Terms

Terms and Conditions

Last Revision: August 24, 2012

PLEASE READ THESE TERMS AND CONDITIONS CAREFULLY BEFORE USING THIS WEBSITE. BY USING THIS WEBSITE, YOU AGREE TO THESE TERMS AND CONDITIONS.

Carewise Health, Inc. (“Carewise Health®” or “CWH”) is a personal health program administrator and an independent third-party provider of health advocacy and health management solutions. CWH is a wholly-owned subsidiary of SHPS, Inc. (“SHPS”).Carewise Health Portal (‘Website’) is owned and operated by CWH who is responsible for any policies regarding this Website, including these Terms and Conditions and the Privacy Policy. Also, these Terms and Conditions apply only to this Website and do not change the terms or conditions of any other agreement you have with CWH and its affiliates and their respective officers, directors, employees, agents, licensors and suppliers for other products or services.By using this Website you are agreeing to comply with and be bound by these Terms and Conditions, which may change at any time. You should read and fully understand this notice before using this Website, and review this notice for changes or whenever questions arise.

Conflict of Interest Policy

All CWH associates are expected to avoid personal situations, which might be construed as conflicts of interest relevant to their employment with CWH. All employees and persons doing business on behalf of CWH sign a conflict of interest statement upon employment and annually thereafter.

General Provisions

The contents of this Website, including all text, graphics, images, information, and other materials (‘Content’), are for informational purposes only and are intended to provide general information on a variety of healthcare and health benefits topics. The Content is NOT intended in any way to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website.If you have a medical emergency, call your doctor or 911 immediately. CWH does not recommend or endorse any specific tests, products, procedures, opinions or other information that may be mentioned on this Website. Reliance on any information provided by CWH employees, others appearing on this Website at the invitation of CWH, or other visitors to this Website is solely at your own risk.This Website may contain medical materials that you might find sexually explicit or otherwise offensive. CWH, and its affiliates and their respective officers, directors, employees, agents, licensors and suppliers accept no responsibility for such materials.

Editorial Policy

All content available to you on the Website is reviewed annually by specialized subject matter physician experts. All content reviewers sign a conflict of interest statement – see Conflict of Interest Policy. All health content will identify the names and credentials of the editorial review team member, the source of the material, the date of the most recent review or update.Any health content developed by CWH will be submitted to a review process by the Chief Medical Officer or the Associate Medical Director in collaboration with the Clinical Information Department.Content that falls within a specific medical specialty will be reviewed and approved annually by a subject-matched medical specialist.The names and credentials of the review team members will be disclosed on the health content material. All reviewers are credentialed every two (2) years.

Privacy Policy

CWH believes strongly in protecting user privacy. Our Privacy Policy explains how CWH collects and uses personal information.

Children’s Privacy

The CWH Website is not designed nor promoted for use by children under the age of 14. CWH does not collect any personal information from children under the age of 14. Please see CWH’s Privacy Policy for more information.

Your Account

If you use this Website, you are responsible for maintaining the confidentiality of your account and password, and you agree to accept responsibility for all activities that occur under your account or password. CWH and its affiliates reserve the right to refuse service, terminate accounts, remove or edit content in their sole discretion.As a subscriber (i.e., employee group health plan participant) who is registering a dependent under the age of 14, you certify that you are the parent or legal guardian of this dependent, that you are registering to track his/her health and will not be granting unsupervised access to this dependent.You are responsible for managing access to this site and maintaining the confidentiality of your dependent’s account and password, and you agree to accept responsibility for all activities that occur under this account or password.

Website User Rights & Responsibilities

1. Website User Rights

• Access to a toll free phone number that is a client designated 800 number.
• Access to a telephonic interpreter when the patient does not speak or understand the primary language of the CWH associate with whom they are speaking.
• Assistance in obtaining quality medical care and pre–certification based on medical necessity.
• To know the staff member and their role, and to speak with a supervisor of the staff member if requested.
• Candid discussion of appropriate or medically necessary treatment options for care.
• Know about the philosophy and characteristics of the program (Disease Management, Case Management, Utilization Management, Demand Management, Workers’ Compensation, Care Coordination).
• Respect from all CWH staff.
• Receive accurate information from CWH staff.
• Receive administrative information regarding any changes in the program.
• Decline participation, revoke consent or un-enroll at any point in time.
• Voice a complaint regarding the care/services received.
• Privacy concerning his/her medical care program. Website user has the right to confidential and discreet case discussion and consultation.
• Information only will be shared by CWH in accordance with state and federal law.
• Confidentiality in all communications and records pertaining to care.
• Initiate the review and when possible, the resolution of complaints regarding quality of care.
• Access to Medical records – To request copies of complete medical records the patient must contact the health care provider, i.e. physician, hospital, etc.
• Medical records retained by CWH are a synopsis and not a complete clinical medical record.
• Initiate an appeal based upon CWH determination.
• Have input in the case management plan.
• Obtain information regarding the Company’s criteria for case closure.
• Receive notification and a rationale when case management services are changed or terminated.

2. Website User Responsibilities

• Be honest about issues that relate to you. The Website user is responsible for providing accurate and complete information about present complaints, past history, hospitalizations, medications and other issues related to his/her health.
• Follow up via telephone if you do not receive a phone call or letter within two business days regarding your pre–certification request.
• Submit written consent if it is required by CWH or if requested by you.
• Refer questions regarding compensability matters to your claims payor. CWH’s recommendation does not guarantee acceptance of your claim.
• Attempt to follow the directions and advice offered by your health care providers.
• Notify the treating provider of the participation in the Disease and/or Case Management program (if applicable).
• Report changes in your condition to those responsible for your care and welfare.
• The information provided by CWH is designed to support, not replace, the relationship that exists between the Website user and his/her existing health care provider.
• Ask questions when you do not understand what you are expected to do.
• Ensure that only covered family members use CWH services.
• Take good care of yourself and your family.

Opt-In

By logging into the Website, you agree to provide personal medical information relevant to the program. If these terms are not acceptable, please click on ‘exit’ to return to the main CWH web page. At any time you may contact CWH via the contact link above. CWH does not use identifiable personal health information for any purpose outside the scope of the participant’s original opt-in consent.

Opt-Out

In order to change personally identifiable information, you can login and correct information such as address, phone. To opt-out of email notification, you can login and remove your email address or call CWH. If you need to correct personal health information previously submitted, you may contact us using the “contact us” link above.

Copyright

Carewise Health is marketed by Carewise Health, Inc., a provider of health advocacy and health management solutions.All content included on this Website, such as text, graphics, logos, button icons, images, audio clips, digital downloads, data compilations, and software, is the property of CWH or its content suppliers and protected by United States and international copyright laws.You may electronically copy and print to hard copy portions of this Website for the sole purpose of using materials it contains for informational and non-commercial, personal use. Any other use of the materials in this Website – including any commercial use, reproduction for purposes other than described above, modification, distribution, republication, display, or performance – without the prior written permission of CWH is strictly prohibited. CWH respects the intellectual property of others, and we ask our users to do the same. CWH may, in appropriate circumstances and at its own discretion, limit access to this Website and/or terminate the accounts of any users who abuse the intellectual property rights of others.

Trademarks

Carewise Health, Inc., Carewise Health, all Carewise Health logos, and the products and services described in this Website, are either trademarks or registered trademarks of CWH, its suppliers and its licensors, and may not be copied, imitated or used, in whole or in part, without the prior written permission of CWH. All other trademarks, registered trademarks, product names, and company names or logos mentioned herein are the property of their respective owners.

Electronic Communications

All communications transmitted via the Website will be responded to within one (1) business day.When you visit the Website or send e-mails to us, you are communicating with us electronically and consent to receive communications from us electronically. We will communicate with you by e-mail or by posting notices on this Website. By using the Website, you agree that all notices, agreements, disclosures, and other messages that we provide to you electronically satisfy any legal requirement that such communications be in writing.

Third Party Content and Services

This Website may include content and features provided by third parties (‘Third Party Content’) who have been contracted by CWH to provide such services. CWH does not warrant the accuracy or completeness of any Third Party Content.Some of the health content is licensed to CWH by Healthwise, Incorporated (“Healthwise”). Healthwise is a nonprofit organization whose mission since 1975 has been to Help People Make Better Health Decisions. Healthwise has not reviewed and does not endorse any information, products, or services other than those clearly marked as from Healthwise. Healthwise provides certain content from its suppliers on this Website. Terms and conditions and end-user licensing arrangements for those content providers appear below:

SELF-HELP CLEARINGHOUSE. By retrieving and/or utilizing information from the American Self-Help Clearinghouse database, you agree to hold harmless American Self-Help Clearinghouse, its owners, and employees from any and all liability arising directly or indirectly from your use of information contained in the database. You be the judge. The Self-Help Clearinghouse does not evaluate or rate the individual self-help groups, which are contained in the database. Therefore, Self-Help Clearinghouse’s listing of a self-help group does not constitute an endorsement of that group. Neither does omission signify disapproval. We include groups in our database based upon a report of their organizations as being focused upon no-fee mutual aid; i.e., members helping one another. The use of any information is entirely the responsibility of the reader. You are the ultimate judge in deciding whether the group is appropriate to your needs. You can send for and review literature or call the phone contact. Self-help means more control, and more responsibility, in your hands.

NATIONAL CANCER INSTITUTE. Some material in the PDQ® is from copyrighted publications of the respective copyright claimants. Users of PDQ are referred to the publication data appearing in the bibliographic citations, as well as to the copyright notices appearing in the original publication, all of which are hereby incorporated by reference.

NORD’S RARE DISEASE DATABASE. The information provided in this report is not intended for diagnostic purposes. It is provided for information purposes only. This information is presented for further understanding that could lead to the prevention, treatment, and/or cure of rare disorders. NORD recommends that affected individuals seek the advice or counsel of his or her own personal physician(s). It is possible that the title of the topic is not the name you selected. Please check the SYNONYMS listing to find the alternate name(s) and disorder subdivision(s) covered by this report. The disease entry is based upon medical information available through the date at the end of the topic. Since NORD’s resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about the disorder.

CERNER MULTUM DRUG REFERENCE. END-USER LICENSE AGREEMENT. The Service is for use by United States and Canadian residents only. The Service is a service provided to you by Cerner Multum (“Multum”). The Service and the “Healthwise Knowledgebase” are separate products provided by separate entities.Every effort has been made to ensure that the information provided in the Service is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive.The Service does not endorse drugs, diagnose patients, or recommend therapy. The Service is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and provide consumers with drug specific information. Healthcare practitioners should use their professional judgment in using the information provided. The Service is not a substitute for the care provided by licensed healthcare practitioners and consumers are urged to consult with their healthcare practitioner in all instances. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information the Service provides.

Multum Disclaimer of Warranties. THE END-USER ACKNOWLEDGES THAT THE SERVICE IS PROVIDED ON AN “AS IS” BASIS. EXCEPT FOR WARRANTIES WHICH MAY NOT BE DISCLAIMED AS A MATTER OF LAW, MULTUM MAKES NO REPRESENTATIONS OR WARRANTIES WHATSOEVER, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO REPRESENTATIONS OR WARRANTIES REGARDING THE ACCURACY OR NATURE OF THE CONTENT OF THE SERVICE, WARRANTIES OF TITLE, NONINFRINGEMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. The END-USER acknowledges that updates to the Service are at the sole discretion of Multum. Multum makes no representations or warranties whatsoever, express or implied, with respect to the compatibility of the Service, or future releases thereof, with any computer hardware or software, nor does Multum represent or warrant the continuity of the features or the facilities provided by or through the Service as between various releases thereof. Any warranties expressly provided herein do not apply if: (i) the END-USER alters, mishandles or improperly uses, stores or installs all, or any part, of the Service, (ii) the END-USER uses, stores or installs the Service on a computer system which fails to meet the specifications provided by Multum, or (iii) the breach of warranty arises out of or in connection with acts or omissions of persons other than Multum.

Multum Assumption of Risk, Disclaimer of Liability, Indemnity. THE END-USER ASSUMES ALL RISK FOR SELECTION AND USE OF THE SERVICE AND CONTENT PROVIDED THEREON. MULTUM SHALL NOT BE RESPONSIBLE FOR ANY ERRORS, MISSTATEMENTS, INACCURACIES OR OMISSIONS REGARDING CONTENT DELIVERED THROUGH THE SERVICE OR ANY DELAYS IN OR INTERRUPTIONS OF SUCH DELIVERY.THE END-USER ACKNOWLEDGES THAT MULTUM: (A) HAS NO CONTROL OF OR RESPONSIBILITY FOR THE END-USER’S USE OF THE SERVICE OR CONTENT PROVIDED THEREON, (B) HAS NO KNOWLEDGE OF THE SPECIFIC OR UNIQUE CIRCUMSTANCES UNDER WHICH THE SERVICE OR CONTENT PROVIDED THEREON MAY BE USED BY THE END-USER, (C) UNDERTAKES NO OBLIGATION TO SUPPLEMENT OR UPDATE CONTENT OF THE SERVICE, AND (D) HAS NO LIABILITY TO ANY PERSON FOR ANY DATA OR INFORMATION INPUT ON THE SERVICE BY THE END-USER TO THE SERVICE.MULTUM SHALL NOT BE LIABLE TO ANY PERSON (INCLUDING BUT NOT LIMITED TO THE END-USER AND PERSONS TREATED BY OR ON BEHALF OF THE END-USER) FOR, AND THE END-USER AGREES TO INDEMNIFY AND HOLD MULTUM HARMLESS FROM ANY CLAIMS, LAWSUITS, PROCEEDINGS, COSTS, ATTORNEY’S FEES, DAMAGES OR OTHER LOSSES (COLLECTIVELY, “LOSSES”) ARISING OUT OF OR RELATING TO (A) THE END-USER’S USE OF THE SERVICE OR CONTENT PROVIDED THEREON OR ANY EQUIPMENT FURNISHED IN CONNECTION THEREWITH AND (B) ANY DATA OR INFORMATION INPUT ON THE SERVICE BY END-USER, IN ALL CASES INCLUDING BUT NOT LIMITED TO LOSSES FOR TORT, PERSONAL INJURY, MEDICAL MALPRACTICE OR PRODUCT LIABILITY. FURTHER, WITHOUT LIMITING THE FOREGOING, IN NO EVENT SHALL MULTUM BE LIABLE FOR ANY SPECIAL, INCIDENTAL, CONSEQUENTIAL, OR INDIRECT DAMAGES, INCLUDING DAMAGES FOR LOSS OF PROFITS, LOSS OF BUSINESS, OR DOWN TIME, EVEN IF MULTUM HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. THE INFORMATION CONTAINED WITHIN THE SERVICE IS INTENDED FOR USE ONLY BY PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS WHO SHOULD RELY ON THEIR CLINICAL DISCRETION AND JUDGMENT IN DIAGNOSIS AND TREATMENT. AS BETWEEN THE END-USER AND MULTUM, THE END-USER HEREBY ASSUMES FULL RESPONSIBILITY FOR INSURING THE APPROPRIATENESS OF USING AND RELYING UPON THE INFORMATION IN VIEW OF ALL ATTENDANT CIRCUMSTANCES, INDICATIONS, AND CONTRAINDICATIONS.

Liability of Multum to the END-USERS. Under no circumstances shall Multum be liable to the END-USER or any other person for any direct, indirect, exemplary, special or consequential damages arising out of or relating to the END-USER’s use of or inability to use the Service or the content of the Service provided thereon or any equipment furnished in connection therewith. Multum’s total liabilities in connection with this Agreement, whether arising under contract or otherwise, are limited to the fees received by Multum under this Agreement specifically relating to the END-USER’s service or product which is the subject of the claim.

Hyperlinks

CWH does not endorse, makes no claim, representation, or warranty regarding, and accepts no responsibility for, the quality, content, nature, or reliability of websites accessible by hyperlink from this Website.Your use of third-party websites is at your own risk and subject to the terms and conditions for such websites. Any links provided by CWH are done so only as a convenience, and inclusion of any link does not imply affiliation with, adoption of any site or endorsement of (i) any website, (ii) any product or service advertised on these websites, or (iii) any other information contained therein.CWH has no material, financial, and/or business relationships based upon the links provided to external web sites. As with any medical information, it should be discussed with your physician or attending medical provider to determine if the information is applicable to you and your medical situation.When you click on a link, a new browser window will open indicating that you are leaving the CWH Website. As a reminder, review a web site’s policies to determine your level of privacy when using any of these links. The sites are reviewed once a year for appropriateness. If you find that a link is no longer functioning, please report it to us.

Disclaimer

This Website and its contents are provided on an ‘AS-IS’ ‘AS AVAILABLE’ basis without warranties of any kind, either express or implied. CWH AND ITS CONTENT PROVIDERS EXPRESSLY DISCLAIM ALL IMPLIED WARRANTIES OF TITLE, MERCHANTABILITY, NONINFRINGEMENT, AND FITNESS FOR A PARTICULAR PURPOSE AND FURTHER DO NOT REPRESENT OR WARRANT THAT THIS WEBSITE OR ITS SERVER(S) ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS. CWH AND ITS CONTENT PROVIDERS ARE NOT RESPONSIBLE FOR THE RESULTS OF YOUR USE OF THE WEBSITE INCLUDING, BUT NOT LIMITED TO, YOUR CHOICE TO SEEK OR NOT TO SEEK PROFESSIONAL MEDICAL CARE, OR YOUR CHOICE OF ANY SPECIFIC TREATMENT BASED ON THE INFORMATION ON THE WEBSITE. CWH reserves the right to change any and all content contained on this Website at any time without notice.

Out of Scope Uses

Suicidal or other emergent threats sent via the CWH Website will be addressed as a crisis situation call. If the user’s contact information is available, CWH will make every attempt to contact the user and assist them in seeking medical attention if necessary. The external medical links are provided as a convenience to users, if you are experiencing a medical emergency please dial ‘911’. Any calls pertaining to child abuse, elder abuse, etc. which require mandatory state reporting shall be documented to include details outlining date, time, and name of state department employee who recorded this event from our nurse. Any out of scope uses requiring reporting to authorities will be referred to the proper authorities. CWH shall comply with state, federal, legal, or regulatory reporting requirements if determined necessary.

Termination

Not withstanding any of these Terms and Conditions, CWH reserves the right, without notice and in its sole discretion, to terminate your right to use this Website and to block or prevent future access to and use of this Website.

Modification and Amendments

CWH reserves the right to amend at any time any policies governing this Website, including these Terms and Conditions and CWH’s Privacy Policy, by posting the amended terms and providing notice of such amendments. The amended terms shall be effective immediately. If you do not accept the amended terms, you should cease using this Website.

Limitation of Liability

In no event shall CWH, its affiliates and their respective officers, directors, employees, agents, licensors content providers or suppliers (collectively “CWH and Affiliates”) be liable for any direct, special, indirect or consequential damages, or any other damages of any kind, including but not limited to loss of use, loss of profits, or loss of data, whether an action in contract, tort (including but not limited to negligence), or otherwise, arising out of or in any way connected with the use of this Website or the content or other materials contained in, or accessed through, this Website, even if CWH is advised of the possibility of such damages, including, without limitation, any damages caused by or resulting from your reliance on any information obtained from CWH, or that results from mistakes, omissions, interruptions, deletion of files or e-mail, errors, defects, viruses, delays in operation or transmission or any failure of performance, whether or not resulting from acts of God, communications failure, theft, destruction or unauthorized access to CWH’s records, programs, or services. In no event will the aggregate liability of CWH (whether in contract, warranty, tort-including negligence, whether active, passive or imputed-product liability, strict liability or other theory) arising out of or related to the use of this Website exceed U.S. $1,000. CWH and Affiliates are not liable for any personal injury, including death, caused by your use or misuse of this Website, the content or other materials contained in or accessed through this Website. All claims arising in connection with your use of this Website, any content or any other materials must be brought within one (1) year of the date on which the event giving rise to such action occurred. Remedies under these Terms and Conditions are exclusive and are limited to those provided for herein.

Indemnification

You shall indemnify and hold harmless CWH, its affiliates and their respective officers, directors, employees, agents, licensors, content providers and suppliers, from and against any claims, actions, demands, liabilities and settlements (including without limitation reasonable attorneys’ fees) arising out of or in connection with your breach of these Terms and Conditions.

Miscellaneous

If any provision of these Terms and Conditions shall be deemed unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from these Terms and Conditions and shall not affect the validity and enforceability of any remaining provisions. These Terms and Conditions shall be governed by and construed in accordance with the laws of the Commonwealth of Kentucky, applicable to agreements made and entirely to be performed within Kentucky, without resort to its conflict of law provisions. You agree that any action at law or in equity arising out of or relating to these Terms and Conditions shall be filed only in Jefferson Circuit Court or U.S. District Court for the Western District of Kentucky, both located in Louisville, Kentucky, and you hereby irrevocably and unconditionally consent and submit to the exclusive jurisdiction of such courts over any suit, action or proceeding arising out of these Terms and Conditions.

Professional Qualification / Verification

All CWH clinical staff are required to have an unrestricted license. All licensures and certifications are validated with primary source verification upon hire and no less than every three years thereafter.

Questions & Contact Information

General questions, comments or complaints about this Website may be directed to portalsupport@carewisehealth.com. CWH corporate headquarters is located at: 9200 Shelbyville Road, Louisville, KY 40222. For more information about our executive team or for additional information about Carewise Health, please visit us on our website at www.carewisehealth.com.