THE FEES DO NOT INCLUDE THE COSTS OF ANY PRESCRIPTION MEDICINES OR OTHER TREATMENTS THAT MAY BE RECOMMENDED/PRESCRIBED BY COMPANY OR THE PROFESSIONALS. I UNDERSTAND THAT I AM WHOLLY RESPONSIBLE FOR THE PAYMENT OF ANY SUCH DRUGS OR MEDICINES OR TREATMENTS.
The Fees set forth above may be changed by Company upon reasonable prior notice; in such event Client may cancel as set forth below prior to incurring the changed Fees. Company may, but is not required to, offer discounted Fees or types of incentives to Client from time-to-time. Company may also offer discounted Fees or other types of incentives to other customers of Company, without changing Client’s liability for the Fees incurred hereunder, it being explicitly agreed that Company is under no obligation to extend such other discounted fees or incentives to Client.
Client agrees and acknowledges the following regarding the Fees:
• No refunds will be issued for any Fees, no warranties of any type are associated with the Services, and by their nature the Services are not returnable;
• No other cancellation, refund, or return policy applies to the Services. The Client may cancel at any time by e-mailing firstname.lastname@example.org, or writing to 4308 Alton Road Suite 920, Miami Beach , Florida, 33140. Regardless of cancellation, no refunds will be issued; and
• Client acknowledges that Client is capable of printing and/or otherwise retaining a copy of this notice and Agreement, including the provisions set forth above regarding how the Client may cancel this Agreement.
Agreements Regarding the Services
Client agrees, and understands that the Services are unique and provided with certain benefits and limitations, including as follows:
1 Client agrees to be fully responsible, for payment of the Services, and understands that no Insurer reimbursement will be provided.
2 For Services provided herein, Client cannot, and will not, bill to or seek reimbursement from any Insurer in which Client is enrolled. Client agrees not to submit a claim (or request that Company or the Professionals submit a claim) for the services provided pursuant to this Agreement, to any Insurer.
3 Services are not covered and otherwise not reimbursable by any Insurer.
Accordingly, Client understands and acknowledges that the Services convey value and benefits that Client does not already receive from any Insurer in which Client is enrolled. To the extent any one or more element of the Services are considered covered and reimbursable benefits, the Fee is consideration for the remaining items/portions of the Services.
4 Client understands that no Insurer reimbursement limits (including Medicare’s limiting charge) apply to the services in question.
5 Client understands that Medi-Gap plans do not, and other supplemental insurance plans may not, make payment for the services because payment is not made under the Medicare program.
6 Client acknowledges that they have the right to have these items and services provided by other physicians for whom Insurers may make payments.
7 Client understands that Insurer payment will not be made for any items or services furnished by the physician that otherwise would have been covered by an Insurer if there was no private contract and a proper Insurer covered claim.
8 Client understands that he/she enters into this contract with the knowledge that he or she has the right to obtain Insurer covered services and items from other physicians, and