither AER, its agents, employees nor its independent contractors are responsible for either the decision to apply for or otherwise utilize said third party financing or for any ramifications associated with the application for or utilization thereof.
RELEASE OF INFORMATION:
In order to receive treatment from AER, its agents, employees and or independent contractor physicians, patients must give permission for the sharing of information regarding thier health so that information can be shared within AER and with other individuals and entities to, among other activities, facilitate treatment, for billing purposes and other healthcare operations. The specific uses and disclosures AER may make, are described in AER’s Notice of Privacy Practices [hyperlink], a copy of which is available upon request and anytime on the America’s ER website at americaer.wpengine.com. Patients have the right to review said Notice of Privacy Practices prior to signing the Consent for the Use and Disclosure of Protected Health Information that is part of the Consent and Disclosure documents provided prior to evaluation and treatment. AER makes all reasonable efforts to protect the privacy of patients health information, whether it is maintained on paper or electronically, and regardless of the method by which it is communicated. AER reserves the right to change its privacy practices as described in its Notice of Privacy Practices. If AER changes its privacy practices, it will issue a revised Notice of Privacy Practices, which will contain the changes that may apply to any protected health information that it maintains.
THE RECEIPT OF AUTOMATED MESSAGES:
From time to time, America’s ER may contact both patients and prospective patients via pre-recorded automated phone messages, text messages and e-mails to, among other things, confirm appointments and follow-ups, provide information regarding “specials” America’s ER is or will be offering, or as a means of performing various additional marketing, sales and quality control functions. Patients will be asked to confirm that they are the owners of both the number(s) and the e-mail address(es) they provided to America’s ER, that the numbers and e-mail addresses are true and correct and that they have the authority to enter into the subject consent notwithstanding the presence of those numbers and addresses on either or both federal and or state do not call lists or any other limitations imposed by federal, state, or local law. This consent is completely voluntary and may be cancelled or withdrawn at any time upon the receipt of written notice directed to AER.
*America’s ER includes all companies in the America’s ER group of companies, its operating divisions and sites, and its affiliates and subsidiaries.
