Last Updated: November 7, 2024

1. General Information

Sailor Health Medical P.A., Sailor Health Medical, and its affiliated professionals (collectively, “Sailor Health Professionals”, “we”, and “our”), operating with support from Sailor Health, Inc. (collectively, “Sailor Health”) provide technology-enabled and in-person mental health services. This Agreement describes Sailor Health Professionals’ services and clinical programs. It is important for you to read this document and discuss any questions you might have with us. Sailor Health, Inc. does not provide clinical services; it performs administrative, payment, and other supportive activities for Sailor Health Professionals. When you request to receive services from a Sailor Health Professionals clinician those services are outlined by this agreement, as well as the discussions between you and/or your child (also referred to collectively as “you”), and your clinician(s). It is important for you to read this document and discuss any questions you might have with your Sailor Health care team. If you agree to these terms we will assume that you have read, understood, and agree to its contents. We reserve the right, at our sole discretion, to change, modify, add or remove portions of these terms, at any time. It is your responsibility to check these terms periodically for changes.

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2. Our Services and Technology

When you or your care recipient becomes a patient of Sailor Health Professionals (a “Member”), you will be given access to the mobile or desktop portal of Sailor Health (the “Sailor Health App”). The Sailor Health portal provides interactive resources for you, simple tools for scheduling appointments, contacting your Sailor Health Professional, and billing, serves as your hub of information including medical records. You may use the Sailor Health portal so long as you are over the age of 18 or other legal age of consent and meet any additional criteria under applicable state law, and/or have the necessary capacity or authority to enter binding agreements like this through a consenting parent or legal guardian, as explained below.

If you access or use the Sailor Health portal, it will mean you read, understood and expressly agree to these Terms and that you will use the services only in accordance with the terms and conditions herein and all other applicable agreements, information, services, materials and other content provided by or through the Sailor Health portal and Sailor Health. Your continued use of the Sailor Health portal following the posting of changes will mean that you accept and agree to the changes.

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3. Telehealth Informed Consent - Risks and Benefits

Sailor Health Professionals will provide mental health care via telehealth using voice calls, video calls and messaging services. Sailor Health Professionals may prescribe you or your care recipient medication or recommend other treatment, as needed. Telehealth care is a flexible and convenient way to get healthcare, but it may not be right for treating certain symptoms or illnesses that need an in-person doctor or urgent care visit.

PLEASE NOTE: OUR SUPPORT TEAM DOES NOT ADDRESS MEDICAL EMERGENCIES. IF YOU OR YOUR CARE RECIPIENT IS EXPERIENCING A MEDICAL EMERGENCY, IS CONSIDERING HARMING THEMSELVES OR OTHERS, OR IS OTHERWISE IN IMMINENT DANGER, YOU SHOULD DIAL 911 AND/OR GO TO THE NEAREST EMERGENCY ROOM.

All laws and protections for in-person medical visits also apply to telehealth visits. This includes confidentiality of information, access to medical records, and sharing of information that could identify you personally.

You may decide that you do not want to use telehealth services for you or your care recipient at any time. This will not make you lose your health program benefits or your rights to future health care.

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4. Important information for all guardians and caretakers

Your participation is important, and is often essential to the success of the treatment. This section is intended to inform you about the risks, rights and responsibilities of your participation as a collateral participant. Your agreement and signature, below, indicates your understanding of your role as a collateral and the limitations therein. If you have any questions or concerns about what it means to be a collateral, and especially if you have questions or concerns about information that may be shared with another parent, it is critical that you discuss these questions/concerns with your Sailor Health Professionals clinician.

Who and what is a collateral?

In the context of Sailor Health, a collateral is usually a parent or caretaker who participates in therapy to assist the care recipient. The collateral is not considered to be a patient and is not the subject of the treatment. In addition to the mental health clinician’s primary responsibility being to the patient with respect to treatment, they also have certain legal and ethical responsibilities to patients, and the privacy of that relationship is given legal protection. That privacy protection does not apply to collaterals.

The role of collaterals in therapy

The role of a collateral can vary greatly. For example, a collateral might attend only one appointment, either alone or with the patient, to provide information to the clinician and never attend another appointment. In another case a collateral might attend all of the patient’s therapy appointments and their relationship with the patient may be a focus of the treatment. Your care recipient’s clinician will discuss your specific role in the treatment at your first meeting and at other appropriate times.

Benefits and risks

Mental health treatment can engender intense emotional experiences, and your participation in your care recipient’s treatment may also cause strong anxiety or emotional distress. It may also expose or create tension in your relationship with your care recipient. While your participation can result in better understanding of your child or an improved relationship, or may even help in your own growth and development, there is no guarantee that this will be the case. If you are participating in your care recipient’s treatment, you should expect the clinician to request that you examine your own attitudes and behaviors to determine if you can make positive changes that will be of benefit to your care recipient.

Professional records

No separate medical record or chart will be maintained on you in your role as a collateral. However, your demographic information will be maintained as part of your care recipient’s record, and information you provide may be entered into your care recipient’s chart, if appropriate. Your care recipient’s and other adults with a right of access to health records may have a right to access the chart and the material contained therein, which may include information and communications you have provided. Other adults with a right of access to the chart / record may also have access to the information / communications you provide. There will not be a diagnosis assigned to you in your role as a collateral and there is no individualized treatment plan for you.

The confidentiality of the things you say to your care recipient’s care team

The confidentiality of information in your care recipient’s chart, including the information that you provide, is protected by both federal and state law. However, as a collateral you are not the patient, but rather you are assisting in the clinical care of a child and are not directly receiving treatment yourself.

Clinicians specializing in the care of older adults recognize the importance of treating individuals within the context of their family or caregiving network. In treatment involving older adults and their caregivers, access to information is both essential and sometimes delicate. Privacy and trust are crucial to the success of treatment, especially as older adults may value their independence. At the same time, caregivers often need access to certain information to provide effective support. For this reason, your clinician may discuss what information will be shared with caregivers and what will remain private, in accordance with applicable state laws.

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5. Payment and Billing

Payment is due after each appointment, and Sailor Health will charge your card or bank account or submit an invoice through the Sailor Health portal for the patient responsibility. Receipts will be provided after each charge, and a single charge may include fees for multiple appointments (due to Sailor Health’s billing to health plans). Your or, as applicable, your care recipient’s insurance may cover some or all of our services. If you have to pay a deductible, copayment or coinsurance for your or your care recipient’s health care, the usual cost-sharing rules will apply. By providing us with your credit card information, you are authorizing us to charge your credit card for agreed upon purchases and save your credit card information for future transactions on your account.

You agree that all people or companies (third parties) who pay any part of your Sailor Health Professionals bill shall pay these amounts directly to the Sailor Health Professionals entities. You understand that you must pay the Sailor Health Professionals entities any costs not paid by your insurance or other third parties, unless state or federal regulations do not allow this.

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6. Refunds

Refund Eligibility. Refunds that Sailor Health is able to confirm are owed will be paid for services that were overpaid, duplicate payments, inaccurate billing, services that were not rendered, or insurance should have been billed. Refunds are subject to verification and approval by Sailor Health’s billing department.

Requesting a Refund. To request a refund, you must contact our billing department within 30 days from the date of the original payment or the discovery of the overpayment or non-rendered service. Refund requests can be made by contacting our billing department directly at sailor@sailorhealth.com. Please provide accurate and complete information, including your name, contact details, payment details, a brief explanation for the refund request, and any relevant supporting documentation

Refund Processing. Upon receipt of your refund request, we will review the request and initiate the refund process if it meets the eligibility criteria. Refunds will be processed within approximately 5-10 business days from the date of approval. Refunds will be issued using the same payment method used for the original payment, unless otherwise specified and approved by our billing department. Whether or not to grant a refund request is solely within the discretion of our billing department.

Refund Denial. We reserve the right to deny refund requests. Refund requests submitted after the 30-day timeframe will not be considered, unless there are extenuating circumstances deemed acceptable by our billing department.

No Refunds for Services Rendered. Refunds will not be issued for services that have been rendered in accordance with the agreed-upon treatment plan or for any charges that are non-refundable for any reason including, but not limited to applicable law, regulation, guidance, or agreement. Any disputes regarding services rendered should be addressed separately in accordance with our patient dispute resolution process.

Modifications to the Refund Policy. We reserve the right to modify or amend this refund policy at any time without prior notice. Any changes to the refund policy will be effective immediately upon posting the revised Agreement on our website or other appropriate channels.

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7. Scheduling and Attendance

We understand you may have to reschedule or cancel an appointment from time to time. We ask that you notify us at least 24 hours in advance of your scheduled appointment. You will be charged for appointments that are not canceled 24 business hours in advance, and appointments to which you are late by 15 or more minutes, as specified on your Sailor Health Professional’s booking page and to the extent permitted under applicable laws or payor requirements. Exceptions will be made at the discretion of the Sailor Health Professional in case of extenuating circumstances. If you repeatedly miss scheduled appointments, and if Sailor Health Professionals are unable to contact you for a period of time, you understand that your agreement with Sailor Health may be terminated and you will be removed from Sailor Health’s platform.

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8. Privacy Practices

We must follow federal healthcare privacy and security laws and protect your health information. We work hard to make sure that your personal information is secure. We use standard physical, electronic, and business security methods (such as encryption) to help prevent access to your health information by people who should not see it. But we cannot promise that data sent over the Internet or through a data storage facility will be perfectly secure. So, although we try to protect your personal information, we cannot guarantee the security of any information you send to us. You can read more information about our use of health information and other personal information in our Notice of Privacy Practices (“NPP”)

We may share your health records with the following individuals under the following circumstances:

• With your other health care providers, either directly or through our participation in health information exchanges, health plans, and for other healthcare treatment, payment, and operations purposes. This may include information relating to genetic tests, substance abuse, mental health, communicable diseases and other health conditions.
• With other individuals involved in your care such as caregivers or family members where we have permission to do so, or in the event of a mental health crisis or other emergency.
• As otherwise permitted in our NPP and by applicable law.
• By signing below, you agree to let us share your records as described above and acknowledge receipt of the NPP.

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9.  Communications

As part of providing services, we may communicate with you, including for purposes such as appointment reminders and announcements. If you have provided us with a cell phone number and email address, we may send you SMS text messages and emails. Text messages and emails are not always secure because they travel over networks that we do not control.

By signing below and providing us your cell phone number and email address, you permit us to contact you by SMS text message and email. You may also ask us to stop sending non-appointment-related messages by responding to the messages, including by texting “STOP” or clicking the email link to “unsubscribe,” or by contacting sailor@sailorhealth.com You understand that you may have to pay data costs to receive SMS text messages that we send to your mobile phone. You may elect not to agree to this section and still receive services from Sailor Health Professionals.

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10. Complaint Policy

All Members have the right to communicate complaints regarding their care. Should you wish to make a formal complaint about one of your care providers you may do so in writing and submit the concern to Sailor Health Professionals at sailor@sailorhealth.com.

Agreement and Consent

If you have questions about any of the contents of this Agreement, our procedures, or your role in this process, please contact us at sailor@sailorhealth.com. Remember that the best way to ensure quality treatment is to keep communication open and direct with your clinician(s). a personal representative of the patient, you have legal authority to provide consent for the treatment of the patient.

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