Terms and Conditions

Terms and Conditions

TERMS & CONDITIONS TO PALADINA HEALTH™ MEMBERSHIP AGREEMENT SPECIAL STATE PROVISIONS 
If the medical office of your Paladina Health™ physician is located in a state shown below, the Membership

Agreement is subject to the provisions applying to that state. All arbitration provisions below shall be governed by, construed and enforced in accordance with the Federal Arbitration Act.

ARIZONA 
Dispute Resolution: All disputes arising out of the Membership Agreement will be submitted to arbitration in the county in the State of Arizona where you receive services covered by the Membership Agreement, pursuant to the rules of the American Arbitration Association then in existence in the State of Arizona. The decision in arbitration shall be conclusive and binding on you (and on Paladina Health™) and may be reduced to judgment in any court of competent jurisdiction. By signing the Membership Agreement, you expressly waive your right to a trial in any court.

CALIFORNIA
Dispute Resolution: AS DESCRIBED BELOW, BY SIGNING THE MEMBERSHIP AGREEMENT YOU ARE AGREEING TO HAVE ANY ISSUE OF MEDICAL MALPRACTICE DECIDED BY NEUTRAL BINDING ARBITRATION RATHER THAN BY A JURY OR COURT TRIAL.

All disputes, including claims of medical malpractice, arising out of the Membership Agreement will be settled by submission to arbitration in the county in the State of California where you receive services covered by the Membership Agreement, pursuant to the rules of the American Arbitration Association then in existence in the State of California. The decision in arbitration shall be conclusive and binding on you (and on Paladina Health™) and may be reduced to judgment in any court of competent jurisdiction. By signing the Membership Agreement, you are agreeing to have any issue of medical malpractice and any issue relating to the delivery of service under the Membership Agreement decided by neutral arbitration and you are giving up your right to a jury or court trial.

COLORADO
Dispute Resolution: It is understood that any claim of medical malpractice, including any claim that medical services were unnecessary or unauthorized or were improperly, negligently, or incompetently rendered or omitted, as well as all other disputes arising out of the Membership Agreement, will be determined by submission to binding arbitration in accordance with the provisions of part 2 of article 22 of Title 13 of the Colorado Revised Statutes, and not by a lawsuit or resort to court process except as Colorado law provides for judicial review of arbitration proceedings pursuant to the rules of the American Arbitration Association then in existence in the State of Colorado.

No health care provider shall withhold the provision of emergency medical services to any person because of that person’s failure or refusal to sign an agreement containing a provision for binding arbitration of any dispute as to professional negligence of the provider.

Rescission: You have the right to seek legal counsel concerning the Membership Agreement, and you have the right to rescind the Membership Agreement by written notice to Paladina Health™ within ninety days after the agreement has been signed and executed by both parties unless said agreement was signed in contemplation of you being hospitalized, in which case the agreement may be rescinded by written notice to Paladina Health™ within ninety days after release or discharge from the hospital or other health care institution. Both parties to the Membership Agreement, by entering into it, have agreed to the use of binding arbitration in lieu of having any such dispute decided in a court of law before a jury.

No health care provider shall refuse to provide medical care services to any patient solely because such patient refused to sign such an agreement or exercised the ninety-day right of rescission.

SOUTH CAROLINA 
Dispute Resolution: All disputes arising out of the Membership Agreement will be submitted to arbitration in the county in the State of South Carolina where you receive services covered by the Membership Agreement, pursuant to the rules of the American Arbitration Association then in existence in the State of South Carolina. The decision in arbitration shall be conclusive and binding on you (and on Paladina Health™) and may be reduced to judgment in any court of competent jurisdiction. By signing the Membership Agreement, you expressly waive your right to a trial in any court.

WISCONSIN 
Dispute Resolution: All disputes arising out of the Membership Agreement will be submitted to arbitration in the county in the State of Wisconsin where you receive services covered by the Membership Agreement, pursuant to the rules of the American Arbitration Association then in existence in the State of Wisconsin. The decision in arbitration shall be conclusive and binding on you (and on Paladina Health™) and may be reduced to judgment in any court of competent jurisdiction. By signing the Membership Agreement, you expressly waive your right to a trial in any court.

UTAH 
Dispute Resolution: All disputes arising out of the Membership Agreement will be submitted to arbitration in the county in the State of Utah where you receive services covered by the Membership Agreement, pursuant to the rules of the American Arbitration Association then in existence in the State of Utah. The decision in arbitration shall be conclusive and binding on you (and on Paladina Health™) and may be reduced to judgment in any court of competent jurisdiction. By signing the Membership Agreement, you expressly waive your right to a trial in any court.

The role of the arbitrator(s) will be to decide the outcome of the claim. A panel of three arbitrators shall be selected as follows: (i) one arbitrator will be collectively selected by all persons claiming damage, (ii) one arbitrator will be selected by Paladina Health™ and (iii) a third arbitrator shall be jointly selected by all persons claiming damages and Paladina Health™ or, if the parties cannot agree on the selection of the third arbitrator, the other two arbitrators shall appoint the third arbitrator from a list of individuals approved as arbitrators by the state or federal courts of Utah. Notwithstanding the foregoing, if both parties agree, a single arbitrator may be selected.

You will be responsible for one-half of the expenses and costs of arbitration of any dispute under the Membership Agreement.

You have the right to have questions about this arbitration agreement answered. You have the right to rescind the agreement within thirty (30) days of signing the agreement. You have the right to require mediation of the dispute prior to the arbitration of the dispute. You have the right to retain legal counsel.

All parties waive the requirement of Utah Code Section 78B-3-416 to appear before a hearing panel in a malpractice against a health care provider.

When a medical malpractice action is arbitrated, except as otherwise governed by the Federal Arbitration Act, the actions shall be subject to Chapter 31a, Utah Uniform Arbitration Act and you will have the right to request the following before an arbitration hearing is commenced:

A) mandatory mediation

B) retention of the jointly selected arbitrator for both the liability and damage stages of an arbitration proceeding if the arbitration is bifurcated; and the filing of the arbitration panel’s award of damages as a judgment against Paladina Health™ in the appropriate district court.

Please note, this provision requiring arbitration of a dispute applies only to:

A) an error or omission that occurred after the Membership Agreement was signed, provided that the Membership Agreement may allow a person who would be a proper party in court to participate in an arbitration proceeding;

B) the claim of: 
(i) a person who signed the Membership Agreement,

(ii) a person on whose behalf the Membership Agreement was signed under Subsection (6) of Utah 
Code 78B-3-421, and

(iii) the unborn child of the person described in subsection (i) and (ii) of this paragraph to the Paladina 
Health™ Terms and Conditions for 12 months from the date the Membership Agreement is signed; and

C) the claim of a person who is not a party to the Membership Agreement if the sole basis for the claim is an injury sustained by a person described in Subsections (i) and (ii) of subparagraph (B) to this paragraph of the Membership Agreement.

No health care provider shall refuse to provide medical care services to any patient solely because such patient or a person described in Subsection (6) of Utah Health Care Malpractice Act Section 78B-3-421 refused to enter into a binding arbitration agreement.

WASHINGTON STATE 
Dispute Resolution: All disputes arising out of the Membership Agreement will be submitted to arbitration in the county in the State of Washington where you receive services covered by the Membership Agreement, pursuant to the rules of the American Arbitration Association then in existence in the State of Washington. The decision in arbitration shall be conclusive and binding on you (and on Paladina Health™) and may be reduced to judgment in any court of competent jurisdiction. By signing the Membership Agreement, you expressly waive your right to a trial in any court.

Paladina Health Group of Washington P.C may terminate the Membership Agreement in those situations specifically allowed under Washington State law.

Direct Patient-Provider Practice: Paladina Health Group of Washington P.C. is a direct patient-provider practice as defined under Washington law.

  • In 2007, the Washington Legislature passed a law to promote access to medical care for all citizens and to encourage innovative arrangements between patients and providers to help provide all citizens with a medical home.
  • A direct patient-provider practice, like Paladina Health Group of Washington P.C., is an arrangement in which patients enter into a direct relationship with medical practitioners for a fixed amount to be paid directly to the healthcare provider for primary care services.

In the event you have any questions regarding direct patient-provider practices in the State of Washington, you may direct your questions to the following: 
Consumer Advocacy/SHIBA 
Office of the Insurance Commissioner 
P.O. Box 40256 
Olympia, WA 98504-0256 
Toll free: 1-800-562-6900 
Olympia: 360-725-7080 
Fax: 360-586-2018 
TDD: 360-586-0241 
Email: cap@oic.wa.gov

Medical Assistance: At this time, Paladina Health Group of Washington P.C. is unable to provide services to individuals who receive medical assistance and/or participate in medical care programs administered by the Washington Department of Social and Health Services. By signing the Membership Agreement, you acknowledge that you have read this document and that you do not currently receive medical assistance and/or participate in medical care programs administered by the Washington Department of Social and Health Services.

  • Washington State has a number of programs dedicated to providing health care coverage to low income residents. The largest single source for this coverage is Medicaid, which offers complete major medical coverage. There are also other programs that offer more limited benefits. Examples of health care coverage options include Healthy Options and Washington Apple Health for Kids. If you are not sure if you receive medical assistance, you may call the Washington Department of Social and Health Services at 1-800-562-3022.

If you receive medical assistance or participate in medical care programs administered by the Washington Department of Social and Health Services during the term of the Membership Agreement, you will immediately notify Paladina Health Group of Washington P.C. in-person at the clinic or by calling Member Services at 1-866-808-6005.

You understand that in the event you receive medical assistance or participate in medical care programs, your Membership Agreement will automatically terminate.

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If any term, provision, covenant or condition of these Paladina Health™ Terms and Conditions is held by a court of competent jurisdiction to be invalid, void or unenforceable, the remaining provisions will remain in full force and effect and will in no way be affected, impaired or invalidated.

Email: MemberServices@paladinahealth.com 
Phone: 1-866-808-6005 
Mail: Paladina Health 
Attn: Member Services 
1551 Wewatta Street 
Denver, CO 80202

@PaladinaHealth