Pivotal Health Terms of Service
Last updated: August 23, 2021
DO NOT USE PIVOTAL HEALTH’S SERVICES OR THE PIVOTAL HEALTH APPLICATION TO SEEK HEALTH CARE SERVICES FOR SOMEONE WHO IS UNCONSCIOUS, NOT BREATHING OR GASPING FOR AIR, EXPERIENCING AN ALLERGIC REACTION, HAVING CHEST PAIN, UNCONTROLLABLY BLEEDING, EXPERIENCING A BEHAVIORAL HEALTH EMERGENCY, OR ANY OTHER SYMPTOMS THAT REQUIRE IMMEDIATE OR EMERGENT MEDICAL ATTENTION. CALL 911 OR GO TO THE NEAREST EMERGENCY ROOM (ER) IMMEDIATELY IF YOU HAVE AN EMERGENCY MEDICAL NEED.
Pivotal Health, Inc., along with its predecessors, licensors, beneficiaries, and its affiliated health care practices and other health care practices with which Pivotal Health, Inc. may contract in the future (each, a “Practice,” and collectively, “Practices”), welcome you to download our proprietary mobile application software called “Pivotal Health™” (or the “Pivotal Health Application”). For purposes of this website and the Pivotal Health Application, Pivotal Health, Inc. and the Practice are sometimes collectively referred to as “Pivotal Health,” “we,” or “us.”
Please note, Pivotal Health provides non-emergent, mobile health care services at locations designated by its patients, and health care services delivered via telehealth.
1. Pivotal Health Application & Services
Congratulations on your decision to download the Pivotal Health Application. We are excited to bring you the Pivotal Health Application, an innovative platform that permits you to initiate and transmit a request for health care services to be provided the comfort and convenience of your specified location, such as your home, office, or workplace, including services delivered via telehealth. The provision of the requested health care services at the user-specified location, whether a house or otherwise, and whether delivered in-person or via telehealth, is referenced herein as a “House Call”.
The Pivotal Health Application is a platform that (1) allows you to request a House Call from Pivotal Health, (2) provides Pivotal Health the capability to respond and schedule a House Call for you, and (3) facilitates communication between you and the Providers by transmitting to the Providers the information you provide to Pivotal Health, including your personal and medical information. Pivotal Health will assess your request for a House Call and use your provided information to determine, in its sole and absolute discretion, whether or not it has an appropriate and available health care provider (a “Provider”) to respond to your request for Services at your requested location. In the event that the Pivotal Health sends a Provider, that Provider may, in his or her best judgment, based on information received prior to the House Call or during the House Call, determine that he or she is unable to provide treatment. The Providers are sometimes referred to herein as “Health Care Professionals.”
You understand that there may be no Health Care Professionals in your area. Neither your registration with the Pivotal Health Application, nor anything else contained herein guarantees, that any Health Care Professionals will be available to provide House Calls in your area.
Unless explicitly stated otherwise, any new features that augment or enhance the current Services shall be subject to this Agreement. You are responsible for all equipment necessary to access the Pivotal Health Application.
2. Your Privacy & Your Obligation to Provide Accurate Information
In order to obtain our Services you must provide Pivotal Health with certain personal information and register for an account. Additionally, you may also choose to provide Pivotal Health with access to your other health data or medical records. For example, you may choose to provide Pivotal Health with access to your electronic health data or electronic medical records that are created or save by third parties, such as Apple Health Record or Apple Health.
It is imperative that you provide accurate and truthful information during the registration process. By submitting the registration information requested you represent and warrant to us that all of the personal information you provide to Pivotal Health, both during the registration process or anytime thereafter, is true and correct to the best of your knowledge. We reserve the right to refuse your registration or to cancel your use of the Application and/or the Services if we determine that you have not provided complete and accurate information regarding your identity and/or have otherwise not provided accurate information.
You also agree that you will not choose or use a username that: (i) belongs to another person or is used with the intent of impersonating another person; or (ii) is subject to any rights of a person other than you without appropriate authorization. You may never use another person’s sign-in details to access the Application and/or Services.
3. Billing for Services
Pivotal Health is responsible for billing patients and patients’ health plans for the health care services rendered by our Health Care Professionals. Information regarding how Pivotal Health submits claims for reimbursement and your expected financial responsibility are summarized below. Pivotal Health makes no guarantee that a House Call will be covered by your health insurance. In addition, not all health plans are contracted with Pivotal Health. Ultimately, it is your responsibility to determine how your health insurance benefits apply to services provided by Pivotal Health.
- In-Network Coverage. If you are a participant in a health plan that has entered into a contract for reimbursement rates with Pivotal Health (an “In-Network Plan”), and your insurance coverage has been verified by Pivotal Health prior to your visit, then Pivotal Health will process all claims for reimbursement in accordance with its contract with the In-Network Plan. This means that Pivotal Health will seek to collect from your In-Network Plan that portion of Pivotal Health’s fee for which your In-Network Plan is responsible. Please note that you will still be financially responsible for any applicable copayments, co-insurance or deductibles, or for any services that are not covered by your In-Network Plan. Your credit card will be charged accordingly.
- Out-of-Network Coverage. If you not a participant in an In-Network Plan, are uninsured, or receive medical and/or health care services that are not covered by your In-Network Plan, then you will be financially responsible for the full payment of the standard rate of the Services. Your credit card will be charged accordingly.
You must be 18 years of age or older to use the Pivotal Health Application. By using the Pivotal Health Application and requesting a House Call you represent that you are at least 18 years of age.
- Minors and Patient with Legal Guardians. To request a House Call for a minor patient or an adult patient who has a legal guardian, you must be the legal guardian, or an individual with uncontested legal authority to arrange for and consent to the treatment of the patient. By using the Application and requesting a House Call for a patient that has a legal guardian, you represent that you have the legal authority to make that request and you guarantee that the legal guardian who can consent to the provision of health services to the patient will be physically present for the duration of the requested House Call. If a legal guardian is unable to be physically present at the house call, the legal guardian must provide Pivotal Health with prior, written authorization that identifies by name an individual who has the power and authority to consent to the treatment of the patient. If the required legal guardian is not present upon the Health Care Professional’s arrival at the House Call, or an authorization to consent to treatment is not received prior to the visit, then the requested medical care will not be provided and Pivotal Health will charge you a cancellation fee of no less than $99. Your credit card will be charged accordingly.
- Vaccine Protocols. For patients who are infants or children, we may require that you provide the complete vaccine record for the patient. Prior to the visit, please have the vaccine record available to give to the Health Care Professional. Please note that the Health Care Professionals will only provide care for children whose parents or legal guardians agree to follow the American Academy of Pediatrics’ (AAP) recommended vaccine schedule or catch-up on vaccines according to the Centers of Disease Control and Prevention’s (CDC) recommended schedule. The Health Care Professionals will not treat infants and children whose parents or guardians refuse routine childhood vaccinations. You agree that you will notify us immediately of any change in your eligibility to use the Services. Additionally, you agree to notify us immediately of any known or suspected breach of security or unauthorized use of your registration with Pivotal Health.
5. The Practices & Health Care Professionals
Pivotal Health performs thorough background checks on all Health Care Professionals that provide House Calls. All Providers are licensed and in current good standing with the applicable state licensing agency.
Consult with your current licensed health care provider as necessary and before seeking any new treatment or before you alter, suspend or initiate any change in your medical treatment, medication routine or health care related procedure or activity. Do not disregard medical advice issued to you by your regular licensed health care provider.
You may be required to review and accept a separate Patient Agreement. The Patient Agreement may include, but is not limited to, information regarding the medical services, payment requirements, assignment of benefits, indemnification, and information security, including the handling of your Protected Health Information.
6. Geo-Location Functionality
7. Additional Services and Terms
Some of the Services we offer may be subject to additional terms and conditions. Your use of such Services is subject to those additional terms and conditions, which will be provided to you before the affected Services are provided. Any such additional terms and conditions are incorporated into this Agreement by reference.
8. Charges; Credit Card Billing; Additional Purchases
There is currently no charge to download the Pivotal Health Application or to register for an account. However, in the future there may be charges for certain Services. Currently, all non-third-party billing (if applicable) will be handled by Apple® or Google® (depending upon which service you use and which version of the application you download). In the future we may ask for payment information from you directly and you will have the option to continue with Services or decline them at that time.
Through the Services, you may also be able to purchase certain goods or additional features or other services designed to enhance the performance of the Pivotal Health Application (“In App Purchase”). When you make an In App Purchase, you are doing so through Apple iTunes service and you are agreeing to Apple’s iTunes’ Terms and Conditions. Alternatively, depending on your operating system, you may be purchasing through the Google® Play service, and by doing so, you are agreeing to Google Play Terms and Conditions for purchases within an application.
During your use of the Pivotal Health Application and our Services, you also may occasionally be offered incentives or merchandise either directly from us or from third-parties that are not In App Purchases. Those purchases, if you agree to them, may require you to provide credit card or other transaction data to us or to third party providers in order to procure such items. We will only collect those details, if ever, for the sole purpose of fulfilling an order for products or services that you request. We may retain your credit card details in an encrypted file, however.
If you choose to cancel your registration, all you have to do is email email@example.com. Pivotal Health reserves the right, at its sole discretion, to reject users of its Services and the Pivotal Health Application, to the extent permitted by law.
10. Account Security
You are responsible for maintaining the confidentiality of your username and password that you designate during the registration process and you are fully responsible for all activities that occur under your username and password. You will immediately notify us of any unauthorized use of your username or password or any other known or suspected breach of security. We will not be liable for any loss or damage arising from your failure to comply with this provision. You should use particular caution when accessing your account from a public or shared computer or using unencrypted email to discuss private matters with a Pivotal Health representative, the Practices or any Health Care Professional, so that others are not able to view, record or intercept your password or other personal information. You have been informed of the risks of transmitting your personal information by an unsecured means.
Once it is received, your personal information and that of any minor for whom you are responsible is kept secure by us, in accordance with applicable law.
11. License and Limitations on Use
We grant to you a limited, personal, non-exclusive and non-transferable right and license to use the Pivotal Health Application. Unless otherwise specified in writing, the Pivotal Health Application is for your personal and non-commercial use. The Pivotal Health Application, including, without limitation, the content, metadata, design, organization, compilation, look and feel, the fitness and nutrition plans, the source, object and HTML code and all other protectable intellectual property available through the Services and/or comprising the Application (the “Proprietary Materials”) are the property of Pivotal Health or the property of our licensors and are protected by copyright and other intellectual property laws. All rights regarding the Proprietary Materials not expressly granted in this Agreement are reserved by Pivotal Health. Unless you have our written consent, you may not copy, reproduce, sell, publish, distribute, display, retransmit or otherwise provide access to the Proprietary Materials to anyone. You agree not to rearrange, modify, create derivative works using or reverse engineer the Proprietary Materials. You agree not to create, scrape or display our content for any purpose. You agree not to post any content from the Pivotal Health Application to weblogs, news groups, mail lists or electronic bulletin boards, without our written consent.
By using the Pivotal Health Application or the Services, you represent and warrant that any personal and/or health information you provide to Heal is true and accurate and that your use:
- Will be for lawful purposes only and never for sending or storing unlawful material or use for fraudulent purposes;
- Will not cause nuisance, annoyance, disruption, or inconvenience to any Pivotal Health representatives, or Health Care Professionals;
- Will not impair the proper operation of the network;
- Will only be through access points or wireless data account (AP) which you are authorized to use; and
- May incur standard messaging charges by your wireless provider.
12. Notice for Claims of Copyright Violations
If you believe that your work has been copied and posted on our website in a way that constitutes copyright infringement, you should provide our Copyright Agent with a written notice that sets forth the infringement details. To be effective, the notice must contain the following information:
- a description of the copyrighted work that you believe has been infringed;
- a description of the material that you claim is infringing the copyrighted work identified in #1, and a detailed description of where it is located on the Pivotal Health Application; your address, telephone number, and email address;
- a written statement by you that you have a good faith belief that the disputed use is not authorized by the copyright owner, its agent, or the law; and
- a statement by you, made under penalty of perjury, that the above information in your notice is accurate and that you are the copyright owner or authorized to act on the copyright owner’s behalf; and an electronic or physical signature of the person authorized to act on behalf of the owner of the copyright interest.
Please send the written communication to our Copyright Agent by email at firstname.lastname@example.org.
We reserve the right, in appropriate circumstances and at our discretion, to terminate the privileges of any account holder who repeatedly infringes the copyrights or other intellectual property rights of others.
13. User Conduct
We reserve the right to terminate your account if you misuse the Pivotal Health Application, our Services or our website, or if you violate this Agreement including, without limitation, the following rules of conduct:
You may not:
- Upload, post, or transmit to Pivotal Health or any Health Care Professionals by any means, or otherwise make available any content or materials that are unlawful, harmful, threatening, abusive, harassing, tortious, defamatory, vulgar, obscene, libelous, invasive of another’s privacy, hateful, or racially, ethnically or otherwise objectionable;
- Impersonate any person or entity, including another user of our Services, a Health Care Professional, or an employee of Pivotal Health, or falsely state or otherwise misrepresent your affiliation with a person or entity;
- Forge headers or otherwise manipulate identifiers in order to disguise the origin of any information transmitted;
- Upload, post, email, or otherwise transmit through the Application by any means, content, materials, or comments that could be characterized as “medical advice;”
- Attempt to interfere with or disrupt our servers or networks;
- Intentionally or unintentionally violate any applicable local, state, national or international law or any regulations having the force of law;
- Stalk or otherwise harass another user of our Services or any of our employees, or any Health Care Professionals;
- Solicit, collect or post personal data or attempt to solicit, collect or post personal data about other users, including usernames or passwords; or access or attempt to access another user’s account without his or her consent or, in the case of a patient with a legal guardian, including minors, , that of the legal guardian or other legally responsible entity.
14. Disclaimers of Warranties
YOU USE THE PIVOTAL HEALTH APPLICATION, THE SERVICES AND OUR WEBSITE AT YOUR OWN RISK. YOU FURTHER ACKNOWLEDGE THAT ANY HOUSE CALL THAT YOU SCHEDULE VIA THE PIVOTAL HEALTH APPLICATION IS AT YOUR OWN RISK. WE EXPRESSLY DISCLAIM ALL REPRESENTATIONS AND WARRANTIES ABOUT THE ACCURACY, COMPLETENESS, TIMELINESS OR EFFICACY OF THE CONTENT OF THE PIVOTAL HEALTH APPLICATION, AND ASSUME NO LIABILITY OR RESPONSIBILITY TO YOU OR ANY MINOR FOR WHOM YOU ARE RESPONSIBLE FOR ANY ERRORS, MISTAKES, OR INACCURACIES IN SUCH CONTENT OR IN THE SERVICES PROVIDED BY US, INCLUDING THE SERVICES, INFORMATION AND ADVICE PROVIDED BY A PRACTICE OR HEALTH CARE PROFESSIONAL OR THROUGH THE PIVOTAL HEALTH APPLICATION OR WEBSITE. YOU AGREE THAT YOUR ACCESS TO, AND USE OF, THE PIVOTAL HEALTH APPLICATION, OUR WEBSITE, ANY PRACTICE AND HEALTH CARE PROFESSIONALS AND THE CONTENT AND SERVICES AVAILABLE THROUGH THE FOREGOING IS ON AN “AS-IS”, “AS AVAILABLE” BASIS AND WE SPECIFICALLY DISCLAIM ANY REPRESENTATIONS OR WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, ANY REPRESENTATIONS OR WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NON-INFRINGEMENT. WE DO NOT WARRANT OR MAKE ANY REPRESENTATIONS REGARDING THE USE OR THE RESULTS OF THE USE OF THE PRODUCTS, OFFERINGS, CONTENT, AND MATERIALS AVAILABLE THROUGH THE PIVOTAL HEALTH APPLICATION OR OUR WEBSITE, INCLUDING WITHOUT LIMITATION THE AVAILABILITY, USE, OR RESULTS OF SERVICES PROVIDED BY ANY PRACTICE AND HEALTH CARE PROFESSIONALS. IF ANY APPLICABLE AUTHORITY HOLDS ANY PORTION OF THIS SECTION TO BE UNENFORCEABLE, THEN OUR LIABILITY AND RESPONSIBILITY WILL BE LIMITED TO THE EXTENT PERMITTED BY APPLICABLE LAW.
15. Limitation of Liability
YOU ACKNOWLEDGE AND AGREE THAT WE SHALL NOT BE LIABLE TO YOU OR ANY MINOR FOR WHOM YOU ARE RESPONSIBLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY OR PUNITIVE DAMAGES, OR ANY OTHER DAMAGES WHATSOEVER, INCLUDING BUT NOT LIMITED TO, DAMAGES FOR LOSS OF PROFITS, GOODWILL, USE, DATA OR OTHER INTANGIBLE LOSSES (EVEN IF WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES), ARISING OUT OF, OR RESULTING FROM, (A) THE USE OR THE INABILITY TO USE THE PIVOTAL HEALTH APPLICATION, SERVICES OR WEBSITE; (B) THE USE OF ANY CONTENT OR OTHER MATERIAL ON OR THROUGH THE PIVOTAL HEALTH APPLICATION, SERVICES OR WEBSITE OR ANY WEBSITES LINKED TO THE PIVOTAL HEALTH APPLICATION OR WEBSITE; (C) THE COST OF PROCUREMENT OF SUBSTITUTE GOODS AND SERVICES RESULTING FROM ANY GOODS, DATA, INFORMATION OR SITE PURCHASED OR OBTAINED OR MESSAGES RECEIVED OR TRANSACTIONS ENTERED INTO THROUGH OR FROM THE PIVOTAL HEALTH APPLICATION, SERVICES OR WEBSITE; (D) UNAUTHORIZED ACCESS TO OR ALTERATION OF YOUR TRANSMISSIONS OR DATA; (E) STATEMENTS, SERVICES OR CONDUCT OF ANY THIRD-PARTY ON OR THROUGH THE PIVOTAL HEALTH APPLICATION; OR (F) ANY OTHER MATTER RELATING TO THE PIVOTAL HEALTH APPLICATION, SERVICES OR THE WEBSITE. IN NO EVENT SHALL PIVOTAL HEALTH’S TOTAL LIABILITY TO YOU OR ANY INDIVIDUAL OR ENTITY FOR WHOM YOU ARE RESPONSIBLE FOR ANY AND ALL DAMAGES, LOSSES, AND CAUSES OF ACTION (WHETHER IN CONTRACT, TORT – INCLUDING, BUT NOT LIMITED TO, NEGLIGENCE – OR OTHERWISE) EXCEED THE AMOUNT PAID BY YOU TO US IN THE IMMEDIATELY PRECEDING TWELVE (12) MONTH PERIOD. IF ANY PORTION OF THIS LIMITATION OF LIABILITY IS FOUND TO BE INVALID, PIVOTAL HEALTH’S LIABILITY SHALL BE LIMITED TO THE FULL EXTENT PERMITTED BY APPLICABLE LAW.
You agree to defend, indemnify, and to hold harmless Pivotal Health, together with Pivotal Health’s officers and directors, from any and all liabilities, penalties, claims, causes of action, and demands brought by third-parties (including the costs, expenses and attorneys’ fees on account thereof) arising, resulting from or relating to: (a) your use of the Pivotal Health Application, Services or our website or your inability to use the Pivotal Health Application, Services or our website; (b) an allegation that you violated any representation, warranty, covenant or condition in this Agreement; (c) your intentional or negligent misrepresentation or misuse confidential or protected information. Your agreement to defend, to indemnify, and to hold Pivotal Health (and Pivotal Health’s officers and directors) harmless applies whether any claim against Pivotal Health is based in allegations of violation(s) of law or contract or tort (including strict liability), and regardless of the form of action, including but not limited to your violation of any third-party rights, a claim that the Pivotal Health Application, Services and/or our website caused damage to you or to any third party and/or your use and access to the Pivotal Health Application, Services and/or our website. This indemnification section shall survive your termination of or cessation of use of the Pivotal Health Application, Services and our website.
17. Third-Party Web Sites, Products and Services
18. Governing Law and Choice of Forum
This Agreement contains the final and entire agreement between us regarding your use of the Pivotal Health Application, the Services and our website for yourself, a member of your household or for any minor for whom you are responsible and supersedes all previous and contemporaneous oral or written agreements regarding your use of the foregoing. The provisions of this Agreement shall be severable, and if any provision of this Agreement is held to be invalid or unenforceable, it shall be construed to have the broadest interpretation, which would render it valid and enforceable. We may discontinue or change the Pivotal Health Application, Services and/or our website, or its/their availability to you, at any time. This Agreement is personal to you, which means that you may not assign your rights or obligations under this Agreement to anyone. You agree that this Agreement, as well as all claims arising from this Agreement will be governed by and construed in accordance with the laws of the State of Wisconsin, United States of America, without regard to any conflict or choice of law principles. The sole and exclusive jurisdiction and venue for any litigation arising out of this Agreement or in any way related to the Pivotal Health Application will be an appropriate federal or state court located in Madison, Wisconsin. This Agreement will not be governed by the United Nations Convention on Contracts for the International Sale of Goods.
Pivotal Health may assign its rights and obligations under this Agreement. This Agreement will inure to the benefit of Pivotal Health’s successors, assigns and licensees. The failure of either party to insist upon or enforce the strict performance of the other party with respect to any provision of this Agreement, or to exercise any right under the Agreement, will not be construed as a waiver or relinquishment to any extent of such party’s right to assert or rely upon any such provision or right in that or any other instance; rather, the same will be and remain in full force and effect.
21. Promotions and Offers
We may, from time to time, offer certain promotions as part of our services to users, and we encourage you to participate. However, unless explicitly stated otherwise, Medicare or Medicaid beneficiaries are not eligible to participate in any promotions or other offers. By accepting any promotional offer, you certify that you are not a Medicare or Medicaid beneficiary and agree to be bound by all the following additional terms.
Price discounts cannot be used together or combined with other discount offers or promotional offers. Promotional offers are intended for the addressed recipient only and cannot be transferred. If you are not the intended recipient, then the offer is null and void. We may request further information from you if you wish to participate in our promotions and offers. Participation in these promotions is completely voluntary. Therefore, you have the choice to decline to participate in any promotion where you are required to provide further information about yourself.
We are not responsible for any unauthorized promotions and offers offered by third parties through the Pivotal Health Application.
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Our mission is to deliver high-quality healthcare to consumers when and where they need it. Pivotal Health’s passionate and seasoned team has developed a scalable, technology-enabled platform to make healthcare more consumer friendly and easier to navigate.