Chronic Retainer For Care (CRFC) Terms of Service

Private Party terms of service:
• You may access the MyHomeAdvisor Private Party Programs by joining the Altruistic Congliere Services Private Membership Association agreement (step 1).
• As part of your private party enrollment, complete all forms provided to you via email and return them via USPS mail with your signed acknowledgment accepting our Terms of Service, which is this contract below, (step 2). This legally binding “Chronic Retainer For Care (CRFC) Contract (i.e. “terms of service”) will be saved in your private party program folder.
• Schedule your private party intake interview (step 3).

COPY, PASTE, SIGN, DATE & SEND to CRFC-Intake@MyHomeAdvisor.Consulting with "CRFC CONTRACT RETAINER" in subject line.

THIS 2-PARTY CONTRACTUAL AGREEMENT is made this day of , 20 (the “Effective Date”) by and between My Home Advisor; L.L.C. (hereinafter referred to as “MHA, us or we”) with it’s mailing office located at 15 W Fifth St., Tonasket WA 98855, (ACS”), and ____________________________, (hereinafter referred to as “you, private party, or your”).

Background:
MyHomeAdvisor (MHA) is a Limited Liability Corporation (L.L.C.), which provides a Chronic Retainer For Care (CRFC) service via private party direct pay for holistic and acute low acuity services. As a private party enrolled in the MHA-CRFC program, your MyHomeAdvisor will be accessible to you 24 hours a day / 7 days a week – 365 days per year for telephone triage, online consultation and in-home concierge services within North Central Washington State. In exchange for certain fees, MHA agrees to provide you with the MyHomeAdvisor services described in this contract on the terms and conditions contained in this contract.

Definitions:
1. Private Party: In this contract, “private party” is synonymous with patient meaning the persons for whom the MyHomeAdvisor shall provide advice and or care, and who have signed this contract or are listed on the document attached as Appendix 1, which is a part of this contract.
2. Services: In this contract, “services” means the collection of services offered to you by your MyHomeAdvisor in this contract. These services are listed in Appendix 1, which is attached and is part of this contract. Contract:
3. Term: this contract will last for 1 year from your signature today.
4. Renewal: the contract will automatically renew each year on the anniversary date of the contract, unless either party cancels the contract by giving 30 days’ written cancellation notice.
5. Cancellation: regardless of anything written above, you always have the right to cancel this contract. Either party can end this contract at any time by giving the other party 30 days’ written notice. If you decide to renew this contract in the future, you will be required to pay for intervening months between cancellation and renewal up to a maximum of 6 months. Acceptance of the “terms of service” constitutes the same as an initial for this item.
6. Payments and refunds: amounts and methods. In exchange for services (see Appendix 1), you agree to pay MHA a monthly fee in the amount that appears in Appendix 2, which is attached and part of this contract.
a. This monthly fee is payable when you sign the contract and thereafter on whatever day of the month that you choose as part of your member enrollment.
b. The parties agree that the required method of payment shall be by cash, check or automatic payment, through a credit or debit card, or direct transfer to the MHA Chronic Retainer For Care (CRFC) business account.
c. The parties agree that the required method of Acute Fee for Care (AFFC) services, beyond the CRFC contractual agreement, shall be paid by cash, check, credit or debit card, or direct transfer to the MHA Acute Fee For Care (AFFC) business account.
d. If this contract is cancelled by either party before the contract ends, we will review your account as follows:
i. We will refund to you the unused portion of your fees on a per diem basis. Acceptance of the “terms of service” constitutes the same as an initial for this item.
Or
ii. If the value of services you received over the term of the contract exceeds the amount you paid in private membership fees, you shall reimburse MHA in an amount equal to the difference between the value of the services received and the amount you paid in membership fees over the term of the contract. The parties agree that the value of the services is equal to the MHA usual Chronic Retainer for Care (CRFC) and/or Acute Fee for Care (AFFC) customary fee-for-services charges. A copy of these fees is available on request. Acceptance of the “terms of service” constitutes the same as an initial for this item.
7. Non-participation in insurance: Your initials on this clause of the contract acknowledge the private members’ understanding that neither My Home Advisor; L.L.C. nor its MyHomeAdvisor participate in any health insurance or HMO plans or panels. Neither
My Home Advisor; L.L.C. nor its MyHomeAdvisor make any representations that the fees paid under this contract are covered by the patient’s health insurance or other third party payment plans. It is the private member’s responsibility to determine whether reimbursement is available from a private, non-governmental insurance plan or HSA and to submit any required billing to their insurance for their personal reimbursement. Acceptance of the “terms of service” constitutes the same as an initial for this item.
8. Medicare: This contract acknowledges the private members’ understanding that neither My Home Advisor; L.L.C. nor its MyHomeAdvisors’ services are covered by Medicare/Medicaid, and as a result, Medicare/Medicaid cannot be billed for any services performed for the patient by the health care provider. The patient agrees not to bill Medicare/Medicaid or attempt to obtain Medicare/Medicaid reimbursements for any such services. If the patient is eligible for Medicare/Medicaid, or becomes eligible for Medicare/Medicaid during the term of this contract, then s/he will sign the Medicare/Medicaid Opt Out and Waiver Contract attached as Appendix 3 and incorporated by reference. The patient shall sign and renew the Medicare/Medicaid Opt Out and Waiver Contract every two years, as required by law. Acceptance of the “terms of service” constitutes the same as an initial for this item.
9. This is not health insurance: Your initials on this clause of the contract acknowledge your understanding that this contract is not an insurance plan or a substitute for health insurance. The private member understands that this contract does not replace any existing or future health insurance or health plan coverage that the patient may carry. The contract does not include hospital services, or any services not personally provided by My Home Advisor; L.L.C. or its MyHomeAdvisor. The private member acknowledges that My Home Advisor; L.L.C. or its MyHomeAdvisor hereby advises the patient to obtain or keep in full force health insurance that will cover the patient for comprehensive healthcare not personally delivered by My Home Advisor; L.L.C. or its MyHomeAdvisor for their clinic visits, hospitalizations and catastrophic events. Acceptance of the “terms of service” constitutes the same as an initial for this item.
10. Communications: The private member acknowledges that although My Home Advisor; L.L.C. or its MyHomeAdvisor shall maintain private party anonymity, communications with the My Home Advisor; L.L.C. or its MyHomeAdvisor using email, facsimile, video chat, cell phone, text, private message, direct message or other forms of electronic communication can never be absolutely guaranteed to be secure or confidential methods of communication. Acceptance of the “terms of service” constitutes the same as an initial for this item.
11. Records requests: The private member agrees that all MyHomeAdvisor records for services you have received are available to you upon written request to MHA by date of encounter(s). These copies will be provided at a cost of $0.25 per printed page with concurrence of your MyHomeAdvisor. Should the MyHomeAdvisor not agree with this request for your mutually contracted encounter documentation, an additional $0.75 will be assessed. All records requests will be processed within 30 days of initial request, or date of clarification of the request if applicable.
12. Change of law: If there is change of any relevant law, regulation or rule, federal, state or local, which affects the terms of this contract, the parties agree to amend this contract to comply with the law.
13. Severability: If any part of this contract is considered legally invalid or unenforceable by a court of competent jurisdiction, that part will be amended to the extent necessary to be enforceable and the remainder of the contract will stay in force as originally written.
14. Reimbursement for services rendered: If this contract is held to be invalid for any reason, and MHA is required to refund fees paid by you, you agree to pay MHA an amount equal to the fair market value of the medical services you received during the time period for which the refunded fees were paid. Acceptance of the “terms of service” constitutes the same as an initial for this item.
15. Amendment: No amendment of this contract shall be binding on a party unless it is in writing and signed by all parties, except for amendments made in compliance with section 11, above.
16. Assignment: This contract, and any rights you may have under it, may not be assigned or transferred by you.
17. Indemnification. You agree to defend, indemnify and hold harmless My Home Advisor; L.L.C., its MyHomeAdvisor and our affiliates, licensors, and third party service providers, and our and their respective officers, directors, employees, contractors, agents, licensors, suppliers, successors and assigns from and against any claims, liabilities, damages, judgments, awards, losses, costs, expenses or fees (including reasonable attorneys’ fees) arising out of or relating to your violation of these Terms of Service.
18. Arbitration Agreement. You and we each agrees that any and all disputes or claims that have arisen or may arise between you and us in connection with these Terms of Service or the MyHomeAdvisor Portal, including without limitation, federal and state statutory claims, common law claims, and those based in contract, tort, fraud, misrepresentation or any other legal theory, shall be resolved exclusively through final and binding arbitration, rather than in court. This agreement to arbitrate is intended to be broadly interpreted. The Federal Arbitration Act governs the interpretation and enforcement of this agreement to arbitrate.
19. Legal significance: You acknowledge that this contract is a legal document and gives the parties certain rights and responsibilities. You also acknowledge that you have had a reasonable time to seek legal advice regarding the contract and have either chosen not to do so or have done so and are satisfied with the terms and conditions of the contract.
20. Miscellaneous: This contract shall be construed without regard to any rules requiring that it be construed against the party who drafted the contract. The captions in this contract are only for the sake of convenience and have no legal meaning.
21. Entire contract: This contract contains the entire contract between the parties between the parties and replaces any earlier understandings and contracts whether they are written or oral.
22. No waiver: In order to allow for the flexibility of certain terms of the contract, each party agrees that they may choose to delay or not to enforce the other parties’ requirement or duty under the contract (for example, notice periods, payment terms, etc.). Doing so will not constitute a waiver of that duty or responsibility. The party will have the right to enforce such terms again at any time.
23. Jurisdiction: The contract shall be governed and construed under the laws of the State of Washington. All disputes arising out of this contract shall be settled via deliberation in a court of proper venue and jurisdiction for the Altruistic Consigliore Home Office in Okanogan County Washington.
24. Service: All written notices are deemed served if sent by first class U.S. mail to the address of the party written above.

Acceptance of the “terms of service” constitutes the same as your signature.

Acute Fee For Care (AFFC) Terms of Service

Private Party terms of service:
• You may access the MyHomeAdvisor Private Party Programs by joining the Altruistic Congliere Services Private Membership Association agreement (step 1).
• As part of your private party enrollment, complete all forms provided to you via email and return them via USPS mail with your signed acknowledgment accepting our Terms of Service, which is this same contract (step 2). This legally binding “Acute Fee For Care (AFFC) Contract (i.e. “terms of service”) will be saved in your private party folder.
• Schedule your private party intake interview (step 3).

ACUTE FEE FOR CARE (AFFC) SERVICE:
If you are in need of acute consultation, you will be paying an “acute fee for care” to schedule an acute consultation via phone, online consultation or Concierge Service to your home. This consultation may result in additional fee’s based upon the complexity of the encounter payable at the time of your encounter to include, but not limited to lab orders, imaging or advanced study orders, specialty referrals and medication prescribing. MyHomeMedical does not accept your insurance as payment, but CAN provide you with an itemized statement (via email or other means, at your request) that you may submit to your insurance carrier for your personal reimbursement. By clicking on ‘terms of service,” you are agreeing to pay for your initial acute fee for care scheduling cost (per preference) and any additional secondary charges which may result from your consultation encounter such as procedure, medication prescriptions, labs and or imaging orders, etc as discussed. Your credit/debit card will be run before performing any procedure, prescribing any medications, or placing any lab and or imaging orders.

COPY, PASTE, SIGN, DATE & SEND to AFFC-Contact@MyHomeAdvisor.Consulting with "AFFC CONTRACT" in subject line.

THIS 2-PARTY CONTRACTUAL AGREEMENT is made this day of , 20 (the “Effective Date”) by and between My Home Advisor; L.L.C. (hereinafter referred to as “MHA, us or we”) with it’s mailing office located at 15 W Fifth St., Tonasket WA 98855, and ____________________________, (hereinafter referred to as “you, private party, or your”).

Background: MyHomeAdvisor (MHA) is a Limited Liability Corporation (L.L.C.), provides an Acute Fee For Care (AFFC) service via private party direct pay for holistic and acute low acuity services.

Definitions:
1. Private Member: In this contract, “private member” is synonymous with patient meaning the persons for whom the MHM providers shall provide advice and or care, and who have signed this contract or are listed on the document attached as Appendix 1, which is a part of this contract.
2. Services: In this contract, “services” means the collection of services offered to you by MyHomeAdvisor in this contract. These services are listed in Appendix 1, which is attached and is part of this contract.

Contract:
3. Term: this Acute Fee For Care (AFFC) contract is valid for 7 days and will remain on record for 7 years for the 1 encounter you receive with your signature today.
4. Renewal: the contract will be renewed with each new Acute Fee For Care (AFFC) encounter scheduled.
5. Cancellation: once entered, there is no cancellation or refunds.
6. Payments: amounts and methods. In exchange for services (see Appendix 1), you agree to pay MyHomeAdvisor a one-time non-refundable scheduling fee in the amount that appears in Appendix 2, which is attached and part of this contract.
a. This scheduling fee is payable when you sign the contract.
b. Additional Acute Fee For Care charges may apply based upon the nature of the encounter and or complexity of the services provided to be determined at the time of service.
i. If the value of services you received over the term of the contract exceeds the amount you paid in the initial Acute Fee for Care (AFFC) Scheduling fee, you shall reimburse MyHomeMedical in an amount equal to the difference between the value of the services received and the amount you paid in membership fees over the term of the contract. The parties agree that the value of the services is equal to the MyHomeMedical usual Acute Fee for Care (AFFC) customary fee-for-services charges. A copy of these fees is available on request. Acceptance of the “terms of service” constitutes the same as an initial for this item.
c. The parties agree that the required method of Acute Fee for Care payment shall be by cash, check or automatic payment, through a credit or debit card, or direct transfer to the MyHomeMedical Acute Fee For Care (AFFC) business account.
7. Non-participation in insurance: Your initials on this clause of the contract acknowledge the private members’ understanding that neither MyHomeAdvisor nor its providers participate in any health insurance or HMO plans or panels. Neither My Home Advisor; L.L.C. nor its MyHomeAdvisor make any representations that the fees paid under this contract are covered by the patient’s health insurance or other third party payment plans. It is the private member’s responsibility to determine whether reimbursement is available from a private, non-governmental insurance plan or HSA and to submit any required billing to their insurance for their personal reimbursement. Acceptance of the “terms of service” constitutes the same as an initial for this item.
8. Medicare: This contract acknowledges the private members’ understanding that neither MyHomeAdvisor nor its providers’ services are covered by Medicare, and as a result, Medicare cannot be billed for any services performed for the patient by the health care provider. The patient agrees not to bill Medicare or attempt to obtain Medicare reimbursements for any such services. If the patient is eligible for Medicare, or becomes eligible for Medicare during the term of this contract, then s/he will sign the Medicare Opt Out and Waiver Contract attached as Appendix 3 and incorporated by reference. The patient shall sign and renew the Medicare Opt Out and Waiver Contract every two years, as required by law. Acceptance of the “terms of service” constitutes the same as an initial for this item.
9. This is not health insurance: Your initials on this clause of the contract acknowledge your understanding that this contract is not an insurance plan or a substitute for health insurance. The private member understands that this contract does not replace any existing or future health insurance or health plan coverage that the patient may carry. The contract does not include hospital services, or any services not personally provided by MyHomeAdvisor. The private member acknowledges that MyHomeAdvisor hereby advises the patient to obtain or keep in full force health insurance that will cover the patient for healthcare not personally delivered by the clinic, and for hospitalizations and catastrophic events. Acceptance of the “terms of service” constitutes the same as an initial for this item.
10. Communications: The private member acknowledges that although MyHomeAdvisor shall comply with HIPPA privacy requirements, communications with the MyHomeAdvisor provider using email, facsimile, video chat, cell phone, texting or other forms of electronic communication can never be absolutely guaranteed to be secure or confidential methods of communication. Communication through the patient portal secure, HIPPA compliant communication at all times, and therefore is the recommended mean of communication. Acceptance of the “terms of service” constitutes the same as an initial for this item.
11. Records requests: The private member agrees that all MyHomeAdvisor records for services you have received are available to you upon written request to My Home Advisor; L.L.C. by date of encounter(s). These copies will be provided at a cost of $0.25 per printed page with concurrence of your MyHomeAdvisor. Should the MyHomeAdvisor not agree with this request for your mutually contracted encounter documentation, an additional $0.75 will be assessed. All records requests will be processed within 30 days of initial request, or date of clarification of the request if applicable.
12. Change of law: If there is change of any relevant law, regulation or rule, federal, state or local, which affects the terms of this contract, the parties agree to amend this contract to comply with the law.
13. Severability: If any part of this contract is considered legally invalid or unenforceable by a court of competent jurisdiction, that part will be amended to the extent necessary to be enforceable and the remainder of the contract will stay in force as originally written.
14. Reimbursement for services rendered: If this contract is held to be invalid for any reason, and MyHomeAdvisor is required to refund fees paid by you, you agree to pay MyHomeAdvisor an amount equal to the fair market value of the medical services you received during the time period for which the refunded fees were paid. Acceptance of the “terms of service” constitutes the same as an initial for this item.
15. Amendment: No amendment of this contract shall be binding on a party unless it is in writing and signed by all parties, except for amendments made in compliance with section 11, above.
16. Assignment: This contract, and any rights you may have under it, may not be assigned or transferred by you.
17. Indemnification. You agree to defend, indemnify and hold harmless My Home Advisor; L.L.C., its MyHomeAdvisor and our affiliates, licensors, and third party service providers, and our and their respective officers, directors, employees, contractors, agents, licensors, suppliers, successors and assigns from and against any claims, liabilities, damages, judgments, awards, losses, costs, expenses or fees (including reasonable attorneys’ fees) arising out of or relating to your violation of these Terms of Service.
18. Arbitration Agreement. You and we each agrees that any and all disputes or claims that have arisen or may arise between you and us in connection with these Terms of Service or the MyHomeAdvisor Portal, including without limitation, federal and state statutory claims, common law claims, and those based in contract, tort, fraud, misrepresentation or any other legal theory, shall be resolved exclusively through final and binding arbitration, rather than in court. This agreement to arbitrate is intended to be broadly interpreted. The Federal Arbitration Act governs the interpretation and enforcement of this agreement to arbitrate.
19. Legal significance: You acknowledge that this contract is a legal document and gives the parties certain rights and responsibilities. You also acknowledge that you have had a reasonable time to seek legal advice regarding the contract and have either chosen not to do so or have done so and are satisfied with the terms and conditions of the contract.
20. Miscellaneous: This contract shall be construed without regard to any rules requiring that it be construed against the party who drafted the contract. The captions in this contract are only for the sake of convenience and have no legal meaning.
21. Entire contract: This contract contains the entire contract between the parties between the parties and replaces any earlier understandings and contracts whether they are written or oral.
22. No waiver: In order to allow for the flexibility of certain terms of the contract, each party agrees that they may choose to delay or not to enforce the other parties’ requirement or duty under the contract (for example, notice periods, payment terms, etc.). Doing so will not constitute a waiver of that duty or responsibility. The party will have the right to enforce such terms again at any time.
23. Jurisdiction: The contract shall be governed and construed under the laws of the State of Washington. All disputes arising out of this contract shall be settled in the court of proper venue and jurisdiction for the Altruistic Consigliore Home Office in Okanogan County Washington.
24. Service: All written notices are deemed served if sent by first class U.S. mail to the address of the party written above.

Acceptance of the “terms of service” constitutes the same as your signature.

By Demand Terms of Service

Private Partry terms of service:
• You may access the MyHomeAdvisor Private Party Programs by joining the Altruistic Congliere Services Private Membership Association agreement (step 1).
• As part of your private party enrollment, complete all forms provided to you via email and return them via USPS mail with your signed acknowledgment accepting our Terms of Service, which is this same contract (step 2). This legally binding “By Demand Contract" (i.e. “terms of service”) will be saved in your private party folder.
• Schedule your private party intake interview (step 3).

COPY, PASTE, SIGN, DATE & SEND to ByDemand@MyHomeAdvisor.Consulting with "By Demand CONTRACT" in subject line.

I. ADULT FEE FOR PHYSICAL GENERAL SERVICES AGREEMENT
This General Services Agreement made and entered in Okanogan County Washington, this day of , 20 by ____ (hereinafter referred to as “the Examinee”) and between My Home Advisor; L.L.C. (herein referred to as “the Contractor”).

WITNESSETH:
That for and in consideration of the mutual agreements set forth, the parties to this Agreement agree as follows:

Article 1 – Definition of Service. MyHomeAdvisor is an independent contractor, shall provide the following service as requested by examinee: ,

Article 2 – Fee for Service. The contractor agrees to provide such service as outlined in Attachment A and the examinee agrees to pay MyHomeAdvisor the sum of: $ at the time of service.

Article 3 – Indemnification Agreement. This Agreement is solely for the one-time services provided on this date. Further, the examinee agrees to indemnify and hold My Home Advisor; L.L.C and its MyHomeAdvisor harmless for any and all actions as this Agreement does not include responsibility for the implementation of any of the services or recommendations which may be made, and MyHomeAdvisor, shall not be responsible for any implementation of the services or recommendations which are inconsistent with the service provided, or any flawed implementation of the services or recommendations on the part of the examinee.

Due to the nature of the service being performed and the location, Contractor shall adhere to all privacy laws and state and federal laws pertaining to the protection of the individual’s personal and medical information. Likewise, the examinee agrees to protect the anonymity of MyHomeAdvisor.

IN WITNESS WHEREOF, the parties have caused this Agreement to be executed as of the day, month and year first above written.

Examinee Printed Name
Examinee Signature

II. CHILD FEE FOR PHYSICAL GENERAL SERVICES AGREEMENT
This General Services Agreement made and entered in Okanogan County Washington, this day of _ , 20_ by ________ (hereinafter referred to as “the Parent / Guardian”) of (hereinafter referred to as “the Examinee”), and between My Home Advisor; L.L.C. (herein referred to as “the Contractor”).

WITNESSETH:
That for and in consideration of the mutual agreements set forth, the parties to this Agreement agree as follows:

Article 1 – Definition of Service. MyHomeAdvisor is an independent contractor, shall provide the following service as requested by Examinee Parent / Guardian : _,

Article 2 – Fee for Service. The contractor agrees to provide such service as outlined in Attachment A and the examinee parent / guardian agrees to pay MyHomeAdvisor the sum of: $ at the time of service.

Article 3 – Indemnification Agreement. This Agreement is solely for the one-time services provided on this date. Further, the examinee parent / guardian agrees to indemnify and hold My Home Advisor; L.L.C. and its MyHomeAdvisor harmless for any and all actions as this Agreement does not include responsibility for the implementation of any of the services or recommendations which may be made, and MyHomeAdvisor, shall not be responsible for any implementation of the services or recommendations which are inconsistent with the service provided, or any flawed implementation of the services or recommendations on the part of the examinee parent / guardian.

Due to the nature of the service being performed and the location, Contractor shall adhere to all privacy laws and state and federal laws pertaining to the protection of the individual’s personal and medical information. Likewise, the examinee parent / guardian agrees to protect the anonymity of MyHomeAdvisor.

IN WITNESS WHEREOF, the parties have caused this Agreement to be executed as of the day, month and year first above written.

Examinee Parent / Guardian Printed Name
Examinee Parent / Guardian Signature