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Telehealth Consent

1. Scope of Telehealth

MedSolRx offers telehealth consultations via live videoconference, telephone calls, or secure messaging through a technology platform powered by OpenLoop Health. Licensed providers are not physically present with you.

2. Confidentiality & Location

You agree to:

🔹 Conduct your telehealth session in a private setting.

🔹 Be informed and consent if another individual is present (e.g., interpreter or tech support).

🔹 Providers likewise will be in private locations.

3. Potential Risks & Technical Limitations

You understand:

🔹 Telehealth may involve technical issues (lag, dropped calls, unauthorized access).

🔹 Either party can pause or end the session due to tech failures.

🔹 Providers may not have full access to your medical history, and they can’t perform physical exams.

🔹 Your condition may not improve—or could worsen.

🔹 You always have the option to seek in-person care instead.

4. Information Accuracy & Appropriateness

You agree that:

🔹 You will provide accurate, complete personal and health information.

🔹 Telehealth may be deemed inappropriate for your condition; if so:

🔹 You’ll be informed and your request will stop.

🔹 Providers won’t receive your data.

🔹 You’ll be advised to seek alternate care.

5. Prescriptions & Treatment

🔹 Telehealth consultations do not guarantee a prescription.

🔹 Providers exercise professional judgment regarding medication.

🔹 You may choose any pharmacy or lab, even if not affiliated with our partners.

6. Compounded Medications

🔹 Adoption of compounded medications acknowledges that such products:

🔹 Are not FDA-approved for safety or efficacy oversights.

🔹 Are prepared by regulated compounding pharmacies.

🔹 Will be dispensed only after provider assessment and under quality control protocols.

7. Financial Responsibility & Insurance

🔹 You are responsible for all charges, including copays or balances not covered by insurance.

🔹 If applicable, MedSolRx (via OpenLoop’s network entities) is authorized to:

🔹 Bill your insurer.

🔹 Receive assignment of benefits.

🔹 Use your PHI to obtain payment and manage your care.

7. Financial Responsibility & Insurance

🔹 Providers will not handle emergencies via telehealth.

🔹 In emergencies (e.g., chest pain, suicidal thoughts), dial 911 or go to the nearest ER.

🔹 Providers may direct you to seek emergency care when needed.

9. PHI Disclosure & HIPAA Compliance

By consenting:

🔹 You authorize use and disclosure of your protected health information (PHI) for treatment via telehealth.

🔹 This information may be shared with billing, operations teams, pharmacies, or labs.

🔹 You have the right to revoke this authorization in writing, except to the extent already acted upon.

10. Communication Consent

You authorize MedSolRx to send communications via:

🔹 Phone calls

🔹 SMS/text

🔹 Email for appointment reminders and general healthcare information.

11. Third-Party Beneficiary

You acknowledge that OpenLoop Health, Inc. is a third-party beneficiary of this Telehealth Consent and may enforce its terms directly against you.

12. State-Specific Disclosures & Rights

Applicable state provisions include:

Alaska, Connecticut, Kansas, New Hampshire, New Jersey, Ohio, South Carolina, Texas:

Providers may share your medical records with your primary care physician or provider, as explicitly authorized. If you'd like them sent, contact MedSolRx support. [email protected]

California:

The Physician Payments Sunshine Act requires disclosure of physician-industry payments. Details are available at OpenLoop’s Open Payments portal.

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