Clinical Services and Practices Policies Agreement
General Information
Thank you for choosing Sunday Health. Sunday Cares, P.C. and its affiliated medical groups (collectively “Sunday Cares”, “we”, “our” or “us”) provide medical, nursing, and care support services through its engaged clinicians (collectively “Professionals”) with support from its technology and administrative partner, Sunday Health, Inc. (we refer to Sunday Cares together with Sunday Health, Inc. as “Sunday Health”). This Agreement describes Sunday Health services and clinical programs. It is important for you to read this document and discuss any questions you might have with us.
Our Services and Technology
Sunday Health primarily provides care via telehealth, and we offer in-person visits in Vienna, VA. Sunday Health does not offer in-home care services. Our programs are delivered through a secure online platform and other remote communication tools.
All clinical services are provided by licensed Professionals practicing within a group of independently owned and operated professional practices, including Sunday Cares, P.C. and its affiliated medical groups. Sunday Health, Inc. does not itself provide any physician, mental health or other healthcare provider services.
Telehealth Informed Consent - Risks and Benefits
Our Professionals may provide clinical services via telehealth through video sessions, phone calls and asynchronous messaging. Telehealth is a flexible and convenient way to get healthcare, but it may not be right for treating certain symptoms or illnesses that need an in-person clinician or urgent care visit. You should not use our services to replace your primary care provider; we encourage you to continue seeing (or start seeing) a primary care provider. If you are having a medical emergency, call 9-1-1 or go to the nearest emergency room.
As with any health service, there are potential risks associated with using technology for telehealth services. These risks include service problems due to technology or internet failures, not having enough information to make health care decisions, rare security errors, and other risks. These risks are inherent to telehealth.
Laws and protections for in-person medical visits also apply to telehealth visits. This includes confidentiality of information, access to medical records, and sharing of information that could identify you personally. You have a right to know who is attending each telehealth visit. You may decide that you do not want to use telehealth services at any time. This will not affect your health insurance benefits or your right to receive health care from health providers outside of our practice.
Recording of Visits
Sunday Health may securely record visits for quality and training purposes. The recordings are stored in a secure platform. The recordings are not part of your medical record and we do not share recordings of the visits with our patients. By signing this agreement, you give Sunday Health your consent to record and prepare transcriptions of sessions you attend with Professionals. You may withdraw this consent at any time by submitting a written withdrawal request to hello@sundayhealth.com.
Payment and Billing
Each of our bills must be paid by the date shown on the bill. Your insurance may cover some or all of our services. If you have to pay a deductible, copayment or coinsurance for your health care, the usual cost-sharing rules will apply. If you request, we will work with you to determine what your charges will be. If you choose to pay your bill using a credit card, you are authorizing us to charge the provided credit card for the agreed upon services and use your credit card details for future transactions on your account. You understand that by using a credit card you may be charged a credit card transaction fee.
You agree that all people or companies (Medicare, Medicaid, health plans and other third parties) who pay any part of your Sunday Health bill shall pay these amounts directly to Sunday Health. If you wish to use your insurance to pay for our services, you assign your right to benefits to Sunday Health. You agree that we may submit claims to these payors on your behalf. In the event any payor pays you directly, you agree to immediately pay such amounts to Sunday Health. You understand that you may be required to pay Sunday Health for costs not paid by your insurance, subject to applicable legal requirements.
Scheduling and Attendance
We understand you may have to reschedule or cancel an appointment from time to time. We ask that you notify us at least 24 business hours in advance of your scheduled appointment. If you repeatedly miss scheduled appointments, or if Sunday Health is unable to contact you for a period of time, you understand that you may be terminated from our programs and no longer have access to our Professionals.
Privacy Practices
We follow certain healthcare privacy and security protocols to protect your health information. We work hard to make sure that your personal information is secure. We use physical, electronic, and business security methods (such as encryption) customary among telehealth providers to help prevent access to your health information by people who should not see it. Despite our best efforts, we cannot promise that data sent over the Internet or through a data storage facility will be perfectly secure. So, although we try to protect your personal information, we cannot guarantee the security of any information you send to us. You can read more information about our use of health information and other personal information in our Notice of Privacy Practices (“NPP”). By signing this agreement, you acknowledge receipt of the NPP.
Sharing Information with Other Providers
We may share, in a HIPAA compliant manner, your health information with your primary care provider (PCP) and other healthcare providers for care coordination, payment, and treatment purposes, either directly or through health information exchanges. If you wish to opt out, please contact us.
Communications
As part of providing services, we may communicate with you, including for purposes such as appointment reminders, care-related messages, and announcements, using text messages and emails. Text messages and emails are not always secure because they travel over networks that we do not control. By signing this agreement and providing us your cell phone number and email address, you permit us to contact you by text message and email. You may also ask us to stop sending text messages at any time by contacting us at hello@sundayhealth.com. You understand that you may have to pay standard data and messaging costs (from your wireless provider) to receive text messages that we send to your mobile phone.
We recommend using our secure patient portal for sensitive information. If we contact you by phone and leave a voicemail, we will include only minimal necessary details to protect your privacy.
Remote Patient Monitoring, Chronic Care Management and Principal Illness Navigation Services
We will coordinate care and services for you in order to improve the clinical effectiveness of our programs. You will meet with our Professionals regularly to go over your health conditions and health goals. We perform chronic care management (CCM) services, which allows us to work with your other doctors and health care providers to help you improve your health.
For some of our programs, we may provide you with remote devices and equipment so that we can remotely monitor clinical and physiological data relating to your health on an ongoing basis as provided in your treatment plan (“Remote Physiologic Monitoring” or “RPM”) and provide you with telehealth and exercise services. Remote Physiologic Monitoring helps us more quickly and proactively assess your clinical needs and make recommendations aimed at improving your health.
We also perform Principal Illness Navigation (“PIN”) services for some patients, which are healthcare services that provide personalized support and guidance to patients with serious, high-risk medical conditions. PIN services aim to empower patients and their caregivers to navigate the healthcare system effectively, access appropriate resources, and improve their health outcomes.
RPM, CCM and PIN services are not emergency services, and your data will not be monitored 24/7. These services may or may not be covered by your insurance. If you are responsible for paying a deductible, copayment or coinsurance for your health care, the usual cost-sharing rules will apply for RPM, CCM, and PIN services. Some insurers and third-party payors, such as Medicare, will only pay for one health care provider or facility to give you CCM, RPM or PIN services during a calendar month. By signing this agreement, you agree to participate in our CCM, RPM and PIN services as ordered by your treating Professional. Your Professional will give you an opportunity to opt out if you do not wish to participate in CCM, RPM or PIN services.
Complaint Policy
All patients have the right to communicate grievances regarding their care. Should you wish to make a formal complaint about one of our Professionals, you may do so in writing and submit the concern to Sunday Health at complaints@sundayhealth.com.
You may also submit a complaint to your state’s applicable licensure board. We will provide you assistance in identifying the licensure board upon request.
Accessibility and Inclusion
Sunday Health is committed to accessibility and inclusion. If you require interpreter services or other accommodations, please let us know in advance.
Legal Authority for Consent
If you are providing consent on behalf of another individual, you certify that you have the legal authority to do so as the patient’s lawful personal representative. You must provide your name, relationship to the patient, and legal documentation.