Terms of Service (ToS)
Telemedicine Consult with Virtual Support
Scope of this Agreement
This TERMS OF SERVICE and any other documents referred to in it (hereinafter collectively referred to as this “ToS”) governs Services (as defined herein) offered by Wound Company Provider Group, Inc. a Pennsylvania professional corporation and its affiliates (collectively, “Medical Group”, “we”, “us” or “our”) that are used by any customers, subscribers, or other users (“you” or “Customers”) who subscribe or otherwise use any Medical Group Services (as defined herein).
IN ADDITION TO ANY OTHER PROVISIONS SET FORTH HEREIN OR IN MEDICAL GROUP’S NOTICE OF PRIVACY PRACTICES, YOU HEREBY ACKNOWLEDGE AND CONSENT THAT IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, YOU WILL SEEK IN-PERSON EMERGENCY CARE IMMEDIATELY OR DIAL 911. THE MEDICAL GROUP DOES NOT PROVIDE ACCESS TO URGENT CARE OR EMERGENCY CARE.
BY YOUR ACT OF CONTINUING TO USE ANY SERVICES (AS DEFINED HEREIN), INCLUDING WITHOUT LIMITATION BY YOUR ACT OF ENGAGING IN FURTHER COMMUNICATION WITH THE MEDICAL GROUP, YOU HEREBY AGREE TO BE BOUND BY ALL OF THE TERMS AND CONDITIONS OF THIS AGREEMENT AS IT IS PRESENTED TO YOU AS OF THE DATE OF YOUR FIRST USE OF ANY OF THE SERVICES (AS DEFINED HEREIN).
NO CHANGES (ADDITIONS OR DELETIONS) BY YOU TO THIS AGREEMENT WILL BE ACCEPTED BY MEDICAL GROUP. THUS, IF YOU DO NOT AGREE TO ALL THE TERMS AND CONDITIONS OF THIS ToS, THEN YOU SHOULD NOT USE OUR SERVICES AND SHOULD IMMEDIATELY DISCONTINUE ANY COMMUNICATION WITH THE MEDICAL GROUP.
THIS IS A LEGALLY BINDING CONTRACT. YOU SHOULD DOWNLOAD AND PRINT THIS AGREEMENT FOR YOUR RECORDS.
Description of Services:
Medical Group provides consultative services by clinicians that specialize in wound and ostomy care.
Medical Group’s clinical experts will assess and implement care, education and/or support for acute and chronic wounds, ostomies, and continence care. Medical Group provides services Monday through Friday from 8 AM to 4:30 PM CT. We do not provide skilled nursing services or on-call services outside the regular business hours.
These services are regularly provided virtually on behalf of home care, hospice, health plans, hospitals, and other healthcare organizations we contract with to serve patients directly. You are receiving this agreement because one such organization is providing our services to you under the contract they have with you and the contract that they separately have with us, the Medical Group. Said differently, we are providing services on their behalf. We, the Medical Group, want you to be aware of the terms and conditions that are unique to our supplemental services. This agreement does not change anything that has been agreed upon by you and other healthcare organizations related to your care or replace or modify any agreements between you and these other healthcare organizations.
The duration of the Medical Group’s services related to your incision, wound or ostomy is determined by the nature of the contract we have with the healthcare organization supporting you that is paying for our services for you.
You have access to clinical support via the Medical Group’s telemedicine platform, including text messages and video visits.
We will respond to your messages and questions within one business day on Mondays through Fridays from 8AM CT to 4:30PM CT, excluding weekends and holidays.
This Agreement covers non-emergent wound and ostomy care, not primary medical care. Wound Company Provider Group, Inc. (“Medical Group”) provides our patients with responsive, thoughtful, and high-quality wound and ostomy care related non-emergent medical services via telemedicine.
Patients requiring additional services such as home health aide, personal care attendants, physical, occupational or speech therapy, medication management, general skilled nursing or hospice care will be referred to agencies which provide these services, including the agency that may be contracting Medical Group to provide supplemental services.
Fees
You are not responsible for paying for our services at this time. The home care, hospice, health plan, hospital or other healthcare organization who we are representing and providing supplemental services on behalf of is paying for our services for you. The duration of our services is determined by our contract with them. If you would like to continue to receive services from us after this period, you will need to enter into a separate agreement with us for these services, which will be governed by its own terms and replace this agreement.
Expiration and Renewal
This Agreement has a term set by the healthcare organization paying for our services
This Agreement will expire at the point where our collaboration in your care as part of our contract with the healthcare organization furnishing us as resource to you expires. Often this is in less than thirty days from initial consultation and communication with you. If you reach out for support after this period, we will notify you of your options.
Consent to Care
The services to be provided to me by the Medical Group have been explained to me. I hereby consent to history and examination. I understand that the plan of care may change and that such changes will be discussed with me. Instructions for my care will be explained to me and will become my responsibility in the absence of a home care staff member in my home. As part of my care I consent to my health information being discussed through various channels of communication, including SMS, phone, email and real-time telehealth applications such as Zoom. I also consent to data being capture and images being taken of my wound or ostomy as part of my care and understand these images will be securely stored by the Medical Group and managed according to the Notice of Privacy Practices shared with me separately. I acknowledge that I have received, reviewed, and agree to all of the information in this document and the detailed Notice of Privacy Practices.
Not Emergency Care
IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, SEEK IN-PERSON EMERGENCY CARE IMMEDIATELY OR DIAL 911. THE MEDICAL GROUP DOES NOT PROVIDE ACCESS TO URGENT CARE OR EMERGENCY CARE.
No Minors
YOU MUST BE 18 YEARS OR OLDER TO USE OUR SERVICES. By using the Medical Group’s services, you represent and warrant that you are of legal age to form a binding contract with the Medical Group and meet all of the foregoing eligibility requirements. If you do not meet all of these requirements, you must stop using our services immediately.
Assignment
This Agreement is personal to each individual patient and may not be assigned by the patient.
Termination of this Agreement
Upon termination of this Agreement, you will have the right to the copies of your medical records with us. If you do not request the return of those records, we will keep them for seven years, after which time you hereby consent to our disposal of those records.
Exclusions and Caveats
This Agreement specifically excludes fees and costs incurred as part of any recommended consultation, diagnostic tests, prescription drugs, or any service or procedure performed by providers and personnel other than those at Medical Group.
Nothing in this Agreement and nothing in our statements to you shall be construed as a promise or guarantee about the outcome of any service rendered. We make no promises or guarantees regarding the outcome of services.
This Agreement shall be governed by Pennsylvania law.
Informed Consent to Telehealth
Medical Group offers certain medical services through telehealth technologies. Telehealth is a mode of delivering health care services via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of health care, while patients and their health care providers are in different sites. Telehealth involves the use of technology to enable remote communications between and among health care providers and patients. While telehealth may improve access to care and lead to more efficient diagnosis, treatment, and care management, there are certain potential risks associated with telehealth, as there are with any medical treatment or procedure. The potential risks associated with telehealth include, but are not limited to, insufficient transmission of information that does not allow for appropriate decision-making and diagnosis by the health care provider; delays in diagnosis, consultation, and/or communication due to deficiencies or failures of equipment or systems; failure of security protocols, resulting in a breach of privacy of personal health information; or adverse results or reactions due to lack of access to complete medical records.
By agreeing to this informed consent, you understand the following:
You understand that the details of your telehealth interaction, which may include oral, visual, and electronic communications between you and your health care provider, will become part of your medical records, as such details would for any other type of face-to-face interaction with a health care provider.
You understand that you have the right to withhold or withdraw your consent to the use of telehealth in the course of your care at any time, without affecting your right to treatment or care in the future.
You understand that it is your duty to inform your health care provider of your medical history and details regarding your condition in order for Medical Group’s health care providers to provide the best care possible.
You understand that you may expect certain anticipated benefits of the use of telehealth by your providers, but that no outcomes or results are guaranteed.
You understand that telehealth-based services may not be as complete or appropriate as face-to-face interactions under certain circumstances, and your health care provider may refer you to another provider for follow-up or additional care.
You understand that nothing within this consent precludes you from seeking or receiving in-person care if you choose, even after consenting to receive services via telehealth.
You acknowledge and agree that you have read and understand the information provided above regarding telehealth, including the potential risks. You acknowledge and agree that you have had the opportunity to discuss the use of telehealth with your Medical Group provider and to ask questions regarding the use of telehealth, and all of your questions have been answered to your satisfaction.
This Agreement contains the entire agreement between us. No other agreement, statement or promise made on or before the effective date of this Agreement shall be binding on the parties. This Agreement can be modified by subsequent agreement of the parties only by an instrument in writing to be discussed and signed by each of us or by an oral agreement to the extent that the parties carry it out. If any provision of this Agreement is held in whole or in part to be unenforceable for any reason, the remainder of that provision and the entire Agreement will be severable and remain in effect. You represent that you have had an opportunity to discuss this Agreement with all appropriate professionals and that you understand the meaning and effect of this Agreement.
You hereby consent to engaging in telehealth with Medical Group’s health care providers and authorize Medical Group’s health care providers to use telehealth in the course of your diagnosis and treatment, and agree to the terms of this Agreement set forth herein.
You herby consent to your personal health information being discussed and shared with you by SMS, phone, email and real-time telehealth applications such as Zoom. You also consent that the Medical Group may acquire and store relevant data and images of your incision, wound or ostomy to provide you with high quality care and document its services.
Furthermore, you acknowledge that you received a copy of Medical Group’s Notice of Privacy Practices, and you further acknowledge that a copy of the current notice and a copy of any amended Notice of Privacy Practices will be available at Medical Group’s website at www.thewound.co/privacy-policy.