BTB Membership Agreement
Please read carefully
1) PROGRAM:
This Membership Agreement describes the services provided through Broken to Better Urgent Care, explains how you may purchase membership. It summarizes the terms and conditions of your membership. By electing to purchase membership in our BTB Membership, you are ensuring you and/or your family same-day access to urgent care services 7 days a week, most days of the year in Rock Hill, SC.
BTB Membership is not insurance. All services provided by the Retained Medical Practice cannot be billed to insurance.
BTB Membership provides only the limited scope of primary care services specified in the Urgent Care 365 membership agreement.
A patient must pay for all services not specified in the BTB membership agreement.
BTB Membership Cancellation Policy
Members may cancel at any time with written notice.
Broken to Better Urgent Care may cancel an individual or family BTB Membership ten (10) business days following notification of failure of a credit or debit card transaction.
2) SCOPE OF SERVICES COVERED BY THIS AGREEMENT:
Broken to Better Urgent Care agrees to provide the following services and amenities to BTB Membership members:
- Experienced and dedicated staff committed to a high level of care and service.
- Seven days per week, most days of the year. Same-day access to Urgent Care services ** (Broken To Better Urgent Care is closed Christmas Day and Easter). No appointment is needed, and online check-in is always available.
- Individual plans are $59/mo, with members receiving unlimited visits.
- At each visit, the patient is expected to pay a facility fee of $25.00.
- Family plans are also available at $50 per member with unlimited visits.
- Free in-house testing as determined by the medical provider with each visit
- All other Urgent Care services are discounted 50% for BTB Membership members. Examples of services included:
- All in-house x-rays
- All procedures such as suturing of wounds, foreign body removals, drainage of boils and abscesses
- All injections and injected medications
- DME (braces, boots, splints)
- All wound care and dressings
- Ear lavage (cleaning)
- Breathing treatments
- EKG
A full list of all covered services and member prices is attached and available on our website.
- Annual sports physicals and flu shots are free of charge for individuals and each member of a family (does not count as a visit)
**Please note:
Urgent Care facilities are also not an appropriate place to manage chronic illness such as diabetes, hypertension, COPD, congestive heart failure, depression or chronic pain. If you have a chronic illness, an urgent care provider may or may not be able to treat you, but will certainly be able to refer you to a primary care provider or an appropriate specialist.
3) MEMBERSHIP PAYMENT:
For the above services and amenities, the cost for individual members will be $59.00 per month, with payment made using a valid credit or debit card. The cost for a family is $50.00 monthly for each member. A one-time fee for processing the application is charged for $35.00 for either the individual or family membership. This will be a one-time fee except in cases where the membership lapses. In the case that a membership lapses, a reapplication fee and the first month’s payment will be required to reactivate the membership.
4) TERM and MONTHLY PAYMENTS:
The membership period is one year. A membership renewal reminder will be sent out in the last quarter of the membership year. Membership will automatically be renewed during the last month of the membership year for the following year. Termination of the BTB Membership must be made by the patient in writing and must be received 10 days in advance of the annual contract renewal date. Members may also change their preferred form of payment by giving 10 days’ notice. Membership will be effective at the date of application upon completion and review of the membership application/ACH authorization form, completed first month’s payment, and application fee. Subsequent monthly payments will continue by automated credit or debit transactions. Should the transaction fail, the member will be notified by email and will be solely responsible for correcting the reason for the transaction failure. The member will not be charged a reapplication fee if the error is corrected within ten (10) business days from the date of email notification of credit/debit transaction failure.
5) CANCELLATION/REINSTATEMENT:
Members may cancel at any time with written notice.
Broken to Better Urgent Care may cancel an individual or family BTB Membership ten (10) business days following notification of failure of ACH transaction.
After ten (10) business days, the patient’s membership which has been canceled for this reason by Broken to Better Urgent Care may be reinstated with a valid credit or debit card entry and the payment of a reinstatement fee of $10.00.
If Broken to Better Urgent Care is unable to provide services as promised for any reason, Broken to Better Urgent Care will refund monthly membership fees back to the patient or family retroactively to the first day of the month in which Broken To Better Urgent Care was unable to provide services as promised.
I have read and accept the terms and conditions of the BTB Membership Agreement (click “Accept” below if you agree).