Terms and Conditions

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Payment Terms

You agree to pay all fees for your Telemedica Services in accordance with the fees, charges, and payment terms in effect at the time a fee or charge is due and payable. All pricing terms are confidential, and you agree not to disclose them to any third party.

You should be aware that Telemedica may use a third-party payment processor (Square) to process fees. The processing of payments or credits in connection with your use of Telemedica services will be subject to the terms, conditions, and privacy policies of the payment processor (Square) and your credit card issuer in addition to this Payment Terms Agreement. Telemedica is not responsible for any errors by the Payment Processor or your credit card issuer.

You understand and agree that for services provided on an appointment basis, if you fail to properly cancel a scheduled appointment at least 72 hours in advance of the appointment or if you fail to attend the appointment, you will be responsible for a missed appointment fee. (See "Missed Appointment Policy")

You understand that Independent Medical Opinions (IMO's), Nexus Letters, and/or any other requested documentation will only be provided to you by Telemedica after full payment of the fee has been received.

For mental health appointments, you understand that you will be matched with a provider licensed in the state you choose upon booking. You need to be physically located in the state at the time of the appointment otherwise, you will be charged a $50 rescheduling fee.

Telemedica charges and collects a portion OR all the fee in advance for the use of all Telemedica Services. Fees for other services will be charged on an as-quoted basis and billed to you directly or charged to your card on file. Telemedica's prices are exclusive of all taxes or duties imposed by taxing authorities, and you shall be responsible for payment of all such taxes or duties.

You agree to provide Telemedica with complete and accurate billing and contact information. This information includes your legal name, e-mail address, street address, and telephone number. You agree to update this information immediately upon any change to it. If the contact information you have provided is false or fraudulent, Telemedica reserves the right to terminate your Telemedica service in addition to any other legal remedies. All transactions will be billed in United States Dollars (USD).

If you believe your invoice/bill is incorrect, you must immediately contact us in writing regarding the amount in question to be eligible to receive an adjustment. You waive your right to challenge the accuracy of any bill or otherwise obtain an adjustment to any bill, if you fail to notify Telemedica in writing within seven (7) calendar days after your receipt of the invoice, indicating that you believe the bill is inaccurate (with an explanation of why).

Fee Disclosures

Telemedica Rates:

Mental Health Evaluation^{1, 4} - $1,495
Psych Re-evaluation - $150
Psych Rebuttal Letter - $200
Telemedicine Medical Diagnosis Evaluation^{1, 4} - $985
Additional Telemedicine Medical Diagnosis Evaluation - $860
Medical Nexus Records Review (up to 500 pages)¹ - $299
Additional Pages For Records Review (500 pages) - $99
Unlimited Pages & Medical Records Review for 90 days¹ - $99
Nexus Letter (1 connection)^{1, 2} - $1,345
P&T Document/Specialty Letter^{1, 2} - $1,345
Nexus Letter Enhanced (2+ connections)^{1, 2} - $1,595
Nexus Service DBQ (1-4 pages)^{1, 2} - $1,145
Nexus Service DBQ Enhanced (4+ pages)^{1, 2} - $1,400
Nexus Service Rebuttal Letter^{1, 3} - $275

¹ This fee is made up of two separate charges: (i) a portion is retained for the Professional Fee charged by the Independent Provider’s PLLC, and (ii) a portion is retained for an Administrative Management Fee charged by Telemedica LLC.

¹ For Mental Health Evaluation, there is a $125 Non-Refundable Technology & Access Fee. There is an additional $54 Non-Refundable Chart Review Fee. This is obtained when services are initiated.

¹ For Telemedicine Evaluation, there is a $125 Non-Refundable Technology & Access Fee. There is an additional $54 Non-Refundable Chart Review Fee. This is obtained when services are initiated.

¹ For Nexus Letter/DBQ Services, there is a $299 ($398 for unlimited chart review) Non-Refundable Technology & Access Fee. This is obtained when services are initiated.

² Chart review must be completed prior to service

³ In some cases, a targeted chart review must be completed before confirmation that this document is possible with a cost of $50

⁴ This fee includes a medical chart review of up to 500 pages. Additional fees apply if uploading more than 500 pages. See fee breakdown for chart review pages

Third-Party Member Discounted Rates:

Mental Health Evaluation^{1, 4} - $599
Psych Re-evaluation - $150
Psych Rebuttal Letter - $200
Telemedicine Medical Diagnosis Evaluation^{1, 4} - $524
Additional Telemedicine Medical Evaluation - $399
Medical Nexus Records Review (up to 500 pages)¹ - $299
Additional Pages For Records Review (500 pages) - $99
Unlimited Pages & Medical Records Review for 90 days¹ - $99
Nexus Letter^{1, 2} - $520
Nexus Letter Enhanced/Specialty Letter/P&T Document^{1, 2} - $620
Nexus Service DBQ (1-4 pages)^{1, 2} - $325
Nexus Service DBQ Enhanced (4+ pages)^{1, 2} - $425
Nexus Service Rebuttal Letter^{1, 3} - $275

¹ You will only be eligible for the preferred third-party discount rate if you have an active contract with the preferred third-party.

¹ Please note that if you cancel your third-party membership 72 hours or more prior to your appointment, you will be billed at the non-discounted rate. Failure to pay the remaining balance will result in the cancelation of your appointment.

¹ For Mental Health Evaluation, there is a $125 Non-Refundable Technology & Access Fee. There is an additional $54 Non-Refundable Chart Review Fee. This is obtained when services are initiated.

¹ For Telemedicine Evaluation, there is a $125 Non-Refundable Technology & Access Fee. There is an additional $54 Non-Refundable Chart Review Fee. This is obtained when services are initiated.

¹ For Nexus Letter/DBQ Services, there is a $299 ($398 for unlimited chart review) Non-Refundable Technology & Access Fee. This is obtained when services are initiated.

² Chart review must be completed prior to service.

³ In some cases, a targeted chart review must be completed before confirmation that this document is possible with a cost of $50.

⁴ This fee includes a medical chart review up to 500 pages. Additional fees apply if uploading more than 500 pages. See fee breakdown for chart review pages.

Please note that for the customer’s convenience, Telemedica LLC collects all of the fees and passes the professional fees directly to the appropriate professional entity without offset. For the avoidance of doubt, Telemedica does not provide any professional services, including but not limited to health evaluations or medical diagnostic services.

Refund/Missed Appointment Policy

To request a refund from Telemedica, you must contact customerservice@telemedicallc.com in writing regarding the amount in question to be eligible to receive a refund. A transaction may be eligible for a refund up to seven (7) days from the date of the completed payment. After this period, Telemedica will not review or issue refunds for captured payments unless an escalation ticket has been submitted at https://help.telemedicallc.com/.

You understand that the $125 "Tech Fee" for all services is non-refundable. You understand that once a provider has begun working on your documents, that no refunds will be issued even if within the 7-day refund eligibility window.

Refunds for completed appointments and completed documentation will only be considered on a case-by-case basis and upon review by the Telemedica Quality Assurance Team, and requests may be submitted at https://help.telemedicallc.com/

You understand and agree that for services provided on an appointment basis, if you fail to properly cancel a scheduled appointment at least 48 hours in advance of the appointment or if you fail to attend the appointment, you will be responsible for a missed appointment fee of $50.