Novi Dermatology & Telehealth Terms of Service

When you enter the Telehealth platform, you will be asked to agree to the Terms of Service as below:

In this agreement, Novi Dermatology, PLLC is referred to herein as “Novi Dermatology,” “Physicians,” “we,” “us,” and/or “ours”.  The terms “Phone Communication”, “Patient Portal Communication” and “Live Interactive Telehealth Visits” are herein encompassed within the term “Telehealth Service(s)”.  In the case of the use Telehealth Services by or on behalf of a minor, “patient”, “you” and “yours” refer to and include both minor utilizing the Telehealth Service and the parent or legal guardian who provides consent to the use of Telehealth Service by or on behalf of such minor.

Fees: You understand that you are fully responsible for payment of all fees billed for Telehealth services. If Telehealth services are covered under an insurance benefit, you hereby assign all payments and medical benefits directly to Novi Dermatology for the services rendered by Novi Dermatology.  You agree that you are responsible for any copays, deductibles, coinsurance or cost-sharing amounts as determined by your insurance benefit.  

How Telehealth Services Work: Telehealth Services involves the remote delivery of healthcare services using audio, video and/or electronic communications. Telehealth Services may be used for diagnosis, treatment, follow-up and/or patient education, and may include, but is not limited to, one or more of the following: 

• Electronic transmission of medical records, photo images, personal health information or other data between a patient and a healthcare provider
• Interactions between a patient and healthcare provider via audio, video and/or data communications

Given medical licensing requirements, only patients physically located in the state of Michigan can be seen via Telehealth services, unless such requirement is waived by federal government. 

Anticipated Benefits: The use of Telehealth Services may have the following possible benefits:

• Making it easier for you to access medical care and treatment 
• Allowing you to obtain medical care and treatment by the Physician at times that are convenient for you 
• Enabling you to interact with the Physician without the necessity of an in-office appointment.

Possible Risks:  The use of Telehealth Services may have the following possible risks which include, but may not be limited to the following:

• The information transmitted by you to your Physician may not be sufficient {e.g. poor resolution of images) to allow for appropriate medical decision making by the Physician
• The inability of your Physician to conduct certain tests or exam you in-person may in some cases prevent the Physician from providing a diagnosis or treatment or from identifying the need for emergency medical care or treatment for you
• Your Physician may not able to provide medical treatment for your particular condition and you may be required to seek alternative health care or emergency care services
• Delays in medical evaluation/treatment could occur due to unavailability of your Provider(s) or deficiencies or failures of the technology or equipment used
• The electronic systems, software, technology or other security protocols or safeguards used in the delivery of Telehealth Services could fail or result in a breach of privacy of your medical or other information.  
• Should you choose to communicate with the Physician with your own technology (ie email, text message), you understand and agree that (i) you are responsible for the security of that information and (ii)  common forms of communication (ie email, text message, Facetime, Skype, etc) are not secure during the process of transmission from your device to the destination device and (iii) you understand that you are responsible for any data breaches that may occur from using these common forms of communication (ie email, text message, Facetime, Skype, etc).  Your physician may decline to communicate with you via these less secure forms of communication. 

Presence of Others During Telehealth Visit: People other than your Physician may be a part of the patient’s care and present during a Telehealth visit. These people may be nursing or administrative staff as needed for the delivery of remote care. Anyone that is part of the Telehealth team will be supervised by your Physician, and the final recommendations about your care will come from the Physician. 

Privacy, Medical Information and Records: All information given at your Telehealth visit will be maintained by the doctors, other health care providers, and health care facilities involved in your care and will be protected by federal and state privacy laws.  All federal and state laws covering access to your medical records (and copies of medical records) also apply to telehealth. No one other than the health care team described above can view your photos or information unless you agree to give them access.

Your Rights: You may opt out of the Telehealth visit at any time. This will not change your right to future care or health benefits.

Waiver/Release: By utilizing Telehealth services, you understand and agree that you solely assume the risk of any errors or deficiencies in the electronic transmission of information during your Telehealth visit or in the electronic submission of your images to your dermatologist and further understand that no warranty or guarantee has been made to you concerning any particular result related to your condition or diagnosis. 

updated 5/11/2020