Medical Terms of Service - Holtorf Medical Group/Dr. Kent Holtorf
These Medical Terms of Service (“Medical Services Terms”) govern your use of the medical services, including the Telehealth Services described in more detail in Section 12 below (“Medical Services”) provided by Holtorf Medical Group. In some regions, Medical Services, with the exception of TeleHealth services, are provided by Holtorf Medical Group jointly with, and as subcontractors for, a health system or academic medical center partner (“Partner(s)”). These Partner relationships are described in more detail in Section 11 below. If you are using Medical Services in a region identified in Section 11, the applicable Partner is also a party to these Medical Services Terms, and “One Medical”, “we”, “us” or “our” means One Medical professional corporations (and our affiliated medical services providers) and the applicable Partner, collectively. Please read the Medical Services Terms carefully before using the Medical Services. By using the Medical Services, including the Telehealth Services, you agree to be bound by these Terms. If you are accepting these Medical Services Terms for another person (“Family Member”) as such Family Member’s guardian, conservator, or custodian, and as parent of a minor child Family Member, you agree to the terms, conditions, and notices contained or referenced herein on behalf of such Family Member.
Please refer to our Privacy Policy to learn how Holtorf Medical Group collects, uses, shares and protects your Protected Health Information.
Please do NOT use the Medical Services, including the Telehealth Services, for emergency or urgent medical matters. For all urgent or emergency matters that you believe may immediately affect your health, you must immediately call 911 or go to the nearest emergency room or urgent care facility.
Updates to the Medical Services Terms We may modify these Medical Services Terms from time to time. We will notify you of material changes by posting the amended terms on the Holtorf Medical Group website at least thirty (30) days before the effective date of the changes. If we have your email on file, we will also notify you of material changes to the Medical Services Terms by email at least thirty (30) days before the effective date of the changes. Please make sure we have your current email address so that you will receive notice of any material changes. If you do not agree with the proposed changes, you should discontinue your use of the Medical Services before the effective date of the change. If you continue using the Medical Services after the effective date, you will be bound by the updated Medical Services Terms.
Your Financial Responsibility; Assignment of Benefits You agree to pay Holtorf Medical Group all applicable charges at the prices then in effect for the Medical Services provided to you or another person on whose behalf you are accepting these Medical Services Terms and/or payment responsibility (such as your children or other family members) (“Covered Family Member”). You will be charged for the Medical Services, including complementary and alternative services provided to you or your Covered Family Member by a Holtorf Medical Group service provider (each, a “Provider”). You authorize Holtorf Medical Group to charge your chosen payment method (your "Payment Method") for the Medical Services provided to you or your Covered Family Member. If your Payment Method is invalid at the time payment is due, you agree to pay all amounts due upon demand. The third party services provider who manages your Payment Method may impose terms and conditions on you, which are independent of these Medical Services Terms, and you agree to comply with all of those terms. Holtorf Medical Group may accumulate charges that you’ve incurred for the Medical Services and submit them as one or more aggregate charges during or at the end of each billing cycle. Holtorf Medical Group reserves the right to correct any billing errors or mistakes even if payment has already been requested or received.
Appointments: Missed/Late Cancellation You understand and agree that if you do not show for your appointment or you cancel your appointment with less than 24 hours’ notice, we may charge you a fee for a missed/late cancelled appointment.
Permission to Treat You give permission to the Providers to medically care for you and your Covered Family Member. You may withdraw this consent at any time by no longer seeking Medical Services from Holtorf Medical Group.
You understand and agree that as part of providing Medical Services to you, your Protected Health Information (as defined by HIPAA), including test results, may be released to an online personal health record and via communication with Holtorf Medical Group’s healthcare team electronically (in accordance with our Notice of HIPAA Privacy Practices).
Service Termination You may terminate your use of the Medical Services at any time by not using the Medical Services any more. We may terminate your use of the Medical Services at any time in our reasonable discretion, for causes including but not limited illegal conduct such as falsifying information to obtain controlled substances, abusive and threatening behavior, and continued refusal to pay for our services. We may terminate your use of the Medical Services by sending notice to you at the mail or email address you provided to us or by otherwise contacting you. If we terminate your use of the Medical Services, we will use reasonable effort to notify your insurer, if any.
Complementary and Alternative Services Disclaimer Holtorf Medical Group may, from time to time, with your consent, offer complementary or alternative methods of treatment (“CAS”) in connection with the Medical Services, which may include, but are not limited to: electrical stimulation, Chinese herbal medicine, and nutritional counseling. You must inform the Provider who is caring for you if you are or become pregnant, as this may affect your treatment protocol.
If you seek CAS treatment, you should also consult with a physician to be screened for any predispositions to injuries and risks in regard to any of the CAS treatments, to address serious health concerns, and to avoid any contra-indications, including:
Herbs and nutritional supplements recommended are traditionally considered safe in the practice of Chinese medicine, although some may be toxic in large doses. You acknowledge that you understand that some herbs may be inappropriate during pregnancy. Some possible side effects of taking herbs include, but are not limited to, nausea, gas, diarrhea, and hives. You acknowledge that you understand that the herbs should be consumed according to the instructions provided verbally and in writing. The herbs may have an unpleasant taste or smell.
You acknowledge that you understand that while this section describes some of the major risks of CAS treatment, it does not address all of them and other side effects and risks may occur.
You understand that the CAS modalities are not a substitute for conventional medical care and the CAS Providers cannot anticipate all possible risks and complications of treatment. You will immediately notify your CAS Provider of any unanticipated or unpleasant effects associated with any of your CAS treatments.
You hereby give consent to any of the CAS Providers at One Medical to assess and care for your present condition and any other future conditions for which you seek attention.
If you later decide that you do not want to receive certain future communications electronically, please send an email to info@holtorfmed.com or a letter to Holtorf Medical Group, 2232 East Maple Drive El Segundo, CA 90245. You may also opt out of certain electronic communications through your account or by following the unsubscribe instructions in any communication you receive from Holtorf Medical Group. Your withdrawal of consent will be effective within a reasonable time after we receive your withdrawal notice described above.
Holtorf Medical Group will need to send you certain communications electronically regarding the Medical Services. You will not be able to opt out of those communications – e.g., communications regarding updates to these Medical Services Terms or information about billing. Your withdrawal of consent will not affect the legal validity or enforceability of the Medical Services Terms provided to and accepted by, you.
The Medical Services are intended for use only within the United States and its territories. We make no representation that the Medical Services are appropriate, or are available for use outside the U.S. Those who choose to access and use our Medical Services from outside the U.S. do so on their own initiative, at their own risk, and are responsible for compliance with applicable laws.
Limitation of Liability TO THE MAXIMUM EXTENT NOT PROHIBITED BY LAW, IN NO EVENT WILL WE AND OUR AFFILIATES, PROVIDERS, EMPLOYEES, OFFICERS, DIRECTORS OR AGENTS BE LIABLE FOR ANY CONSEQUENTIAL, EXEMPLARY, INCIDENTAL, SPECIAL OR PUNITIVE DAMAGES, INCLUDING WITHOUT LIMITATION THOSE RELATING TO LOST PROFITS OR THE COST OF SUBSTITUTE PRODUCTS OR SERVICES ARISING OUT OF OR IN CONNECTION WITH THE MEDICAL SERVICES OR FROM THE USE OF OR INABILITY TO USE THE MEDICAL SERVICES, WHETHER BASED ON CONTRACT, WARRANTY, PRODUCT LIABILITY, TORT OR OTHER LEGAL THEORY AND EVEN IF WE HAVE BEEN INFORMED OF THE POSSIBILITY OF SUCH DAMAGES. SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR CONSEQUENTIAL OR INCIDENTAL DAMAGES, SO THE ABOVE EXCLUSION MAY NOT APPLY TO YOU.
Regional Partners Holtorf Medical Group has partnered with select health systems and academic medical centers in some of our markets to provide Medical Services, with the exception of Telehealth Services. As a result, for Medical Services, with the exception of Telehealth Services, in the following markets, these Medical Services Terms are modified as set forth below.
You give permission to Holtorf Medical Group and the Telehealth Services Providers to record and process your personal details and medical data. You may withdraw these permissions at any time by no longer seeking Telehealth care from Holtorf Medical Group.
"Telehealth" is the delivery of healthcare services using technology when the healthcare provider and patient are not in the same physical location, and/or the virtual delivery of healthcare services, including by a medical provider or via digital or automated tools, including without limitation tools for medical or health-related diagnosis and treatment. The Telehealth Services may be used for diagnosis, treatment, care, follow-up and/or patient education, and may include, without limitation, the following: electronic transmission of patient medical records, medical images, and/or other patient data or information; synchronous (i.e., "real time") and asynchronous (i.e., non-"real time") interactions via audio, video, text, and/or data or other electronic communications; automated, electronic or digital tools or services for diagnosis, care, treatment and/or communication pertaining to healthcare or medical matters; and output, transmission or exchange of data from medical devices, sound and video files. Further, you understand that it may be possible that your condition cannot be treated via the Telehealth Services, or that information transmitted through the Telehealth Services may not be sufficient or of too poor of image quality, or insufficient information or data to allow for appropriate medical decision making. Accordingly, you may be required to seek additional in-person medical care, alternative healthcare or emergency services. If your health or medical problem or condition persists after use of Telehealth Services, you will immediately contact your medical services provider and seek appropriate additional in-person medical care or emergency care, as appropriate.
We may change, suspend, or discontinue any of the Medical Services at any time. We will try to give you prior notice of any material changes to the Medical Services. We will not be liable to you or to any third party for any modification, suspension or discontinuance of the Medical Services. We may change, suspend, or discontinue any of our partnerships, including health system partnerships, at any time. We will provide you with notices of such changes as applicable.
You may not transfer any of your rights or obligations under these Medical Services Terms to anyone else without our consent. Holtorf Medical Group may assign our rights in connection with a merger, acquisition, or sale of assets, or by operation of law or otherwise.
Even after termination, these Medical Services Terms will remain in effect such that all terms that by their nature may survive termination will survive such termination.
If you have any questions about these Medical Services Terms, please contact info@holtorfmed.com.