Medical Terms of Service

Last Updated: April 21, 2022
For Regional Affiliated Partners, see Section 11

These Medical Terms of Service (“Medical Services Terms”) govern your use of the medical services, including the Telehealth Services described in more detail in Section 12 below (“Medical Services”) provided by Synergy Health 360 professional corporations and our affiliated medical services providers (“Synergy”, “we”, “us”, or “our”). In some regions, Medical Services, with the exception of TeleHealth services, are provided by Synergy Health 360 jointly with, and/or as affiliates or subcontractors for, other health provider entities, health systems or academic medical center partners (“Partners”). 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 “Synergy”, “we”, “us” or “our” means Synergy Health 360 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, including the Telehealth 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.

Synergy Health 360 is one of the organizations operated and managed by Synergy Physicians, along with any affiliated medical service providers, including providers of telehealth services. Synergy Health 360 provides medical services, including telehealth services. Synergy Health 360 also provides membership and other non-medical services to consumers, and the Membership Terms of Service govern your use of the services provided by Synergy Health 360. Please read the Membership Terms of Services carefully before using Synergy Health 360 services.

Please refer to our Notice of HIPAA Privacy Practices to learn how Synergy Health 360 collects, uses, shares and protects your Protected Health Information (as defined under the Health Insurance Portability and Accountability Act of 1996 or “HIPAA”).

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

Synergy Health 360 may modify these Medical Services Terms from time to time. We will notify you of material changes by posting the amended terms on the Synergy Health 360 website and the Synergy Health 360 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 Synergy Health 360 all applicable charges or co-payments associated with your insurance plan and/or 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 not covered by insurance (including your children or other family members as “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 Synergy Health 360 healthcare service provider (each, a “Provider”). You authorize Synergy Health 360 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. Synergy Health 360 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. Synergy Health 360 reserves the right to correct any billing errors or mistakes even if payment has already been requested or received.

Medical Services include remote visits with our providers. Remote visits are scheduled just like an in-office visit and provide the same service experience, with the exception that the remote visit is conducted remotely over a secure video and audio connection rather than in person. Remote or Telehealth visits are billable just like an in-office visit, if not at the same rate.

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 $25 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 Synergy Health 360.

You understand and agree that as part of providing Medical Services to you, your Protected Health Information (as defined by HIPAA), including test results, may be released to an online personal health record and via communication with Synergy Health 360’s healthcare team electronically (in accordance with our Notice of HIPAA Privacy Practices).

5. Service Termination

You may terminate your Membership and use of our Medical Services at any time. We may also terminate your Membership or use of our 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 our 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 our 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 in person or via TeleHealth (defined below); 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

Synergy Health 360 may, from time to time, with your consent, recommend complementary or alternative methods of treatment (“CAS” or Wellness Programs) in connection with the Medical Services. 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 Wellness Programs 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.
• Aesthetic treatments and all common side effects.
• Herbs and nutritional supplements recommended are traditionally considered safe in the practice of functional 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.

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 Synergy Health 360 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 Synergy Health 360 may send the following to you by email or SMS, or by posting them on your account 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 Synergy Health 360 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 admin@synergyhealth360.com or a letter to Synergy Health 360, 9070 E Desert Cove Ave #A102 Scottsdale, AZ 85260. You may also opt out of certain electronic communications through your account or by following the unsubscribe instructions in any communication you receive from Synergy Health 360. Your withdrawal of consent will be effective within a reasonable time after we receive your withdrawal notice described above.

Synergy Health 360 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.

9. Disclaimers

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.

Our 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 Affiliate Partners

Synergy Health 360 has affiliate partnerships with select health systems, providers and academic medical centers in many of our markets to provide Medical Services, with the exception of Telehealth Services provided by Synergy Health 360 per state.

You understand that if you elect or choose to obtain services from an affiliate partner or Medical Services 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.

12. Telehealth Services and Permission

Synergy Health 360 may provide certain Telehealth (defined below) services to you (the “TeleHealth Services”), together or separately from its regional affiliate partners. You consent to receive emails or SMS, or other electronic communications from Synergy Health 360 pertaining to your care and your health, which may include Protected Health Information. You understand that virtual encounters 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 Synergy Health 360 and the Telehealth Services Providers to record and process your personal details and medical data. You may withdraw these permissions at any time by no longer seeking Telehealth Services from Synergy Health 360.

“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. The Telehealth Services 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 the Telehealth Services, or that information transmitted through the Telehealth Services 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 Services, you will immediately contact your medical services provider and seek appropriate additional in-person medical care or emergency care, as appropriate.

The state in which you reside may also require us to provide additional notices to you or obtain additional consents from you regarding our TeleHealth Services. These notifications and consents are incorporated into these Medical Services Terms.

13. General Provisions

• These Medical Services Terms make up the entire agreement relating to your use of our Medical Services, and supersede all prior agreements relating to the subject matter hereof.
• We may change, suspend, or discontinue any of our 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 affiliate partners as 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 Services Terms directly as it deems necessary to enforce its rights or protect its interests in connection with these Medical Services Terms. You may not transfer any of your rights or obligations under these Medical Services Terms to anyone else without our consent. Synergy Health 360 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 terms@synergyhealth360.com.