Healthcare Agreement overview

Modified on Tue, Aug 4 at 8:50 AM

The Healthcare Agreement is a contract between the practice and the client that is automatically created when a plan is added. An updated agreement is generated if a plan is later changed.

Petly Plans stores an unsigned copy of the agreement within the application for each plan. A signed copy must be printed, reviewed with the client, and retained at the practice.

Key facts

The agreement is automatically created when a plan is added and updated if the plan is later changed.

Petly Plans stores an unsigned copy of the agreement for each plan within the application.

A signed copy must be retained at the practice for a minimum of two years.

If someone other than the account holder is paying, they must also sign as a co-subscriber.

Agreement structure

Page 1 — Plan and subscriber information

Overview of the plan, fees, and key terms

The first page includes subscriber information, pet and agreement details, and monthly fees. It also states that:

The plan is not insurance

The initial membership fee is non-refundable

Services provided with this plan type

Any restrictions that apply

Page 2 — Legal terms and conditions

Full terms governing the plan agreement

The second page contains the additional legal terms and conditions that apply to the plan, including:

General terms

Payment collection

Plan cancellation

Plan renewal

Initial membership fee exceptions

Plan changes

Early services usage

Limitations and exclusions

Discounts applied

Plan usage

Method of payment

Collection costs

Co-subscriber requirements

Signature page — Client and hospital signatures

Must be completed before the pet owner leaves

The signature page requires the following to be completed:

Client full name and date

Co-subscriber signature (if applicable)

Hospital representative signature and date

Payment authorization signature

Co-subscriber: If someone other than the person listed on the pet's account is paying for the plan, that person must also sign and date the healthcare agreement in the co-subscriber section.

Payment authorization: Below the signature area is information about the payment method assigned to the plan. The person listed on that payment method must sign the authorization to allow the practice to automatically charge the account.

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