In-House Membership

AGREEMENT

• NOTICE: THIS AGREEMENT DOES NOT CONSTITUTE DENTAL INSURANCE, IS NOT A DENTAL PLAN THAT PROVIDES DENTAL INSURANCE COVERAGE, AND IS NOT INTENDED TO REPLACE DENTAL INSURANCE. THIS MEMBERSHIP PLAN WILL COVER ONLY LIMITED, ROUTINE DENTAL SERVICES AS DESIGNATED IN THIS AGREEMENT.
• Term. This Agreement will last for 12 months (1 year), starting on the date this agreement is signed. 
• Renewal. The Agreement will automatically renew each year on the anniversary date of the agreement unless either party cancels the Agreement by giving a 30-day written cancellation notice. If canceled, there is a 12-month waiting period before renewal is permitted. The parties agree that the required method of yearly payment shall be automatic payment, through a debit or credit card. 
• Termination. Regardless of anything written above, you always have the right to cancel this agreement. Either party can end this agreement at any time by giving the other 30 days written notice. The paid membership dues will be applied as payment towards those services, at the UCR rate. If canceled, there is a 12-month waiting period before renewal is permitted. 7. Payments and Refunds, Amount and methods. In exchange for the Services ( see Appendix A), you agree to pay US a yearly fee in the amount that appears in Appendix C, which is attached and part of this Agreement.
  • If this agreement is canceled by either party before the Agreement ends, we will review and settle your account as follows: We will refund to You the unused portion of your fees on a per diem basis; or If the value of the Services you received over the term of the Agreement exceeds the amount You paid in membership fees, You shall reimburse the Practice 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 Agreement. The Parties agree that the value of the services is equal to the Practice’s usual and customary fee-for-service charges.
• Non-participation in Insurance. Your signature on this clause of the Agreement acknowledges the Patient understands that neither the Practice nor its Dentists participate in any health insurance or HMO/DHMO plans or panels and cannot accept Medicare. We make no representations that any fees that You pay under 1 Membership Contract in this agreement are covered by your health insurance or other third-party payment plans. This membership plan CANNOT be combined with any dental insurance.
• This is not Dental Insurance. Your signature on this clause acknowledges your understanding that this Agreement is not an insurance plan or a substitute for dental insurance. You understand that this Agreement does not replace any existing or future dental insurance that You may carry. You may not use this Membership plan if you use a Dental Insurance Plan.
• Communications. The Patient acknowledges that although the dental practice shall comply with HIPAA privacy requirements, communications with the dentist using email, fax, video chat, cell phone, texting, and other forms of electronic communication can never be absolutely guaranteed to be secure or confidential methods of communication. As such, the Patient expressly waives the Dentist’s obligation to guarantee confidentiality with respect to the above means of communication. The patient further acknowledges that all such communications may become part of the dental record. By providing an email address in the attached Appendix B and/or during online enrollment, the Patient authorizes the dental practice and its Dentists to communicate with them by email regarding the Patient’s protected health information (PHI). The Patient further acknowledges that:
  • Email is not necessarily a secure medium for sending/receiving PHI and there is always a possibility that a third party may gain access: 
  • Although the Dentist will make all reasonable efforts to keep email communications confidential and secure, neither the Practice nor the dentist can assure or guarantee the absolute confidentiality of email communications.
  • At the discretion of the dentist, email communications may be made a part of the Patient’s permanent dental record; and
  • You understand and agree that email is not an appropriate means of communication in an emergency, for time-sensitive problems, or for disclosing sensitive information. In an emergency, or a situation that You could reasonably expect to develop into an emergency. You understand and agree to call 911 or go to the nearest emergency room and follow the directions of emergency personnel.
• Email usage. The dentist checks email frequently on weekdays, during business hours. If You do not receive a response to an email by the next business day, You agree that you will contact the dentist by telephone.
• Technical failure. Neither the dental practice nor the dentist will be liable for any loss, injury, or expense arising from a delay in responding to the patient when that delay is caused by technical failure. Examples of technical failures are (i) failures caused by an internet service provider, (ii) power outages, (iii) failure of electronic messaging software, or email provider, (iv) failure of the practice’s computers or computer network, or faulty telephone or cable data transmission, (v) any interception of email communications by a third party which is unauthorized by the practice; or (vi) Patient failure to comply with the guidelines for use of email and described in this Agreement.
• Dentist Absence. From time to time, due to vacations, illness, governmental mandate, or personal emergency, the dentist may be temporarily unavailable to provide the services referred to above in paragraph one. In the event of the dentist’s absence during usual clinic hours, Patients will be given the name and telephone number of an appropriate provider for the Patient to contact. Any treatment rendered by a non-Bruce, DMD, and Ririe, DMD DDS PA provider is not covered under this contract.
• Change of Law. If there is a change in any relevant law, regulation, or rule, federal, state, or local, which affects the terms of this Agreement, the parties agree to amend this Agreement to comply with the law.
• Severability. If any part of this Agreement 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. 
• Reimbursement for Services Rendered. If any part of this Agreement is considered invalid for any reason, and the practice is required to refund fees paid by You, You agree to pay the practice an amount equal to the fair market value of the dental services You received during this time period for which the refunded fees were paid. 
• Amendment. No amendment of this Agreement shall be binding on a party unless it is in writing and signed by all the parties. Except for amendments made in compliance with Section 12.
• Assignment. This Agreement, and any rights You may have under it, may not be assigned or transferred by You.
• Legal Significance. You acknowledge that this Agreement 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 Agreement and have either chosen not to do so or have done so and are satisfied with the terms of the Agreement.
• Miscellaneous. This Agreement shall be construed without regard to any rules requiring that it be construed against the party who drafted the Agreement. The captions in this Agreement are only for the sake of convenience and have no legal meaning.
• Entire Agreement. This Agreement contains the entire agreement between the parties and replaces earlier understandings and agreements whether they are written or oral.
• No Waiver. In order to allow for flexibility in certain terms of the Agreement, each party agrees that they may choose to delay or not enforce the other party’s requirement or duty under this agreement (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.
• Jurisdiction. This Agreement shall be governed and construed under the laws of the State of Idaho. All disputes arising out of this Agreement shall be settled in the court of proper venue and jurisdiction for the dental practice.
• Service. All written notices are deemed served if sent to the address of the party written above or appearing in Appendix B by first class U.S. Mail.