Effective Date: March 1, 2019
For Regional Partners, see Section 11
These Medical Terms of Service (“Medical Services Terms”) govern your use of the medical services (“Medical Services”) provided by One Medical professional corporations and our affiliated medical services providers (“One Medical”, “we”, “us”, or “our”). In some regions, Medical Services, with the exception of TeleHealth services, are provided by One Medical 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 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.
One Medical is affiliated with 1Life Healthcare, Inc. (“1Life”), where 1Life provides management and administrative services to One Medical. 1Life also provides membership and other non-medical services to consumers, and the Membership Terms of Service govern your use of the services provided by 1Life. Please read the Membership Terms of Services carefully before using 1Life’s services.
Please refer to our Notice of HIPAA Privacy Practices to learn how One Medical collects, uses, shares and protects your Protected Health Information (as defined under the Health Insurance Portability and Accountability Act of 1996).
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.
1. Updates to the Medical Services Terms
We may modify these Medical Service Terms from time to time. We will notify you of material changes by posting the amended terms on the One Medical website and the One Medical mobile application 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.
2. Your Financial Responsibility; Assignment of Benefits
You agree to pay One Medical 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 One Medical healthcare service provider (each, a “Provider”). You authorize One Medical 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. One Medical 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. One Medical reserves the right to correct any billing errors or mistakes even if payment has already been requested or received.
If you provide information about your health insurance or health plan, that will be deemed your authorization for us to submit claims for covered Medical Services to your health insurer or health plan. You hereby assign or otherwise authorize payment of medical benefits to us for the Medical Services provided to you or your Covered Family Member. You authorize the release of any medical or other information necessary to process any claims for the Medical Services provided. You further understand and accept your financial responsibility for any portion of the bill not covered by your health insurer or health plan. SUBMISSION OF CHARGES DOES NOT WAIVE OUR RIGHT TO SEEK PAYMENT DIRECTLY FROM YOU.
3. 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.
4. 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 One Medical.
You understand and agree that as part of providing Medical Services to you, your Protected Health Information (as defined by the Health Insurance Portability and Accountability Act (“HIPAA”)), including test results, may be released to an online personal health record and via communication with One Medical’s healthcare team electronically (in accordance with our Notice of HIPAA Privacy Practices).
5. 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.
6. Mental Health Services Disclaimer
Mental health services may involve discussing sensitive aspects of your life; you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, or helplessness. If at any point you experience significant increased distress or have thoughts of harming yourself or others, you agree to notify your mental health provider so that an appropriate level of support can be provided. Your mental health provider may utilize a set of psychological symptom questionnaires in order to assist with determining a diagnosis and track your progress in counseling, and may discuss the nature of these assessments and your results when applicable.
7. Complementary and Alternative Services Disclaimer
One Medical 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: acupuncture, moxibustion, cupping, electrical stimulation, Tui-Na (Chinese massage), Chinese herbal medicine, chiropractics, 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:
- Chiropractic care is generally considered to be a safe method of treatment, but it carries risks and may have side effects, including without limitation strokes, dislocations, and pains.
- Nutrition consultation services are not licensed by many states in the U.S. The methods of evaluation employed, which may include diet, supplementation, and assessment analysis, are not intended to diagnose disease.
- Acupuncture is generally considered a safe method of treatment, but it carries risks and may have side effects, including without limitation, bruising, numbness, or tingling near the needling sites that may last a few days, and dizziness or fainting. Unusual risks of acupuncture include, without limitation, spontaneous miscarriage, nerve damage and organ puncture, including lung puncture (pneumothorax).
- Bruising is a common side effect of cupping.
- Burns are also a potential risk of moxibustion.
- 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.
8. Consent to Electronic Communications
You agree that One Medical may send the following to you by email or by posting them on our website and mobile application: legal disclosures; these Medical Services Terms, Notice of HIPAA Privacy Practices; future changes to any of the above; and other notices, policies, communications or disclosures and information related to the Medical Services. You agree that One Medical may contact you via secure messaging, email, phone, text, or mail regarding the Medical Services. You consent to receive such communications electronically. You agree to update your contact information to ensure accuracy.
If you later decide that you do not want to receive certain future communications electronically, please send an email to firstname.lastname@example.org or a letter to One Medical, One Embarcadero, 19th Floor, San Francisco, CA 94111. You may also opt out of certain electronic communications through your account or by following the unsubscribe instructions in any communication you receive from One Medical. Your withdrawal of consent will be effective within a reasonable time after we receive your withdrawal notice described above.
One Medical 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.
TO THE MAXIMUM EXTENT NOT PROHIBITED BY LAW, EXCEPT IN CASE OF NEGLIGENCE OR WILLFUL MISCONDUCT, WE AND OUR AFFILIATES, PROVIDERS, EMPLOYEES, OFFICERS, DIRECTORS OR AGENTS WILL NOT BE RESPONSIBLE FOR ANY LOSS OR DAMAGE, INCLUDING PERSONAL INJURY OR DEATH, RESULTING FROM ANYONE'S USE OF OR INABILITY TO USE THE MEDICAL SERVICES.
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.
10. 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.
11. Regional Partners
One Medical has partnered with select health systems and academic medical centers in some of our markets. As the result, for Medical Services, with the exception of Telehealth services, in the following markets, these Medical Services Terms are modified as set for the below. Each of the Partners identified in this section is deemed to be a party to these Medical Services Terms, with the exception of Section 12 TeleHealth Services and Permission, as they relate to Medical Services provided by the Partner in the corresponding regions identified below.
Chicago - Advocate Aurora Health
One Medical has partnered with Advocate Aurora Health, Inc. and its applicable affiliates (“Advocate Health”) in Chicago. Specifically, you agree to pay Advocate Health for all Medical Services and you authorize Advocate Health to submit claims for covered Medical Services to your health insurer or health plan. You assign or otherwise authorize payment of medical benefits to Advocate Health for the Medical Services provided to you or your Covered Family Member. You also give permission to Advocate Health to medically care for you and your Family Member.
Los Angeles - Providence Health and Services
One Medical has partnered with Providence Health and Services - Washington and its applicable affiliates, including Providence Saint John’s Medical Foundation (“Providence”) in Los Angeles. Specifically, you agree to pay Providence for all Medical Services and you authorize Providence to submit claims for covered Medical Services to your health insurer or health plan. You assign or otherwise authorize payment of medical benefits to Providence for the Medical Services provided to you or your Covered Family Member. You also give permission to Providence to medically care for you and your Family Member.
Seattle - Providence Health and Services
One Medical has partnered with Providence Health and Services - Washington and its applicable affiliates, including Swedish Health Services (“Providence”) in Seattle. Specifically, you agree to pay Providence for all Medical Services and you authorize Providence to submit claims for covered Medical Services to your health insurer or health plan. You assign or otherwise authorize payment of medical benefits to Providence for the Medical Services provided to you or your Covered Family Member. You also give permission to Providence to medically care for you and your Family Member.
New York City - Mount Sinai
One Medical has partnered with Icahn School of Medicine at Mount Sinai (“Mount Sinai”) in New York City. Specifically, you agree to pay Mount Sinai for all Medical Services and you authorize Mount Sinai to submit claims for covered Medical Services to your health insurer or health plan. You assign or otherwise authorize payment of medical benefits to Mount Sinai for the Medical Services provided to you or your Covered Family Member. You also give permission to Mount Sinai to medically care for you and your Family Member.
New York State “Out-of-Network” Law
Mount Sinai and One Medical are participating providers in certain health plan networks in New York state. A list of the plans that we participate in can be found on Mount Sinai’s website.
You understand that One Medical providers may not participate in the same health plans and networks as the hospitals and facilities in the Mount Sinai health system even though we are affiliated with Mount Sinai. You can review and determine the providers who are within the Mount Sinai network by visiting https://www.mountsinai.org/find-a-doctor. You can also review and determine the health plans accepted by Mount Sinai hospitals and facilities by visiting https://www.mountsinai.org/about/insurance.
You understand that you may be billed separately by other providers or facilities if you receive additional services by other Mount Sinai providers or facilities outside of One Medical (such as laboratories). You understand that these other Mount Sinai providers may be outside of your health care plan network, and you can contact these providers regarding their health plan participation. You understand that if you elect or choose to obtain services from a provider that you know or who has been disclosed as not participating in your health plan network, you will be responsible for the charges billed by that provider to you. You further understand that you can request to see the estimated fees for healthcare services of providers who are outside of your health plan and/or network prior to receiving services.
San Diego - UC San Diego Health
One Medical has partnered with UC San Diego Health (“UCSD”) in San Diego. Specifically, you agree to pay UCSD for all Medical Services and you authorize UCSD to submit claims for covered Medical Services to your health insurer or health plan. You assign or otherwise authorize payment of medical benefits to UCSD for the Medical Services provided to you or your Covered Family Member. You also give permission to UCSD to medically care for you and your Family Member.
12. Telehealth Services and Permission
Separate from its regional Partners, One Medical may directly provide certain Telehealth (defined below) services to you. You consent to receive emails or other electronic communications from One Medical pertaining to your care and your health, which may include Protected Health Information. You understand that virtual encounters with One Medical’s Telehealth services via phone, email, video, or otherwise, could involve, and you hereby consent to the use of, automated tools for diagnosis, care, treatment or communication pertaining to healthcare matters. You also acknowledge that such virtual encounters may involve care by a variety of Providers, including Physicians, Registered Nurses, Nurse Practitioners, Physician Assistants, Nutritionists, Naturopathic Doctors, Therapists, and other support or medical personnel.
You give permission to One Medical and the Telehealth Providers (some of whom may be based outside of the U.S.) to record and process your personal details and medical data. By agreeing to these Medical Service Terms, you also give permission for that data to be transferred back to the U.S. You may withdraw these permissions at any time by no longer seeking Telehealth care from One Medical.
"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. Telehealth 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 Telehealth, or that information transmitted through Telehealth 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, you will immediately contact your medical services provider and seek appropriate additional in-person medical care or emergency care, as appropriate.
13. General Provisions
- These Medical Service Terms make up the entire agreement relating to your use of the Medical Services, and supersede all prior agreements relating to the subject matter hereof.
- 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.
- These Medical Services Terms do not confer any third-party beneficiary rights, except to Partners in the corresponding regions identified in Section 11. Each of the Partners is a third party beneficiary of these Medical Services Terms and shall have the right to enforce these Medical Service Terms directly as it deems necessary to enforce its rights or protect its interests in connection with these Medical Service Terms.. You may not transfer any of your rights or obligations under these Medical Services Terms to anyone else without our consent. One Medical 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 email@example.com.