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Terms and conditions for Monthly Membership

Terms and Conditions of Medical Membership Program

1. MEMBERSHIP IS NOT AN INSURANCE POLICY:

  • Individual understands that they are purchasing a membership to an identified group in order to receive access to an affordable rate plan for medical services.
  • That membership rate plan is being offered by Davam Urgent Care clinics and covers services provided only at their clinic locations.
  • Member understands that this is NOT an insurance plan.
  • Member should not consider it to be an insurance plan or intend to use it as a substitute for an insurance plan.

2. DEFINITIONS:

  • Membership: For the purpose of these “Terms and Conditions”, membership is defined as an agreement entered into voluntarily by all parties. Terms of membership provide that for an established monthly rate, the member receives standard medical care as then provided in the normal course of business by Davam Urgent Care at a pre-established rate.
  • Member: The term which identifies the individual wishing to be provided with a membership to the Davam Urgent Care Medical Membership Program.
  • Minor: Will have the same meaning as that established by the State of Texas.
  • Dues: The monthly rate charged by Davam Urgent Care for inclusion in the Medical Membership Program.
  • Family Member: Immediate family members living in the home of the member (husband, wife, children and stepchildren under the age of 25).
  • Provider: Physician

3. MEMBERSHIP RESTRICTIONS:

  • A member’s privileges are subject to their having no outstanding amounts due to Davam Urgent Care.
  • Member must present a current picture ID in order to receive membership benefits.
  • Dues will be charged and deducted on a monthly basis.
  • Minors may not be seen by staff without parent or a legal guardian being present or having signed a consent form on file, or as defined by state law.
  • Membership rates and hours of use are subject to change without notice.
  • This membership is non-transferable.
  • New memberships must undergo a 24 hour processing time before becoming active.

4. MEMBERSHIP RATES:

  • Members choosing the Monthly Membership Plan will be responsible for dues of $35 per month, which will include a $30 signup fee.
  • Members choosing the Yearly Membership Plan will be responsible for dues of $299 annually.
  • Member will be responsible for a per visit utilization fee of $20 to be collected at the time of service.
  • Members who choose to add family members to their Monthly Membership Plan will be responsible for dues of $30 per month for each additional family member added to their account. The membership will not exceed $150 per family per month.
  • Members who choose to add family members to their Yearly Membership Plan will be responsible for dues of $299 annually for each additional family member added to their account. The membership will not exceed $1495 per family annually.
  • Primary member understands that they are responsible for payment of their dues as well as those of all other family members covered under their membership.

5. AUTOMATIC PAYMENTS:

  • Member understands their membership dues are paid by automatic withdraw/charge.
  • Member herein:

• Grants Davam Urgent Care permission to make such withdraws/charges.

• Agrees to provide Davam Urgent Care with accurate and valid account information to perform such withdraws/charges.

• Agrees to provide the identified entity (Bank, Savings Institution, etc.) from which these withdraws/charges are to be made with all notice and documentation that may be required.

6. TREATMENT INCLUDED IN MEMBERSHIP:

  • Only those healthcare services then provided by Davam Urgent Care in the normal course of business subject to the sole discretion of Davam Urgent Care.
  • Treatment that is currently included within the membership:
    • Urgent care office visits, laboratory tests performed on site at Davam Urgent Care (i.e. CBC, CMP, urinalysis, pregnancy test, strep screens, cardiac enzyme, flu screens), x-rays, EKG’s, IV fluid administration, nebulizer treatment, simple laceration repair, injections, injectable medicines, tetanus immunization, flu vaccines when available, splinting and office procedures that are then provided in our clinics.

7. TREATMENT EXCLUDED FROM MEMBERSHIP:

  • Member understands Davam Urgent Care:
    • Is a provider of non-emergent episodic care.
    • Provides services within a certain scope of healthcare and there are services Davam Urgent Care does not provide.
    • The list below includes most, but possibly not all, of the services that are not included under the terms of their membership.
  • Excluded services include, but are not limited to:
    • Prescription refill requests
    • On-going medical care.
    • Life threatening events such as gun shot wounds, heart attacks, serious infections, hospitalizations and treatment with other doctors or providers at another facility that is not Davam Urgent Care.
    • Special diagnostic studies such as outside labs, ultrasounds, doppler studies, mammograms, MRI’s, CAT scans, PET scans, and other special x-rays that are not provided at Davam Urgent Care.
    • Hepatitis immunizations, and any other immunizations not listed in “Included Services”.
    • Durable medical equipment (DME), physical and occupational therapy, chronic pain management, psychiatric emergency management, outpatient pharmacy, work injuries and other workers compensation services.
    • Weight management, and any emergency care that the attending physician believes should, in the best interest of the member, be provided by another facility or provider.

8. MEMBER USAGE:

  • Certain situations may require further medical attention including but not limited to: medical prescriptions, referral to a specialist, referral to a hospital, or treatment that is not included in your membership.
  • The cost of any charges associated with these additional services are NOT covered by this membership. Any such cost are the sole responsibility of the member.
  • Davam Urgent Care reserves the right, in its sole discretion, to cancel Membership for inappropriate use of the urgent care based services, including but not limited to request for services that are not then currently provided at Davam Urgent Care.
  • The attending physician will determine the appropriateness of members’ visit.

9. TERMINATION OF MEMBERSHIP:

  • Membership may be terminated by any of the following methods:
  • Member terminating account online. For which member will then be charged a $30 cancellation fee.
  • Members of the Yearly Membership plan will not be subject to any cancellation fee, as it is a one-time annual charge.
  • Member fails to allow Davam Urgent Care the authority to withdraw/charge the monthly fees.
  • Davam Urgent Care has the right to cancel any memberships at any time for any reason. Effective date will be the same as day of termination.
  • Falsification of identification or failure to pay will result in immediate termination of membership, assessment of utilization fee, full price charges for any services rendered, and the full pursuit of the legal rights held by Davam Urgent Care.

10. REACTIVATING A CANCELLED MEMBERSHIP:

  • A cancelled member, in good standing with Davam Urgent Care, may reactivate membership at any time, but will be charged the same fees and dues that apply to new membership.
  • Davam Urgent Care reserves the right to deny the renewal privileges of any membership terminated in accordance within the Terms and Conditions of membership.

11. CHANGES IN PERSONAL INFORMATION:

  • Members must inform Davam Urgent Care in a timely manner of all changes to billing information.
  • If Davam Urgent Care is not able to receive payment of monthly dues because of changes in billing information not being provided, account will be placed on hold until past balance of Dues and correct billing information is provided to Davam Urgent Care. Accounts that are on hold will be terminated after 3 months of inactivity.

12. WAIVER:

  • The failure by Davam Urgent Care to exercise or enforce any of the terms or conditions of this Terms and Conditions of membership is not to be deemed a waiver of Davam Urgent Care’s rights to enforce each and every term hereof. The failure by Davam Urgent Care to insist upon strict performance of any of the terms or conditions of the Terms and Conditions of membership will not be deemed a waiver of any subsequent breach or default in the terms or provisions herein.

13. ASSIGNMENT:

  • This Membership may not be re-assigned or transferred.

14. LIMITATION OF ACTIONS:

  • Any legal action against Davam Urgent Care for a default of its obligations to the member must be commenced within one (1) year from the date the default was, or should have been, discovered.

15. FORCE MAJEURE:

  • Davam Urgent Care is not liable for any delay or failure of performance caused by strikes, insurrection, war, fire, electrical failure, brown-outs, disruption of transmission lines, government acts or regulations, acts of third parties, or any cause not within the control of Davam Urgent Care.

16. GOVERNING LAW:

  • The validity, construction, and interpretation of this Agreement and the rights and duties of the parties hereto will be governed by the laws of Texas without regard to choice of law principles.

17. VENUE:

The exclusive venue for any litigation arising out of, or related to, these Terms and Conditions of membership will be Montgomery County and the state of Texas.

18. ADR CLAUSE:

If a dispute arises from or relates to these Terms and Conditions or the breach thereof, and if the dispute cannot be settled through direct discussions, the member and Davam Urgent Care agree to endeavor first to settle the dispute by mediation before resorting to arbitration. The member and Davam Urgent Care further agree that any unresolved controversy or claim arising out of or relating to these Terms and Conditions, or breach thereof, shall be settled by arbitration.

19. ENTIRE AGREEMENT:

  • These Terms and Conditions of membership constitute the entire agreement between the parties relating to the specific subject matter hereof. There are no terms, obligations, covenants, representatives, statements, or conditions other than those contained herein. No variation or modification of these Terms and Conditions of membership or waiver of any of the terms or conditions hereof, except that Davam Urgent Care may add or cease medical services it provides and included under the terms hereof, at its sole discretion will be deemed valid unless in writing and signed by both parties.

20. UNENFORCEABLE TERMS:

  • If any provision of these Terms and Conditions of membership is held invalid, illegal, or unenforceable, these Terms and Conditions of membership will be interpreted as if such provision, to the extent the same has been held invalid, illegal, or unenforceable, had never been contained herein.

21. SUCCESSORS:

  • These Terms and Conditions of membership shall be binding upon and inure to the benefit of the parties hereto and their respective heirs, successors, or executors.

22. NOTICES:

  • Any notice required or allowed to be given shall be addressed in a timely manner to the other party at the address set forth immediately below or to such other address as either party may instruct the other party in writing in accordance with this Section 21.

Davam Urgent Care

Medical Membership Program

6022 Farm to Market RD 1488

Magnolia, TX 77354