Please review these Terms carefully before using the Services. We may change these Terms or modify any features of the Services at any time. You accept the Terms by using the Services, and you accept any changes to the Terms by continuing to use the Services after we post the changes.
The Service respects and upholds patient confidentiality with respect to protected health information as outlined by the Health Insurance Portability and Accountability Act (HIPAA), and, subject to HIPAA regulations, will obtain express patient consent prior to sharing any patient-identifiable information to a third party for purposes other than treatment, payment or health care operations.
In addition, by clicking the “AGREE” button you are authorizing Providers to release your contact information to Telemedicine Group PC solely in order for Telemedicine Group PC to provide you with information about additional clinical services or general wellness. You may opt out of receiving such information by contacting us at Privacy@TeleMed2U.com. When using the Service you may be asked if you would like to share certain Protected Health Information (PHI) collected by third party platforms with Telemedicine Group PC. By clicking on “AGREE” you are authorizing Telemedicine Group PC to collect and Provider to utilize such PHI.
We are providing this information on behalf of Providers:
Telemedicine involves the use of audio, video, or other electronic communication to enable health care providers at sites remote from patients to provide medical consultative services, therapy, or treatment remotely. Video-conferencing technology will be used by your provider to facilitate the telehealth session. With your consent, the session may be recorded for quality review, operations, training, research, and safety purposes. The information may be used for diagnosis, therapy, follow-up and/or education, and may include live two-way audio, video, and other materials.
- Improved access to health care providers by allowing a patient to consult a provider from his or her home or office.
- Improved efficiency for access to medical evaluation and management.
As with any medical procedure, there are potential risks associated with the use of telemedicine. These risks may include, without limitation, the following:
- Technical problems: digital issues such as video quality, sound quality, or connectivity issues that may require an encounter to be rescheduled or referral to an in person appointment.
- Although measures are in place to prevent a breach of privacy, security protocols could fail, causing a breach of privacy of personal medical information.
By accepting these Terms, you acknowledge that you understand and agree with the following:
- I understand that a video consultation will not be the same as an in-person visit with a healthcare provider due to the fact that I will not be in the same room as my provider. Telemedicine may involve electronic communication of my personal medical information to medical practitioners who may be located in other areas, including out of state.
- I may ask my provider questions regarding the benefits and risks of telehealth and ensure those questions are answered to my satisfaction prior to receiving services.
- I understand that the laws that protect privacy and the confidentiality of medical information also apply to telemedicine; I have reviewed the HIPAA Notice.
- I understand that I may expect the anticipated benefits from the use of telemedicine in my care, but that no results can be guaranteed or assured.
- I understand that my healthcare information may be shared with others (including health care providers and health insurers) for treatment, payment, and healthcare operations purposes.
- I understand that I have the option to refuse the delivery of health care services by telehealth at any time without affecting my right to future care or treatment, and without risking the loss or withdrawal of any benefits to which I would otherwise be entitled.
- You may receive services from network providers on an in-person basis or via telehealth, if available. Contact your primary care provider, treating specialist, facility, or other health professional to learn whether telehealth is an option. Network telehealth and in-person services are subject to the same timeliness and geographic access standards. If your plan has out-of-network benefits, they are subject to your plan’s cost sharing obligations and balance billing protections.
- You may receive services from network providers on an in-person basis or via telehealth, if available. Contact your primary care provider, treating specialist, facility, or other health professional to learn more. Network telehealth and in-person services are subject to the same timeliness and geographic access standards. Although your plan has [no/limited] out-of-network benefits, if you use out-of-network services, you are subject to the plan’s cost-sharing obligation and balance billing protections.
- You may receive services from providers on an in-person basis or via telehealth, if available. Contact your provider, treating specialist, facility, or other health professional to learn more. Telehealth and in-person services are subject to the same timeliness and geographic access standards. You are subject to your Medicare Supplement plan’s cost-sharing obligations and balance billing protections.
- You have the right to access your medical records. Records of the care you receive from third-party corporate telehealth providers will be shared with your primary care provider (PCP). Your record will be made accessible in an electronic patient record system or provided in a different manner unless you opt out. Costs incurred for services received through the third-party corporate telehealth provider are available at in-network cost-sharing rates. Out-of-pocket costs shall accrue to any applicable deductible or out-of-pocket maximum.
- If you do not want a third-party telehealth provider to share information about the care you receive with your primary care provider, call the number on the back of your medical insurance card or contact us (your telehealth provider) at email@example.com to opt out.
- I further understand that my healthcare information may be shared in the following circumstances:
- When a valid court order is issued for medical records.
- Reporting suspected abuse, neglect, or domestic violence.
- Preventing or reducing a serious threat to anyone’s health or safety.
Patient Consent to the Use of Telemedicine
I have read and understand the information provided above, and understand the risks and benefits of Services. By accepting these Terms, I hereby give consent to telehealth as an acceptable form of delivering healthcare services to me and that this consent will cover any and all of my sessions using telehealth.