Individuals/Family Clients – The Term of the Care Package is 12 months, however either party may terminate the program by providing 90 days written notice.
In the event that participant provides notice of termination within 90 days of program initiation, and having received discounted service fees, they are ineligible to re-enroll for a period of 18 months.
Corporate Clients – The Term of the CarePackage is 12 months. Either party may terminate the program by providing notice 90 days prior to the renewal date.
Participant Responsibilities & Commitments
Participant agrees to and or acknowledges the following:
Participants will adhere to the policies and guidelines of the clinic.
Participants will present CarePackage ID card at registration for each visit.
Participant will provide updated personal and or health when necessary to Quick Doc.
Participant will pay for all services rendered during each visit prior to departure from the Clinic.
Participant is financially responsible to make each Monthly Participation Fee payment by the 1st of each month. Any payment received after the 1st of each month is considered late.
Participants are responsible for providing correct and complete information about their health and past medical history.
Participants are responsible for reporting changes in their general health condition, symptoms, or allergies to the responsible caregiver.
Participants are responsible for seeking clarification if they do not understand the planned treatment or their part in the plan.
Participants are responsible for following the recommended treatment plan they have agreed to, including instruction from providers and other health personnel.
Participants are responsible for keeping appointments.
Participants are responsible for conducting themselves in a respectful, non-disruptive manner while on clinic property. This includes use of personal cell phones, tablets or any other similar electronic devices.
Participants understands We are a No Smoking property. This includes the parking lot.
Participants are responsible for what happens if they refuse the planned treatment.
Participants are responsible for respecting the property and rights of others.
Participants are responsible for assisting in the control of noise and the number of visitors in their room.
Participants will NOT file any claims with any insurance company for any reimbursement related to services provided by Quick Doc while a participant in a CarePackage program. In addition, by enrolling in and while participating in a CarePackage program the Participant formally requests that QuickDoc not submit any claims to any payor (insurance company or third-party administrator) on behalf of the Participant. Furthermore, the Participant acknowledges and agrees that while they are participating in a CarePackage, Quick Doc is under no obligation or expectation to submit any claims to any payor.
Participant will provide an active working email address to use to register for included virtual Telehealth services.
Participant will download the app on their smartphone, computer or tablet to access the virtual urgent care Telehealth services. Participant will utilize the app to access all available virtual healthcare services
Billing
Monthly Participation Fees are outlined in the most current Pricing Exhibit, which may change from time to time with 30-days notice prior to renewal or following any material regulatory change impacting the cost of services provided.
To participate in the CarePackage program, a credit card must be provided at registration. The Participant must agree to recurring billing. By registering and participating in this CarePackage program the Participant agrees to allow Quick Doc to charge a recurring fee each month (or annually) to the credit card provided upon registration.
CarePackage Fees are due on the 1st of every month, and credit card on file will be automatically charged on that day. If the charge is declined for any reason, you will be required to bring your account to a zero-dollar balance before receiving any further services.
Services fees are quoted on a per service basis and each service is independent of the other.
All Services Fees are to be paid when services are received prior to departing the clinic.
Application Fees (“App Fees”) are a one-time fee unless there is a 3-month gap between monthly service fee payments. If 3 months lapses before the receipt of a monthly service fee payment, all applicable participants may be deemed inactive, at the sole discretion of Quick Doc. If Participant(s) is deemed inactive a new Application Fee will be required to reinstate active status.
Participants who come in for Pain Management or Behavioral Health office visits that include the prescribing of controlled substances are subject to increased office visit fees. Please see the applicable services fees
Service, Product, or Equipment Exclusions
Any and all services, products, and equipment and not explicitly identified in the listed above Included Services
Clinic Information
The Clinic is physically located at 3734 Reynolda Rd, Winston Salem, NC 27106. In the future we may add another other clinic in the local area.
Quick Doc operates family practices and urgent care clinics only. We do not offer any type of specialty healthcare services, emergency medicine, or surgical services.
Quick Doc clinicians may refer Participants to other healthcare practices for care/tests not provided at the clinic. The fees charged by these other healthcare practices is incremental and determined by those entities independent of Quick Doc.
Eligibility
Quick Doc’s CarePackages are not offered to any participants of a government sponsored health plan including any rail road, Medicare or Medicaid plan. Each participant must sign an addendum that acknowledges they do not (nor do they intend to) participate in any government health plan (“including any rail road, Medicare or Medicaid plan“) while they are participating in a CarePackage program. Any participant determined by Quick Doc to be participating in a government health plan will be immediately terminated from the CarePackage program.
Disclaimers / Caveats
All services provided will be consistent with the generally accepted principles of evidence-based medicine and in accordance with all applicable federal, state and local regulatory requirements and laws.
Quick Doc reserves the right to refuse to perform any service for any patient for any reason.
Any service not performed in the clinic or performed by a third party is not included in the CarePackages and is subject to being billed independently by the third party.
This is not insurance and is not a substitute for insurance as it does not include or cover ANY type of service(s) performed outside of our clinic(s).
*Injection Service Fees only apply to the administration of the injection. The cost of the medicine to be injected (“injectable”) is incremental and will be determined on a case by case basis if applicable.
Service Fee discounts do not apply to pharmaceuticals, physicals, or vaccines.
Quick Doc reserves the right to cancel, modify, revise or suspend the CarePackage program for any reason at any time without prior notice.
This is not a qualified health plan under the Affordable Care Act.
This plan does not meet the minimum essential coverage requirements under any state or federal laws.
This is not a Medicare prescription drug plan.
Clinic Access /Provider Availability
Quick Doc’s current office hours are Monday through Friday 8 AM to 5 PM Eastern Time and Saturday 9 AM to 2 PM Eastern Time. These hours are subject to change without notice.
In the event of an emergency please call 911 immediately.
In Clinic Service Limitations
Each Participant is eligible for up to 24 office visits per year. While we will make a reasonable effort to offer same day appointments, we cannot guarantee availability.
Each Participant will be eligible for and allowed one annual physical per 12 consecutive months unless more are determined necessary by a Quick Doc provider.
Each participant will be eligible for and allowed one annual Flu Shot per 12 consecutive months.
