Appointment & Billing Policy
Rescheduling or cancelling an appointment requires a 24-hour notice. Failure to provide notice will result in a $75 cancellation fee.
Payments are collected at the time of service. We accept cash, check, and credit card payments.
We accept Blue Cross/Blue Shield of North Carolina and United Healthcare insurance. Patients are responsible for verifying their benefits prior to the appointment. As a courtesy, we are able to submit out-of-network claims directly to your insurance company on your behalf.
Initial visits are billed at a rate of $140 per hour. Follow up visits are billed at a rate of $110 per hour or $55 per half hour.
Reset & Rebalance Course Policies
Individuals who enroll in the Reset & Rebalance online course should read and understand these general policies, as well as the terms and conditions of purchase.
COURSE ACCESS AND MATERIALS
The Reset & Rebalance workbook is not available for download and it can only be viewed and printed.
Upon registration and payment, you will receive access the course materials within three business days. You have access to the course site, which includes videos and content, as well as the private Facebook group, for one year from the date you receive access.
Course support is available to general questions and assistance in navigating the course. Course support does not include personalized health, nutrition, or wellness advice. Individual nutrition counseling is available (live in person, or via HIPAA-compliant telehealth) for purchase at an additional cost. Once counseling sessions are purchased, you become a patient of Summerfield Custom Wellness and your dietitian can answer your individual health and nutrition questions.
This Course includes materials protected by copyright, trademark and other intellectual property laws. Such materials include but are not limited to written text, workbooks, videos, audio recordings, photos, designs and graphics. Any reproduction or unauthorized use shall constitute infringement. Duplicating, sharing or uploading Course files to sharing sites is considered stealing and Company may prosecute such misconduct to the fullest extent permitted by law.
Company provides you with this Course solely for your personal, noncommercial use and you agree that you will not use such proprietary information or materials in any way whatsoever except for use in compliance with this Agreement. You will not use the Course in a manner that constitutes infringement or that has not been authorized by Company. More specifically, you may view, download, print, email and use these materials for your personal, noncommercial purposes only. You may not republish, reproduce, duplicate, copy, display, distribute or otherwise use any material from the Course for commercial purposes. Additionally, you may not modify, republish, upload, post, transmit, rent, lease, loan, translate, sell, create derivative works, exploit or distribute in any manner or medium, including by email or other electronic means, any material from the Course.
RESULTS DISCLAIMER AND INDIVIDUAL RESPONSIBILITIES
This Course is intended to be a wellness program that can be customized to individual preferences. Company cannot guarantee any success or weight loss by purchasing the Course. Although there are many happy students of the Course, many of whom have provided testimonials, their results may not be typical for everyone and they are not intended to guarantee, promise, represent and/or assure that you will achieve similar results from taking the Course. Each person’s success and results depends on many factors, including dedication, desire and motivation. You accept the risk of not achieving any results (or less than desirable results) from taking the Course.
You should consult your physician or other health care professional before starting this or any other nutrition program to determine if it is right for your needs. This is particularly true if you (or your family) have a history of high blood pressure or heart disease, or diabetes. Do not start this program if your physician or health care provider advises against it. You are responsible for your own physical, mental and emotional well-being, decisions, choices, actions and results.
This Course offers health, fitness and nutritional information and is designed for educational purposes only. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional. Do not disregard, avoid or delay obtaining medical or health related advice from your health-care professional because of something you may have read on this site. The use of any information provided through this Course is solely at your own risk.
Developments in medical research may impact the health, fitness and nutritional advice that appears here. No assurance can be given that the advice contained in this Course will always include the most recent findings or developments with respect to the particular material.
If you are in the United States and think you are having a medical or health emergency, call your health care professional, or 911, immediately. If you experience faintness, dizziness, pain or shortness of breath at any time while exercising you should stop immediately.
Company disclaims any liability for your reliance on any opinions or advice contained in the Course.
Any third party links to products or services are subject to separate terms and conditions. Company is not responsible for or liable for any content on or actions taken by such third party websites. Although Company may recommend third party sites, products or services, it is your responsibility to fully vet such third parties before entering into any transaction or relationship with them.
TERMS AND CONDITIONS OF PURCHASE
By purchasing the Reset & Rebalance online course (the “Course”) from Summerfield Custom Wellness (“Company”), you agree and consent to the following legal terms and conditions that govern your use of the Course and that form a legal agreement between you and the Company.
You must be at least 18 years of age or older to purchase this Course.
The Course is available for individual purchase only. Friends, family, partners, colleagues, etc, will need to each purchase the Course individually. You are expressly prohibited from sharing access to the Course with anyone else. Additionally, you have no right to assign this Agreement as this Course is non-transferable.
You are responsible for paying for the Course in full and for providing Company with a valid credit card or other payment method. If the payment is declined, returned or deemed fraudulent, your access to the Course will be terminated until all payments are made in full.
To access certain features of the Course, you may need a username and/or password. You agree to keep this information confidential and not share it with anyone else. If Company has reasonable grounds to suspect that you have shared your username and/or password with anyone else, or forwarded course material to any other person, Company has the right to suspend or terminate your account and refuse any and all current or future use of the website and online courses, in whole or part, without refund.
You are strictly forbidden from the following:
- Causing damage to the Course website or private membership
- Using the Course website or private membership site for any unlawful, illegal, fraudulent or harmful purpose or activity.
- Using the Course website or private membership site to copy, store, host, transmit, send, use, publish or distribute any spyware, virus, worm, Trojan horse, keystroke logger or other malicious
- Sharing private, copyrighted and proprietary information from the Course with anyone else or otherwise sharing your username and/or password
PRIVATE FACEBOOK GROUP
Every term and condition of this Agreement equally applies to any activities in the private Facebook group created for members of the Course (the “Group”). The Group is a complimentary bonus and subject to Facebook terms and conditions. Company does not have authority or control over Facebook and cannot predict any changes or rules to Facebook. Company is not liable for the Group being made available to you or your rights to access Facebook. Additionally, Company may institute community rules and guidelines for the Group with which you agree to comply.
You agree to indemnify, defend and hold harmless Company and her agents and contractors harmless from any claim or demand, including reasonable attorneys’ fees, made by any third- party due to or arising out of your breach of this Agreement or your violation of any law or the rights of a third party.
This Agreement shall be governed by and construed in accordance with the laws of the State of North Carolina, without giving effect to its conflict of laws. The state and federal courts located in New Hanover County, North Carolina shall have exclusive jurisdiction over any case or controversy arising from or relating to the Course. You hereby submit to the exclusive jurisdiction and venue of such courts and consent irrevocably to personal jurisdiction in such courts and waives any defense of forum non conveniens.
CONSTRUCTION OF AGREEMENT
This Agreement constitutes the entire understanding and agreement of the parties with respect to its subject matter and supersedes all prior and contemporaneous agreements or understandings, inducements or conditions, express or implied, written or oral, between the parties.
In the event that any provision of this Agreement is determined to be unlawful, void or unenforceable, such provision shall nonetheless be enforceable to the fullest extent permitted by applicable law, and the unenforceable portion shall be deemed to be severed from the Agreement, such determination shall not affect the validity and enforceability of any other remaining provisions.
The failure of Company to exercise or enforce any right or provision of the Agreement shall not constitute a waiver of such right or provision. Any ambiguities in the interpretation of the Agreement shall not be construed against the drafting party.
DISCLAIMER OF WARRANTIES AND LIMITATIONS OF LIABILITY
THE INFORMATION, PRODUCTS AND SERVICES OFFERED IN THE COURSE ARE PROVIDED “AS IS” AND WITHOUT WARRANTIES OF ANY KIND EITHER EXPRESS OR IMPLIED. TO THE FULLEST EXTENT PERMISSIBLE BY APPLICABLE LAW, COMPANY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. COMPANY DOES NOT WARRANT THAT THE COURSE WEBSITE OR ANY OF ITS FUNCTIONS WILL BE UNINTERRUPTED OR ERROR-FREE, OR THAT ANY PART OF THE WEBSITE IS FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS.
COMPANY SHALL NOT BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR PUNITIVE DAMAGES ARISING FROM OR OUT OF YOUR USE, INABILITY TO USE, OR PURCHASE OF THE COURSE. YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USING THE COURSE. NOTWITHSTANDING THE FOREGOING, ANY DAMAGES SHALL BE LIMITED TO THE AMOUNT PAID BY YOU FOR THE COURSE. BECAUSE SOME STATES OR JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITED OF LIABILTIY FOR CONSEQUENTLIAL OR INCIDENTAL DAMAGES, IN SUCH STATES OR JURISDICTIONS THE COMPANY’S LIABILITY SHALL BE LIMITED TO THE FULLEST EXTENT PERMITTED BY LAW.
What information do we collect?
We collect information from you when you register on our site, place an order, subscribe to our newsletter, respond to a survey or fill out a form.
When ordering or registering on our sites, as appropriate, you may be asked to enter your: name, e-mail address, mailing address, phone number or credit card information. You may, however, visit our site anonymously.
What do we use your information for?
Any of the information we collect from you may be used in one of the following ways:
To personalize your experience
Your information helps us to better respond to your individual needs.
To improve our website
We continually strive to improve our website offerings based on the information and feedback we receive from you.
To improve customer service
Your information helps us to more effectively respond to your customer service requests and support needs.
To process transactions
Your information, whether public or private, will not be sold, exchanged, transferred, or given to any other company for any reason whatsoever, without your consent, other than for the express purpose of delivering the purchased product or service requested.
To administer a contest, promotion, survey or other site feature
To send periodic emails
The email address you provide for order processing, may be used to send you information and updates pertaining to your order, in addition to receiving occasional company news, updates, related product or service information, etc. Note: If at any time you would like to unsubscribe from receiving future emails, we include detailed unsubscribe instructions at the bottom of each email.
Do we disclose any information to outside parties?
We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information. This does not include trusted third parties who assist us in operating our website, conducting our business, or servicing you, so long as those parties agree to keep this information confidential. We may also release your information when we believe release is appropriate to comply with the law, enforce our site policies, or protect ours or others rights, property, or safety. However, non-personally identifiable visitor information may be provided to other parties for marketing, advertising, or other uses.
How do we protect your information?
We implement a variety of security measures to maintain the safety of your personal information when you place an order or enter, submit, or access your personal information.
We offer the use of a secure server. All supplied sensitive/credit information is transmitted via Secure Socket Layer (SSL) technology and then encrypted into our Payment gateway providers database only to be accessible by those authorized with special access rights to such systems, and are required to keep the information confidential.
After a transaction, your private information (credit cards, social security numbers, financials, etc.) will not be kept on file for more than 30 days.
Yes (Cookies are small files that a site or its service provider transfers to your computer’s hard drive through your Web browser (if you allow) that enables the sites or service providers systems to recognize your browser and capture and remember certain information
Third Party Links
Occasionally, at our discretion, we may include or offer third party products or services on our website. These third party sites have separate and independent privacy policies. We therefore have no responsibility or liability for the content and activities of these linked sites. Nonetheless, we seek to protect the integrity of our site and welcome any feedback about these sites.
Childrens’ Online Privacy Protection Act Compliance
We are in compliance with the requirements of COPPA (Childrens Online Privacy Protection Act), we do not collect any information from anyone under 13 years of age. Our website, products and services are all directed to people who are at least 13 years old or older.
This policy was last modified on 4/19/2017.
SUMMERFIELD CUSTOM WELLNESS
HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date: 04.23.2013
THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY. THIS INFORMATION IS APPLICABLE TO PATIENTS ONLY.
If you have any questions about this notice, please contact:
Summerfield Custom Wellness
OUR PLEDGE REGARDING PROTECTED HEALTH INFORMATION
Summerfield Custom Wellness understands that protected health information about you and your health is personal. We are committed to protecting health information about you. This Notice applies to all of the records of your care generated by Summerfield Custom Wellness, whether made by Summerfield Custom Wellness personnel or your personal doctor.
This Notice will tell you about the ways in which we may use and disclose protected health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of protected health information. The law requires us to:
- make sure that protected health information that identifies you is kept private;
- notify you about how we protect protected health information about you;
- explain how, when and why we use and disclose protected health information;
- follow the terms of the Notice that is currently in effect.
We are required to follow the procedures in this Notice. We reserve the right to change the terms of this Notice and to make new notice provisions effective for all protected health information that we maintain by:
- posting the revised Notice in our office
- making copies of the revised Notice available upon request;
- posting the revised Notice on our Web site.
HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU
The following categories describe different ways that we use and disclose protected health information without your written authorization.
For Treatment. We may use protected health information about you to provide you with, coordinate or manage your medical treatment or services. We may disclose protected health information about you to doctors, nurses, technicians, medical students, or other personnel who are involved in taking care of you.
Summerfield Custom Wellness staff may also share protected health information about you in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose protected health information about you to people outside Summerfield Custom Wellness who may be involved in your medical care, such as clergy or others we use to provide services that are part of your care.
We may use and disclose protected health information to contact you as a reminder that you have an appointment for treatment or medical care at Summerfield Custom Wellness. We may use and disclose protected health information to tell you about or recommend possible treatment options or alternatives or health-related benefits or services that may be of interest to you.
For Payment for Services. We may use and disclose protected health information about you so that the treatment and services you receive at the Summerfield Custom Wellness may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about nutrition services you received at Summerfield Custom Wellness so your health plan will pay us or reimburse you for the service. We may also tell your health plan about the nutrition services you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
For Health Care Operations. We may use and disclose protected health information about you for Summerfield Custom Wellness health care operations, such as our quality assessment and improvement activities, case management, coordination of care, business planning, customer services and other activities. These uses and disclosures are necessary to run the facility, reduce health care costs, and make sure that all of our patients receive quality care.
For example, we may use protected health information to review our treatment and services and to evaluate the performance of the dietitian who is providing your services. We may also combine protected health information about many Summerfield Custom Wellness patients to decide what additional services the Summerfield Custom Wellness should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other Summerfield Custom Wellness personnel for review and learning purposes. We may also combine the protected health information we have with
protected health information from other health care facilities to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of protected health information so others may use it to study health care and health care delivery without learning who the specific patients are. We may also contact you as part of a fundraising effort.
Subject to applicable state law, in some limited situations the law allows or requires us to use or disclose your health information for purposes beyond treatment, payment, and operations. However, some of the disclosures set forth below may never occur at our facilities.
As Required By Law. We will disclose protected health information about you when required to do so by federal, state or local law.
Research. We may disclose your PHI to researchers when their research has been approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.
Health Risks. We may disclose protected health information about you to a government authority if we reasonably believe you are a victim of abuse, neglect or domestic violence. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent or lessen a serious and imminent threat to you or another person.
Judicial and Administrative Proceedings. If you are involved in a lawsuit or dispute, we may disclose your information in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made, either by us or the requesting party, to tell you about the request or to obtain an order protecting the information requested.
Business Associates. We may disclose information to business associates who perform services on our behalf (such as billing companies;) however, we require them to appropriately safeguard your information.
Public Health. As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
To Avert a Serious Threat to Health or Safety. We may use and disclose protected health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Health Oversight Activities. We may disclose protected health information to a health oversight agency for activities authorized by law. These activities include audits, investigations, and inspections, as necessary for licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Law Enforcement. We may release protected health information as required by law, or in response to an order or warrant of a court, a subpoena, or an administrative request. We may also disclose protected health information in response to a request related to identification or location of an individual, victims of crime, decedents, or a crime on the premises.
Organ and Tissue Donation. If you are an organ donor, we may release protected health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Special Government Functions. If you are a member of the armed forces, we may release protected health information about you if it relates to military and veterans activities. We may also release your protected health information for national security and intelligence purposes, protective services for the President, and medical suitability or determinations of the Department of State.
Coroners, Medical Examiners, and Funeral Directors. We may release protected health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose protected health information to funeral directors consistent with applicable law to enable them to carry out their duties.
Correctional Institutions and Other Law Enforcement Custodial Situations. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release protected health information about you to the correctional institution or law enforcement
official as necessary for your or another person’s health and safety.
Worker’s Compensation. We may disclose information as necessary to comply with laws relating to worker’s compensation or other similar programs established by law.
Food and Drug Administration. We may disclose to the FDA, or persons under the jurisdiction of the FDA, protected health information relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
YOU CAN OBJECT TO CERTAIN USES AND DISCLOSURES
Unless you object, or request that only a limited amount or type of information be shared, we may use or disclose protected health information about you in the following circumstances:
- We may share with a family member, relative, friend or other person identified by you protected health information directly relevant to that person’s involvement in your care or payment for your care. We may also share information to notify these individuals of your location, general condition or death.
- We may share information with a public or private agency (such as the American Red Cross) for disaster relief purposes. Even if you object, we may still share this information if necessary for the emergency circumstances.
If you would like to object to use and disclosure of protected health information in these circumstances, please call or write to our contact person listed on page 1 of this Notice.
YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU
You have the following rights regarding protected health information we maintain about you:
Right to Inspect and Copy. You have the right to inspect and copy protected health information that may be used to make decisions about your care. Usually, this includes medical and billing records.
To inspect and copy protected health information that may be used to make decisions about you, you must submit your request in writing to Summerfield Custom Wellness. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request, and we will respond to your request no later than 30 days after receiving it.
There are certain situations in which we are not required to comply with your request. In these circumstances, we will respond to you in writing, stating why we will not grant your request and describe any rights you may have to request a review of our denial.
Right to Amend. If you feel that protected health information we have about you is incorrect or incomplete, you may ask us to amend or supplement the information.
To request an amendment, your request must be made in writing and submitted to Summerfield Custom Wellness. In addition, you must provide a reason that supports your request. We will act on the your request for an amendment no later than 60 days after receiving the request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request, and will provide a written denial to you. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not part of the protected health information kept by Summerfield Custom Wellness;
- Is not part of the information which you would be permitted to inspect and copy; or
- We believe is accurate and complete.
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of protected health information about you.
To request this list or accounting of disclosures, you must submit your request in writing to Summerfield Custom Wellness. You may ask for disclosures made up to six years before your request (not including disclosures made before April 14, 2003). The first list you request within a 12-month period will be free.
For additional lists, we may charge you for the costs of providing the list. We are required to provide a listing of all disclosures except the following:
- For your treatment
- For billing and collection of payment for your treatment
- For health care operations
- Made to or request by you, or that you authorized
- Occurring as a byproduct of permitted use and disclosures
- For national security or intelligence purposes or to correctional institutions or law enforcement regarding inmates
- As part of a limited data set of information that does not contain information identifying you
Right to Request Restrictions. You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment or health care operations or to persons involved in your care.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment, the disclosure is to the Secretary of the Department of Health and Human Services, or the disclosure is for one of the purposes described on pages 4-5.
To request restrictions, you must make your request in writing to Summerfield Custom Wellness.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to Summerfield Custom Wellness. We will accommodate all reasonable requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice at any time by contacting Summerfield Custom Wellness.
OTHER USES AND DISCLOSURES
We will obtain your written authorization before using or disclosing your protected health information for purposes other than those provide for above (or as otherwise permitted or required by law). You may revoke this authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing your information, except to the extent that we have already taken action in reliance on the authorization.
YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES
If you believe your privacy rights have been violated, you may file a complaint with the Summerfield Custom Wellness or file a written complaint with the Secretary of the Department of Health and Human Services. A complaint to the Secretary should be filed within180 days of the occurrence or action that is the subject of the complaint.
If you file a complaint, we will not take any action against you or change our treatment of you in any way