Pinnacle Privacy Policy and Terms of Service

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Privacy Policy

Effective Date: January 1, 2024

At Pinnacle Advanced Primary Care, accessible from www.pinnacleapc.com, we value your privacy and are committed to protecting any personal information that you may provide us. This Privacy Policy outlines how we collect, use, and safeguard your information. By using our website, you agree to the terms described in this policy.

1. Information Collection

We may collect the following types of information:

• Personal Information: Includes your name, email address, phone number, and other contact details you provide when signing up for services, submitting inquiries, or contacting us through the website.

• Usage Data: Information on how our website is accessed and used. This may include your IP address, browser type, pages visited, and other usage data.

2. Use of Information

We use your information to:

• Provide, maintain, and improve our services.

• Respond to inquiries, process requests, and communicate with you.

• Personalize user experience and understand customer needs.

• Analyze website usage for website improvement and user experience enhancement.

3. Information Sharing and Disclosure

We do not sell, rent, or otherwise disclose your personal information to third parties, except:

• With Service Providers: To perform website-related services on our behalf, such as analytics, data storage, or email communications.

• Legal Requirements: When required by law, to protect our legal rights, or to ensure the safety of our users.

4. Security

We employ reasonable security measures to protect your information; however, no method of transmission over the internet or electronic storage is 100% secure. While we strive to use acceptable means to protect your data, we cannot guarantee absolute security.

5. Third-Party Links

Our website may contain links to third-party sites. We are not responsible for the content, privacy policies, or practices of these third-party sites.

6. Cookies

Our site may use cookies to enhance user experience, analyze usage, and improve our services. You may opt to disable cookies through your browser settings, but this may affect certain functionalities of the site.

7. Changes to This Policy

We reserve the right to modify this Privacy Policy at any time. Any updates will be posted here with an updated effective date.

8. Contact Us

If you have any questions about this Privacy Policy, please contact us at info@pinnacleapc.com.

Terms and Conditions

Effective Date: January 1, 2024

Welcome to www.pinnacleapc.com. By accessing or using this website, you agree to the following Terms and Conditions. Please read these terms carefully. If you disagree with any part, please refrain from using our website.

1. Use of Our Website

The information on this website is for general information purposes only and does not constitute medical advice. Use of this website is subject to these Terms and Conditions, and by using our website, you agree to comply with all applicable laws and regulations.

2. Intellectual Property

All content on this website, including text, images, logos, and trademarks, is the intellectual property of Pinnacle Advanced Primary Care, unless otherwise stated. You may not use, modify, reproduce, or distribute any part of this site without prior written consent.

3. User Conduct

You agree not to:

• Use the site in any way that could harm, disable, or impair its functionality.

• Attempt to gain unauthorized access to any part of the website.

• Post or transmit any content that is unlawful, harmful, or offensive.

4. Disclaimer

This website and its content are provided "as is" without warranties of any kind, either express or implied. Pinnacle Advanced Primary Care does not guarantee the accuracy, completeness, or reliability of the website content and disclaims liability for any errors or omissions.

5. Limitation of Liability

Pinnacle Advanced Primary Care shall not be held liable for any direct, indirect, incidental, or consequential damages arising from the use of this website or any linked third-party sites.

6. Changes to These Terms

We reserve the right to amend these Terms and Conditions at any time. Your continued use of the website constitutes your acceptance of the new terms.

7. Governing Law

These terms are governed by and construed in accordance with the laws of the State of Colorado. Any disputes arising from these terms shall be subject to the exclusive jurisdiction of the courts in Colorado.

8. Contact Us

For questions about these Terms and Conditions, please contact us at info@pinnacleapc.com.

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This notice describes how medical information about you may be used and disclosed

and how you can get access to this information. Please review it carefully.

OUR RESPONSIBILITY

Pinnacle Advanced Primary Care ("the Practice") is committed to protecting the privacy

of your medical information. Your care/treatment is recorded in a medical record that is

considered protected health information ("PHI"). To best meet your medical needs, we

share your PHI with the providers and facilities involved in your care. We share your

information only to the extent necessary to collect payment for services we provide and

to conduct our business operations. We train our employees, associates and providers

to be sensitive to the privacy and confidentiality of your PHI. Except as outlined below,

we will not use or disclose your PHI for any other purpose unless you have signed a

Medical Record Release Authorization form.

USES AND DISCLOSURE OF YOUR PHI

We may use and share your PHI in the following ways without requiring your

authorization. It should be noted that while not every use or disclosure will be listed,

each of the ways we are permitted to use or disclose information will fall into one of the

following areas:

• To provide, coordinate or manage your medical treatment and services. For

instance, doctors, nurses and other professionals involved in your care, will use

information in your medical record to plan a course of treatment for you that may

include procedure, medications, tests, etc. We may also disclose your PHI to

institutions and individuals outside of the Practice that are or will be providing

treatment to you.

To bill and receive payment for the treatment and services you received. For

instance, we may forward information regarding your medical procedures and

treatment to your employer to arrange payment for the services provided to you

or we may use your information to prepare a bill to send to you or to the person

responsible for your payment.

• To run our practice, improve your care, and contact you when necessary. For

example, we may use your PHI in order to conduct an evaluation of treatment

and services we provide.

• We may use your PHI to remind you about appointments and from time to time,

to communicate with you about treatment alternatives and other health-related

benefits and service that may be of interest to you.

• For workers' compensation or similar programs.

• For public health safety issues such as preventing disease, helping with product

recall, reporting adverse reactions to medications, reporting suspected abuse,

neglect, or domestic violence.

• For a health oversight agency.

• In response to a court order, subpoena, or warrant and to law enforcement

officials in certain limited circumstances.

RIGHTS THAT YOU HAVE

When it comes to your health information, you have certain rights. This section explains

your rights and some of our responsibilities to help you.

 

You can ask to see or get an electronic or paper copy of your medical record, by

filling out a Medical Record Authorization form and submitting it to our office. We

will provide a copy of your medical record within 30 days of your request.

You can ask us to correct your medical record if you think it is incorrect or

incomplete. You will need to complete a Health Information Amendment form

and submit it to our office. We may decline your request, but we'll tell you why in

writing within 60 days.

You can ask us not to share certain medical record information for treatment or

payment.

You can ask us to communicate with you by email or standard SMS messaging

• You can ask us to contact you in a certain way or at a certain location.

• You can ask for an accounting of the times we have shared your medical record

for the last 6 years, who we shared it with and why.

• You can ask for a paper copy of this notice at any time.

• You can choose someone to whom information may be disclosed or if someone

is your legal guardian, that person can make choices about your medical record.

BREACH NOTIFICATION

We are required to notify you in writing of any breach of your unsecured PHI as soon as

possible, but in any event, no later than 60 days after we discovered the breach.

At times it may be necessary for us to provide your PHI to one or more outside persons

or organizations who assist us with our payment/billing activities and healthcare

operations. In each case, we require these business associates and any of their

subcontractors, to appropriately safeguard the privacy of your information.

OUR NOTICE OF PRIVACY PRACTICE

We are required by law to maintain the privacy of our patients' PHI. We are required to

abide by the terms of this Notice of Privacy Practice so long as it remains in effect. We

reserve the right to change the terms of this Notice of Privacy Practice as necessary.

You may receive a copy of any revised notice at any of our clinic locations.

This Notice of Privacy Practice is effective June 1, 2021.

 

Pinnacle Advanced Primary Care, LLC, ("Practice") and

(Patient" hereby enter into this Direct Primary Care Membership Agreement ("Membership

Agreement) with the Effective Date indicated below. Practice and Patient are referred to herein

collectively as the "Parties."

1. Membership and Program Services.

a. DPC Program Membership. In exchange for Patient's payment of the Registration Fee

(as defined in Section 2.a.) and the periodic Monthly Membership Fee (as defined in

Section 2.b.), Patient is hereby enrolled as a member in the Practice's Direct Primary

Care Membership Program ("Program"), subject to the terms and conditions contained in

this Membership Agreement. As a member of the Program, Patient shall be eligible to

receive certain primary care medical services ("Services") provided at the Practice as

specified in Appendix A attached hereto and incorporated herein by reference. The

Practice will maintain a complete list of the Program Services on its website, available at:

T h e Practice may add or discontinue a service in Appendix A in its

sole discretion by updating the Practice's website of any change in the Program

Services as well as emailing Patient at least thirty (30) days prior to the change.

b. DPC not Concierge. This Agreement is for membership in the Practice's Direct Primary

Care (DPC) Program and is not an agreement for membership in a concierge program.

The difference between DPC and concierge is that DPC provides patients with certain

primary care medical services for the payment of a flat monthly fee. Concierge involves

patient's payment of a flat monthly fee to obtain immediate or priority access to a

physician but does not cover the cost of any medical services; patient's insurance is

billed for these medical services. Consequently, under this Agreement, Practice will

strive to see Patient in a timely fashion, including seeing Patients with acute issues

within 24-48 hours if medically necessary, excluding weekends, but Patient is not

entitled to immediate access to his or her physician whenever he or she s e e s fit, nor will

Patient be guaranteed to have his or her prescriptions refilled on the same day.

2. Fees.

a. Initial Registration Fee/Re-enrollment Fee. Each Patient shall pay to the Practice, on or

prior to the Effective Date, a one-time, non-refundable registration fee of seventy-five

dollars ($75.00) to cover the costs associated with Patient's initial enrollment into the

Program ("Registration Fee"). Patients under the age of eighteen who are enrolling

under a Family Plan or with another adult as discussed in Appendix B will not be

required to pay a registration fee. Likewise, Patients who turn 18 while enrolled in the

Program will not be required to pay an enrollment fee. In the event Patient terminates

this Membership Agreement, Patient will be ineligible to re-enroll in the Program for a

period of six (6) months following the effective date of termination. Notwithstanding the

preceding sentence, Practice, in its sole discretion, may allow Patient who has

terminated his or her Membership Agreement to re-enroll before the six (6) month period

has passed. Any re-enrollment after termination will require Patient to pay a re-

enrollment fee in the amount of one hundred and fifty dollars ($150.00 dollars) and sign

a new Membership Agreement.

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b. Monthly Fee. In addition to the Registration Fee, each Patient shall pay a Monthly

Membership Fee ("MMF") according to the fee schedule noted in Appendix B. This

MM wil be due at the time of enrollment and wil be setup by Patient as monthly

automatic payments, pursuant to Section 3 as part of the enrollment process. This MMF

will be due at the time of enrollment. Thereafter, the MM wil be due on the anniversary

date of each month thereafter until this Membership Agreement is terminated by either

Party according to the terms set forth in Section 13.

c. Additional Fees. Only those services described in Appendix A and not requiring an

additional fee are included in the MMF. Services described in Appendix A as requiring

the payment of an additional fee will require payment to the Practice at the time the

services are provided.

d. Changes to Fees. Practice may change the amount of the Registration Fee, the MMF,

any of the fees referenced on Appendix B, and the additional fees described in

Appendix A, or any other fees associated with this Membership Agreement at any time,

in its sole discretion, upon providing Patient at least thirty (30) days' advance notice by

emailing Patient.

e. Late Fees. If Patient's MMF is not made or fails for any reason when due, Patient agrees

to pay a late fee of fifteen dollars ($15.00) to Practice within fourteen (14) days of the

date Patient's MMF was originally due. This late fee will be collected from Patient via

automatic payment in accordance with Patient's automatic payment selection as

contained in Section 3 of this Agreement. If Patient fails to make the MMF payments

unpaid balance will be assessed interest at the rate of 18.00% (1.5% monthly). Last

year, Colorado passed SB23-093, Increase Consumer Protections for Medical

Transactions. Among the many provisions of this new law is the capping of interest

rates on medical debt at 3% per annum.

f. No-show Fees. If Patient is unable to attend his or her scheduled in-person or

telemedicine appointment, Patient is required to notify Practice at least 30 minutes prior

to the scheduled appointment. Failure to do so wil result in Patient being charged a

five-dollar ($5.00) no-show fee, which shall be collected by Practice prior to Patient's

next appointment. I revised this section and added when it will be collected.

3. Automatic Payment of Membership Fees.

a. Credit Card. If Patient chooses to pay the MMF by credit card, then Patient/Card Holder

agrees to complete the attached Appendix C providing Practice with credit card

information to allow Practice to make monthly recurring charges for the MM.

b. Checking Account. If Patient chooses to pay the MMF by checking account, then Patient

or the bank account holder or authorized signor to the account ("patient/authorized

signor") shall complete the attached Appendix D providing Practice with checking

account (Automated Clearing House) information to allow Practice to deduct the

recurring MM charges on a monthly basis. Patient/authorized signor acknowledges

that the origination of ACH transactions to patient/authorized signor's account must

comply with the provisions of U.S. law.

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c. Appearance and Recurring Debits. The MMF charge or debit will appear on card holder

or patient/authorized signor's bank statements as Pinnacle Advanced Primary Care.

Card holder or patient/authorized signor agrees that no prior notification will be required

unless the amount changes, in which case card holder or patient/authorized signor will

receive notice from Practice at least thirty (30) days prior pursuant to Section 2d of this

Agreement. Card holder or patient/authorized signor understands that this authorization

will remain in effect until Patient cancels this Agreement in writing in accordance with the

language in Section 13 of this Agreement. Card hold or patient/authorized signor agrees

to notify Practice in writing of any changes to card holder's credit card information or

patient/authorized signor's account information at least 15 days prior to the next billing

date.

d. Timing of Automatic Debits. If payment dates fall on a weekend or holiday, card holder

or patient/authorized signor understands that the payments may be executed on the next

business day. For credit card payments and ACH debits to a bank account, charges to a

card may be made and funds may be withdrawn as soon as the signed execution date of

this agreement.

e. Charge rejected due to NSF. If an ACH transaction is rejected for Non-Sufficient Funds

(NSF), patient/authorized signor understands that Practice may at its discretion attempt

to process the charge again within fourteen (14) days. Patient understands that he or

she will be charged the additional late fee in accordance with Section 2e above.

Charge/Debit Disputes. If Patient is not the individual named on the credit card or is not

the owner of the bank account from where the ACH debits will be processed, then

Patient certifies that he or she is authorized to utilize the credit card associated with

making the MMF payments or the bank account for ACH debits. Accordingly, Patient

agrees that patient/authorized signor or credit card holder will not dispute these

scheduled transactions with the bank or credit card company so long as the transactions

correspond to the terms indicated in this Agreement.

4. Duration. This Membership Agreement shall continue automatically every month until

terminated by either Party in accordance with the termination provisions of Section 13 of this

Membership Agreement.

5. Not Insurance. PATIENT ACKNOWLEDGES AND UNDERSTANDS THAT THIS

MEMBERSHIP AGREEMENT IS NOT A CONTRACT FOR HEALTH INSURANCE AND

DOES NOT MEET THE INDIVIDUAL HEALTH MANDATE UNDER FEDERAL LAW.

FURTHER, THIS AGREEMENT IS NOT GOVERENED BY THE COLORADO DIVISION

OF INSURANCE NOR DOES IT PROVIDE FOR HEALTH INSURANCE CONSUMER

PROTECTIONS UNDER TITLE 10 OF THE COLORADO REVISED STATUTES.

6. No Insurance Claims. Patient understands and agrees that Practice will not bill any

insurance carriers or health care plan to which Patient may be a subscriber or beneficiary for

Pace understan

the MMF or any additional fees associated with Membership and the Program Services.

Patient acknowledges that he or she is solely responsible for payment for all Services

Patient receives from Practice regardless of whether such Services are reimbursable or

payable by Patient's insurance carrier. Any amounts due for additional fees will be paid by

Patient at the time the services are rendered. Patient may ask Practice for an invoice for

those Services that require an additional fee to be paid so that he or she can submit a claim

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for reimbursement to Patient's Insurance carrier, if he or she believes the Services are

reimbursable.

7. No Government Healthcare Program Beneficiaries. Patient acknowledges and

understands that the Practice and its providers have opted out of participation in all

governmental healthcare programs (including, but not limited to Medicare, Medicaid,

TRICARE, SCHIP, VHA, HIS). This means that Practice cannot bill any of these

government healthcare programs on behalf of Patient nor can Patient make any attempt to

collect reimbursement from any of these programs. Patient is solely responsible for the

payment of the MM and any and all additional fees associated with the Program Services.

Further it is illegal for Health First Colorado recipients to enter into this Membership

Agreement for Program Services. Accordingly, Practice will not accept any Patient into the

Program who is a beneficiary of Health First Colorado and wil immediately terminate

Patient's membership if it is later discovered that Patient is a beneficiary of Health First

Colorado. Any Patient that is a Medicare Part B Beneficiary will need to notify Practice of

this fact and will be required to sign the Pinnacle Advanced Primary Care, LLC Medicare

Private Contract prior to receiving any services.

8. Tax-Advantaged Medical Savings Accounts. Some Patients may have tax-advantaged

savings accounts, including, but not limited to, health savings accounts, medical savings

accounts, flexible spending arrangements, health reimbursement arrangements, or other

similar health plans (collectively, "Tax-Advantaged Savings Accounts"). Because every Tax-

Advantaged Savings Account is unique, Patient is advised to consult with their accountant

regarding whether any of the fees incurred pursuant to this Membership Agreement may be

paid using funds contained in a Tax-Advantaged Savings Account.

9. Other Insurance; High Deductibles. Patient acknowledges that some services provided

herein may be a covered benefit or covered service, at no cost to Patient, under Patient's

health benefit plan. Further, Patient understands that third-party payers may not count the

Membership Fees incurred pursuant to this Membership Agreement or the fees associated

with excluded services toward any deductible Patient may have under a high deductible

health plan. Patient should consult with their health benefits adviser regarding whether

Membership Fees may be counted toward Patient's deductible under a high deductible

health plan.

10. No Emergency or Urgent Care. Patient acknowledges and understands that Practice is not

an emergency room or urgent care center, and accordingly, does not have the ability to treat

Patient during a medical emergency or urgent care situation. Patient is advised that if he or

she is experiencing a medical emergency or urgent care situation, Patient should contact

911 or go to the nearest emergency room to seek immediate treatment.

11. Virtual Visits. Virtual visits are an Included Service under this Membership Agreement but

are at the sole discretion of Practice as there are times when a virtual visit is not suitable

given the situation, which will require Patient to schedule an in-person appointment for

treatment. Patient understands and agrees, as a condition of membership in the Program, to

schedule an in-person appointment when directed by Practice.

12. First Visit and Annual Wellness Visit. While the Program includes virtual visits, patient

understands and agrees that, as a condition of membership in the Program, he or she will

schedule an appointment to be seen in person by Practice for an initial assessment/first

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visit. Thereafter, Patient agrees to physically visit Practice for an annual wellness visit at

least once per year following the anniversary of the Effective Date.

13. Termination. Patient or Practice may terminate this Membership Agreement at any time for

any reason or no reason at all, upon providing the non-terminating Party 30-days prior

written notice of such termination via CERTIFIED U.S. Mail or hand delivery a copy of which

must be signed by the non-terminating Party acknowledging receipt. Practice may terminate

this Agreement immediately without notice to Patient if Patient fails to pay his or her

Membership fees. Upon termination, Patient can utilize, for a fee, the services of Practice's

outside medical records copying service in the transfer of Patient's medical records to the

Patient's new primary care provider. Monthly Membership Fees will continue to accrue and

be due under this Agreement until Patient complies with the written notice requirements

pursuant to this Section 13.

14. HIPAA and Communications. Practice shall comply with the Health Insurance Portability

and Accountability Act of 1996 ("HIPAA") requirements including the privacy regulations,

security standards and the standards for electronic transactions. Patient's participation in the

Program and execution of this Agreement will provide Patient with the ability to

communicate with the Practice through the use of an encrypted portal. If Patient would like

for Practice to communicate with Patient outside of this encrypted portal, such as by regular

e-mail, texting and cell phone, Patient will be required to execute the Consent to

Unencrypted Email and SMS Messaging of PHI. This will authorize Practice and its staff to

communicate with Patient by e-mail and cell phone regarding Patient's "protected health

information" (PHI). Patient also understands and agrees that e-mail is not an appropriate

means of communication in an emergency for dealing with time-sensitive issues. In a n

emergency, or a situation in which could reasonably be expected to develop into an

emergency, Patient understands and agrees to call 911 or go to the nearest hospital as

opposed to emailing Practice or leaving a cell phone message.

15. Non-Protected Communication. I hereby authorize Pinnacle Advanced Primary Care and

its employees, agents, and assignees to contact me via e-mail, text messaging and to my

cellular devices using automated telephone dialing systems for the purposes of collections.

16. Code of Conduct. In order for Practice to provide a safe and healthy environment for staff,

patients and their families, Practice expects Patient and accompanying family members or

friends to refrain from unacceptable behaviors that are disruptive or pose a threat to the

rights or safety of other patients or staff. Accordingly, as a condition of membership in the

Program, Patient agrees to execute a copy of the Pinnacle Code of Conduct as part of the

onboarding process. Any violation of this Code of Conduct by Patient or his or her

accompanying family members or friends will result in Patient's immediate termination in the

Membership Program.

17. Indemnification. Patient agrees to indemnify and to hold Practice and its members,

officers, directors, agents, and employees harmless from and against all demands, claims,

actions or causes of action, assessments, losses, damages, liabilities, costs and expenses,

including interest, penalties, attorney fees, etc. which are imposed upon or incurred by

Practice as a result of Patient's breach of any of Patient's obligations under this Agreement.

18. Entire Agreement. This Membership Agreement constitutes the entire understanding

between the Parties hereto relating to the matters herein and shall not be modified or

amended except in a writing signed by both Parties hereto.

19. Waiver. The waiver by either Practice or Patient of a breach of any provisions of this

Membership Agreement must be in writing and signed by the waiving party to be effective

and shall not operate or be construed as a waiver of any subsequent breach by either

Practice or Patient.

20. Change of Law. If there is a change of any law, regulation or rule, federal, state or local,

which affects this Membership Agreement, any terms or conditions incorporated by

reference in this Membership Agreement, the activities of Practice under this Membership

Agreement, or any change in the judicial or administrative interpretation of any such law,

regulation or rule, and Practice reasonably believes in good faith that the change will have a

substantial adverse effect on Practice's rights, obligations or operations associated with this

Membership Agreement (a "Legal Change"), then Practice may, upon written notice, require

Patient to enter into good faith negotiations to renegotiate the terms of this Membership

Agreement. If the parties are unable to reach an agreement concerning the modification of

this Membership Agreement within ten (10) days after the effective date of the Legal

Change, then Practice may immediately terminate this Membership Agreement upon

providing written notice to Patient.

21. Dispute Resolution/Governing Law/Jury Waiver. Any dispute regarding this Agreement

shall be resolved first by mediation conducted in accordance with the Commercial Arbitration

Rules and Mediation Procedures of the American Arbitration Association ("AAA"). Each

Party shall bear its own costs of mediation and one-half of the mediator's and/or AAA's fees.

If the dispute is not resolved by mediation, the matter shall be settled by final and binding

arbitration before a single arbitrator in accordance with the rules of the applicable dispute

resolution organization. Any award by an arbitrator shall not include punitive or exemplary

damages. This Agreement and the rights and obligations of Practice and Patient hereunder

shall be construed and enforced pursuant to the laws of the State of Colorado. Patient

irrevocable submits to the exclusive jurisdiction of the state and county courts located in E

Paso County and agrees that all proceedings may be brought in such courts. EACH PARTY

TO THIS AGREEMENT ACKNOWLEDGES AND AGREES THAT ANY CONTROVERSY

WHICH MAY ARISE UNDER THIS AGREEMENT IS LIKELY TO INVOLVE

COMPLICATED AND DIFFICULT ISSUES, AND THEREFORE, EACH PARTY HEREBY

IRREVOCABLY AND UNCONDITIONALLY WAIVES ANY RIGHT TO A TRIAL BY JURY

IN RESPECT OF ANY LITIGATION DIRECTLY OR INDIRECTLY ARISING OUT OF OR

RELATING TO THIS AGREEMENT AND ANY OF THE AGREEMENTS DELIVERED

WITH THIS AGREEMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY OR

THEREBY.

22. Assignment. This Membership Agreement shall be binding upon and shall inure to the

benefit of the Practice and its respective successors, heirs and legal representatives.

Neither this Membership Agreement, nor any rights hereunder, may be assigned by Patient

without the written consent of Practice.

 

Appointments. All appointments will be at Practice's discretion and scheduling. Practice does

not provide walk-in urgent care services. Practice strives to see Patients in a timely manner

during normal business hours, which are M-F 9:00 am to 5:00 p.m. Same-day appointments

must be scheduled no later than 1:30 that afternoon. New Patients and Wellness visits will not

be scheduled for same day appointments and must be scheduled at least one week in advance.

For Patients with acute issues, Practice wil attempt to see Patients within 24-48 hours if

nedically n e c e s s a r y, excluding weekends. Outside of normal b u s i n e s s hours, Patients m a y call

or text the Practice's provider every day including holidays and weekends. Calls or texts will be

returned by Provider within 12 hours. In an emergency situation or anything that could possibly

be perceived as an emergency situation, Patients should proceed to the nearest emergency

room or call 911. In the event Practice's provider is unavailable either in person or via text or

phone, Practice will arrange for another licensed provider to address Patient's medical needs.

After-hour Communications. Outside of normal business hours, Patients may call or message

their provider every day including holidays and weekends for urgent/acute clinical concerns that

cannot wait until the next business day. Practice will make every effort to address Patient's

medical needs in a timely manner, but Practice cannot guarantee provider's availability, and

cannot guarantee that Patient will not need to seek treatment in an urgent care or emergency

department setting. Appointment requests, prescription refills, billing/membership issues and

routine health care concerns or questions will not be addressed outside of normal business

hours. Routine or continued disregard of this policy may result in termination of Patient's

membership in the Practice.

Emergency Care. In an emergent situation, or anything that could possibly be perceived as an

emergent situation, Patients should proceed to the nearest emergency room or call 911.

Ongoing Primary Care and In-Office Procedures. While there are no fees for office or virtual

visits associated with the Program Services, such as well child checks, sports physicals, weight

loss management and acute visits, there are some procedures, medications, vaccinations and

injections that require an additional fee to be paid at the time of service. These are detailed

below. The Practice does not perform FMCSA/DOT (Federal Motor Carrier/Department of

Transportation) physicals, disability determinations for insurance, social security, or ADA

purposes or Workman's Compensation visits.

Vaccinations. While the practice will advise Patients whether certain vaccines are necessary

and should be obtained by Patient, the administration of vaccinations are not offered by the

Practice at this time. The Practice will make every effort to assist Patient in obtaining medically

necessary vaccinations. Vaccines for Children (VFC) is a federally funded, nationwide program

available in Colorado that provides vaccines at no cost to children who might not otherwise be

vaccinated because of inability to pay. The Colorado Department of Public Health &

Environment has a mapper on their website that assists Patients in finding free vaccinations for

a d u l t s a n d children.

Family Planning. Practice will provide advice and consult on family planning issues. Practice

does not provide birth control pills but will provide Patient with a prescription that can be filled at

any pharmacy. For Patients who choose to use Long-Acting reversible contraception ("LARC")

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such as IUDs and Nexplanon devices, Practice will place these devices in Patient for an

additional fee of $65.00 but will not cover the cost of the IUD or Nexplanon device. Practice will

provide Patient with a prescription to obtain the IUD or Nexplanon device at Patient's own cost.

Once the prescription is paid for by the Patient and filled, the LARC be sent directly to Practice's

office. Once received, Practice will notify Patient of this fact and then schedule an appointment

for Patient to come in for placement. Practice will assist eligible Patients to apply for patient

assistance programs to offset the cost of LARC devices. Patients with insurance will need to

inquire of their insurance company to see if their benefits include LACR.

Labs. Most laboratory draws are performed off-site at outside laboratories, such as LabCorp or

Quest diagnostics. These outside laboratory testing services, which are ordered in the most

economical manner possible, are not included in the Monthly Membership Fee ("MMF") and

Patient will be responsible for paying the lab directly for these draws. If the cost of the lab is

covered by insurance, Patient may be able to have his or her insurance billed directly for the

cost of the labs.

Medications. Medications will be ordered in the most cost-effective manner possible for Patient.

Medications dispensed in the office are not included in the MMF and the cost will be due at the

time they are dispensed. Patient's membership in the Program does NOT guarantee

medications wil be prescribed or that certain medications wil be provided to Patient; the

Provider will do what is medically appropriate for the Patient in determining whether to prescribe

medication.

Pathology. Pathology examinations for procedures such as pap smears and skin biopsies are

not included in the MMF and will be ordered in the most economical manner possible. Patient

wil either be billed for these services by the outside pathology lab or wil be billed by the

Practice at the time the tissue sample is taken.