Direct Primary Care Terms and Conditions
I acknowledge and understand that Direct Primary Care (DPC) is NOT insurance. This agreement does not provide comprehensive health insurance coverage, nor is it a contract of insurance, and provides only the health care services specifically executed by Inspire Health and Wellness, LLC for a single low-cost monthly fee.
I understand that Inspire Health and Wellness, LLC strongly recommends that I maintain health insurance for services not provided by this agreement in order to cover unpredictable and/or catastrophic expenses or medical services beyond the scope of those provided by Inspire Health and Wellness, LLC.
I further understand that to maximize member benefits I need to maintain monthly membership. Benefits of maintaining membership include low cost monthly fee, enhanced patient-to-provider relationship, office visits that are timely, un-rushed, and patient centered, the convenience of same or next day appointments when available, access to provider via phone calls, secure text or email, and video visits if clinically appropriate, annual labs (as deemed clinically pertinent by provider) included in membership, in house injections and treatments included with membership or at a low member’s only price.
Membership benefits do not include any services provided by other health care providers, institutions, or organizations. Specialist care, including OB, surgery, emergency department visits or emergency services, imaging, non-clinic lab testing, and medications prescribed are also not included.
Charge Responsibility: I understand and accept that I am responsible for all charges incurred for health care services provided by Inspire Health and Wellness, LLC. Inspire Health and Wellness, LLC will NOT bill insurance carriers for services provided. I acknowledge and understand that I am responsible for all charges incurred for services outside of Inspire Health and Wellness, LLC including but not limited to emergency department visits, hospital and specialist care, imaging and laboratory tests, equipment and medications.
Billing Details: I acknowledge that membership fees are due monthly on the day of the month that membership was initiated (if you sign up on 15th of the month then you will be charged monthly on the 15th). Membership fees apply to the entirety of the month without proration. In addition to the monthly membership fee, I acknowledge and agree to pay established charges related to hospital visits, skilled nursing, copies of medical records, home medical equipment, returned checks and other administrative and compensatory fees. These fees are available on request and are subject to change without notice.
Late Payments: If I am unable to pay my bill at the time of billing, I understand that the following will occur I will be charged a $15 late fee for EACH late payment. The late fee will be assessed on the 15th of each month.
Consecutive Late Payments: Members who miss payment for two (2) consecutive months will be terminated from the membership service agreement and will need to pay an additional $100 reinstatement fee AND must wait a minimum of 30 days for reinstatement.
Changes in services or fees: As Inspire Health and Wellness, LLC grows and adjusts to the needs of our patients, our community and the health care environment, it is possible that we will need to make changes to our services and fees. Inspire Health and Wellness, LLC reserves the right to change and/or discontinue services, change the fee schedule, or membership rates at any time. Members will receive written notice of at least sixty (60) days prior to changes taking effect.
No Show Fees: We know emergencies and unforeseen circumstances occur. Please make us aware of any appointment cancellations as soon as they are known or occur. All cancellations must be completed at least 24 hours prior to your appointment. If you do not show up for an appointment or are significantly late (more than 15 minutes) to the appointment, you may be charged a $25 fee for a missed visit. Exceptions to this fee may be granted at the discretion of the provider and based upon individual patient circumstance, scheduling, the needs of all patients, and the availability of the provider.
Termination: I acknowledge that membership in Inspire Health and Wellness, LLC is designed and intended to be continuous, though members may terminate their membership at any time. If a member terminates their membership at least twice annually they will have to wait six (6) months to reinstate their membership or pay $100 reinstatement fee. Inspire Health and Wellness, LLC will reimburse members any fees collected in advance for the months following termination of membership. All membership termination requests must be made in writing AND with at least 30 days’ notice before the next payment is scheduled to draft. Inspire Health and Wellness, LLC does not offer prorated refunds for partial months.
I acknowledge and understand that Inspire Health and Wellness, LLC may terminate my membership by providing me thirty (30) days written notice in accordance with the laws of the State of Mississippi. Inspire Health and Wellness, LLC will not terminate the membership agreement based on health condition or protected status.