Please ensure that you have read and Agree to the – Patient Contract below by making an online booking or using any of our services you are bound by our terms and conditions listed below:
*Mandatory Tick Box I acknowledge I have read and understood the Terms and Conditions by which I accept the services and charges of this Practice. I acknowledge that I am signing these terms and conditions voluntarily without being pressured to do so.
TERMS AND CONDITIONS AGREED TO BY PARENTS & LEGAL GUARDIANS
Acknowledge that I;
- Am aware that this Practice may not charge the rates that my Medical Aid has decided upon. We charge rates which are commensurate with SAMA Billing Codes and the skills and experience of our practitioners for the services we provide. For more information on the rates we charge please contact our rooms.
- Understand that my Medical Aid and plan of choice, may or may not cover all the fees charged by this Practice. For more information regarding which benefits your chosen Medical Aid plan includes and/or excludes please contact your Medical Aid Scheme.
- Accept that I am fully responsible for payment of services rendered and should I not pay timeously, understand that I will be liable for debt recovery costs on an attorney and own client scale. Even if you are insured by a Medical Aid or other third party. If your account is not paid after the 30 calendar days, we will, in terms of the National Credit Act, give notice of 20 working days that your account is in arrears. If you fail to settle your account within another 10 days, your account will be handed over for debt collection.
- Understand that our fees exclude the costs of the emergency rooms and hospital (admission, ward, ICU, theatre and other fees), anaesthetists, pathologists (for blood tests), radiologists (for X-rays and scans) and any other therapists that may be involved in your child’s hospital care. You must discuss the respective fees with these providers directly.
- Am aware that the Practice regrets that it cannot get involved in parental disputes with regards the financial aspects of healthcare provided to a child(ren). Unless a signature of the person responsible for the account, in terms of a parental agreement, is provided, the parent / guardian / caregiver who signs the Practice forms and accepts these terms and conditions will be held legally liable for the cost of healthcare provided and the account will be addressed to that person.
- Understand that this Practice takes the privacy of its patient/s seriously and has implemented reasonable security measures to guard against the unauthorised disclosure of my patient information.
- Acknowledge that my patient information may be disclosed by this Practice in response to a specific request by a law enforcement agency, subpoena, court order, or as required by law.
- Understand the implication and agree to the doctor and/or Practice disclosing my ICD10 diagnosis code(s) and charges, as is directed by my Medical Aid.
- If you feel that your Medical Scheme should have paid in full, you can approach the Principal Officer of the Medical Scheme. If not resolved, you can lay a complaint at the Council for Medical Schemes by fax: (012) 431 0608 or email: email@example.com. Please inform the Practice should you require assistance in this regard.
- We request 24 hours’ notice of cancellation of an appointment. Should we not be notified of your cancellation and you do not attend the appointment, you will be liable for 50% of the fees charged by the specialist for that consultation.
- We will do our best to render the services at the time we set. Our specialists may have to rush off to a child who may require urgent assistance or may be with a child that requires more time. Emergencies must, by law, get preference. By agreeing to our services, you agree to this uncertainty. We will, if possible, inform you if we run late.
- Confirm that I understand that in healthcare results cannot be guaranteed. Results also depend on how a child’s body reacts to treatment. You confirm that you understand that your own behaviour or that of a child may affect the outcome of the healthcare received.
- You agree to follow the instructions provided to you by the healthcare professionals and/or come for follow-ups, etc. If you do not do this, you undertake not to hold the Practice or its staff liable for any negative consequence. You have the right to ask questions and to have them answered. If you do not ask any questions, we will assume that you have understood and agree to what is being discussed.
- You and/or your family or other persons that come to the Practice should not harass the healthcare professionals and staff. They must be treated with respect. If not, we are permitted by law to refuse to treat or to continue to treat your child(ren). In such cases we will refer you to another Practice.
- If you are offered a alternative medicine at a pharmacy level, ask the pharmacist whether such substitution would be in your child’s best interest, or ask us at the Practice. Remember that the law only permits for generic substitution (the same molecule) and does not permit therapeutic substitution (another molecule). In general, science behind medicines is that one should not switch from one product to another, and one should take care before switching in babies and patients who are critically ill.
- I agree to newsletters and communication notices from this Practice.