MEMBER PARTICIPATION AGREEMENT (CLA-MPA/06-11)

When you join Chiropractic Lifecare of America, LLC (CLA) referred hereafter as the "Plan" you become a participant in a Discount Medical Plan Organization, provided by AccessOne Consumer Health, Inc. Below are the terms and conditions of your membership in the discount medical plan. This agreement is between you and AccessOne.

Additional or replacement membership cards may be purchased for $10 per card. To receive your in-network benefits, your chiropractic care must be obtained through CLA Providers. Your participation in the Plan is for one year and expires on the date shown on your Member ID Card (CLA-ID/06-11).

The annual cost for the plan is $49.95

Disclosures
  1. The Plan is not insurance.
  2. The Plan provides discounts at participating healthcare providers for medical services.
  3. The Plan does not make payments directly to the providers of medical services.
  4. The Plan member is obligated to pay for all healthcare services at the time of service but will receive a discount from participating Lifecare providers who have contracted with the discount plan organization.
  5. This Member Participation Agreement (CLA-MPA/06-11), the Member ID Card (CLA-ID/06-11) and the Notices available on our website at CLAHealthcare.com/legal.html and CLAHealthcare.com/privacy.html represent the entire Member Agreement between you and the Plan. If any terms or provisions are found to be in conflict between the Notices and this Agreement (CLA-MPA/06-11) or are found to be in conflict, invalid or unenforceable, this Agreement (CLA-MPA/06-11) takes precedence and the remaining terms and provisions hereof shall not be affected in any way.
  6. The name and address of the licensed discount medical plan organization is: AccessOne Consumer Health, Inc., 84 Villa Rd., Greenville, SC 29615; 800-896-1962; www.accessonedmpo.com.
You may find a list of participating providers at: CLAHealthcare.com or you may call 800-775-7900.

All Plan members receive the following discounts at participating Plan chiropractors:
  1. 50% off initial exams, consultation and diagnostics
  2. 50% off the cost of in-house x-rays
  3. From 20-35% discount on spinal adjustments
  4. Other services may be discounted up to 50% at participating offices (only)
The Plan includes you and your legal dependents at no additional charge. You are not required to list your dependents for them to participate in the Plan.

At participating providers, you will be billed at the time of service and the applicable discount(s) will be applied to that bill. In no instance can the Plan make payments to the provider on your behalf. Payments are to be made at the time of service to receive your discount.

Refund Policy for First Year Membership Only: The entire cost of your membership will be refunded if you use your network card during your first 12-month membership year and do not save at least the cost of your membership. Simply return your card with your doctor's bills for a refund to: Chiropractic Lifecare of America LLC, 1031 Parkside Commons, Ste. 202, Greensboro, GA 30642.

If you have a complaint regarding the Plan, you may go to www.accessonedmpo.com or call 800-896-1962. You may also write to AccessOne Consumer Health, Inc., 84 Villa Rd., Greenville, SC 29615. The complaint will be addressed and you will receive a response within 15 days. Note to West Virginia Residents: If after receiving our response you are not satisfied with the resolution, you may write or call the West Virginia Insurance Commissioner.

This Member Participation Agreement and its Benefit Descriptions represent the entire agreement between you, CLA and AccessOne Consumer Health, Inc., and supersede all other prior representations, statements, or written agreements between you, CLA and AccessOne. Neither CLA nor AccessOne Consumer Health, Inc. has any liability for providing nor guaranteeing service or any liability for the quality of services rendered.

TEXAS RESIDENTS: Note to Texas Consumers: Regulated by the Texas Department of Insurance, PO Box 12157, Austin, TX 78711, telephone 800-252-3439 or 512-463-6515; website: www.tdi.state.texas.com

CLA's Privacy Policy: We do not sell or share confidential information received from our doctors or members with persons or companies outside of CLA that would use information for solicitation purposes. All personal information is kept confidential during the lifetime of membership and destroyed thereafter.

Chiropractic Lifecare of America is not insurance; it is a discount program. Please read these legal notices and our privacy policy.




© 2007-2012 Chiropractic Lifecare of America