The following disclosures are required by Oregon law for Northwest Concierge Medicine (NWCM):
 

• A retainer medical agreement with NWCM does not constitute health insurance, and covers only the limited scope of primary care services specified in the retainer medical agreement.

• Medications, labs, diagnostic studies, hospitalizations, and specialist care is billed separately by the individuals or institutions providing these services. The patient is responsible for payment (directly or through their insurance) for all services not specified in the retainer medical agreement.

• NWCM recommends maintaining your own health insurance coverage for services that it does not provide. 

• Please confirm with your insurance that referrals, labs, medications and studies ordered by an out-of-network provider will be covered.

• The fee structure is detailed in the Establish Care Packet. Payment is due in advance of your monthly or annual membership term. A signed contract will be kept on file, and will automatically renew each year. Either party may terminate your membership at any time with thirty days written notice. Nonpayment of fees will constitute a termination after 90 days from the time payment is due. If your membership terminates prior to the end of the membership period, you are entitled to a prorated refund of payments made based on the remaining full months in the annual period. 

• The laws of the state of Oregon govern the agreement between NWCM and its patients. 

• The Department of Consumer and Business Services issued a certification to this practice. You can contact consumer advocates at the Department of Consumer and Business Services at (888) 977-4894, dcbs.insmail@state.or.us, or www.insurance.oregon.gov.