Michael Chan, MD, MS, RST, Inc., a Nevada professional corporation, including any board members, representatives, employees, contractors, agents, and affiliates ("Company," "Medical Group", "Practice", "Clinic", "provider", "provider's delegate", "we," "us," "our") provides its services to you ("you", "user", "patient", "intended patient", "responsible party") through its website, software, applications, communications, documents, and select electronic services from third party providers (collectively, the "Platform"), subject to the following Terms and Conditions ("Terms", "Terms of Service", "Company's posted Terms of Service", "related consumer disclosure").
1. Financial Responsibility
1.1. Payments and Charge Dispute Policy
1.1.1. Payment Guarantees
You or your responsible party ("Guarantor") hereby guarantee payment of all charges incurred.
1.1.2. Credit Card Usage, Charges, and Payment Processing
We accept U.S.-issued credit and debit cards only. Payments and purchases are processed through third-party vendors.
By signing a Credit Card Authorization form that includes details of a given payment card, you are putting the payment card on file in perpetuity, and you understand and agree to the Company's standard practice of card-on-file billing in a card-not-present environment. You agree to have any payment cards on file charged for the full cost of your appointment and any anticipated orders, up to several weeks before your next appointment, appointment package (bundled appointments), and/or subscription begins. This is the standard billing practice for all patients we follow, in order to secure your timeslot(s) for your upcoming appointment(s). Further, we reserve the right to charge a patient or patient’s responsible party using any credit card(s) on file for any funds or payments owed. Any charges we make to your card(s) on file for an upcoming appointment that occurs within 30 days (or in rare cases, up to 1 year) are valid, authorized by you in full in advance, and are not fraudulent. You may retrieve an itemized receipt associated with an appointment or charge in our Patient Portal.
It is your responsibility to request or make changes to your billing information and preferences before a card on file is charged. Once charges for an upcoming appointment are made using a card on file, they will not be reversed. If we are unable to successfully charge customer-provided credit card(s) for the full amount of funds or payments owed, then we will bill the patient or patient’s responsible party, and the funds or payments owed are due within 24 hours of the bill being sent.
You and your responsible party agree to refrain from initiating a payment on your own, whether online, through the Patient Portal, or by other means, unless we provide an expressly written agreement or approval of such payment in advance. We are unable to refund payments that are initiated by users, but if such payment was made by or on behalf of an established, active patient, we will treat the funds received as an account credit for the intended established patient: we will apply any funds received in full towards the established patient’s future appointments, orders, charges, and/or fees. If a user is not an established, active patient but has initiated a payment that was not agreed upon or approved in advance, we are unable to refund the payment, and will not provide account credit for a user.
If you or your responsible party do not have a payment card on file due to removing it, or requesting to remove it, we are unable to refund any previous payments. Any payments made previously will remain as account credit or be applied to any upcoming appointments and/or orders.
1.1.3. Credit Card Ownership and Payment Approval
By adding a payment card on file (“card on file”), you confirm that you are the primary owner of the card on file, are solely responsible for and guarantee all charges made on it, and authorize all charges made to the card prior to your upcoming appointment. If you are not the primary owner of the card on file, you confirm that you have received pre-approval in writing that 100% of any charges made on the card are valid, acknowledged, understood, approved, and guaranteed by the primary owner of the card on file. Further, you testify that, if you are not the primary owner of the card on file, it belongs to your responsible party, and you have previously officially designated them as your responsible party in your account with us. You agree that, if the owner of the primary card on file denies or disputes charges made on your behalf, or if any charges do not get made in full for payments you and/or your responsible party owe, that you will be 100% financially responsible for any charges, payments, and fees, and penalties owed, as determined solely by the Company.
For any card on file you and/or your responsible party designate, you and/or your responsible party pre-approve and guarantee any charges made to the card in order to cover any amounts owed to the Company on your behalf, in accordance with the Terms specified herein, irrevocably and in perpetuity.
You agree that if you provide us with a payment card that you do not have written pre-approval for, and/or that your responsible party does not authorize, any charges made by the Company to the payment card were made in error due to being misled by you, and the Company is to be held harmless against any repercussions. In this case, you and/or your responsible party may have committed fraud against the Company and the payment card owner(s). The Company has the right to pursue any legal action as a result. You and/or your responsible party are still fully responsible for any payments owed.
1.1.4. Financial Responsibility for Scheduled Appointments
By requesting, booking, confirming an appointment, and/or having an appointment confirmed, you agree to:
1.1.4.1. Prepayment Authorization
You agree to be charged in full for your next appointment or appointment subscription up to several weeks before it is scheduled to begin. This enables us to secure your upcoming appointment timeslot(s). It is under our sole discretion whether to honor any requests to refrain from charging for any appointments, services, subscriptions, orders, or medications until a specified date and/or time before an appointment or other time of service or delivery. Once a charge or payment is made before an upcoming appointment, subscription, order, or medication sent, it cannot be reversed or refunded.
1.1.4.2. Recurring Appointments
Following an initial appointment, you agree that all subsequent appointments shall recur every four 4 weeks (28 calendar days) thereafter, on the same day of the week and at the same time of day, unless otherwise mutually agreed in writing by the Company. In the event any appointment is rescheduled, all subsequent appointments shall be deemed amended to recur every 4 weeks (28 calendar days) from the rescheduled appointment date, on the same day of the week and at the same time of day, unless otherwise mutually agreed in writing by the Company.
1.1.4.3. Valid Payment on File
By adding any payment card on file, you authorize it to be charged in full for upcoming appointments, services, and/or outstanding payments due. If you do not remove your card from your file before it is charged for your upcoming appointment, any charges made are valid and not fraudulent. If you fail to specify a preferred, valid payment method before your card is charged for your upcoming appointment, and/or fail to change the preferred payment status of payment card(s) on file such that your preferred payment card is valid and can be charged for the full payment due, we are not responsible, and it does not change our rights to charge any of your payment card(s).
1.1.4.4. Medication Orders
You agree to be charged a deposit for the full projected cost of any weight loss medication order from a pharmacy partner(s) up to several weeks before any such order is confirmed, finalized, and/or shipped. Since we are charged for weight loss medications that are shipped to patients regardless of a patient’s ability to pay, this enables us to ensure that your payment is processed in full before we order medications that are shipped to you. If you want to request that charges for your medication are not made until your upcoming appointment, please email us your request at ml@captainmd.com a minimum of 2 weeks before potential charges are made; requests are not guaranteed to be honored. If during your appointment the cost of your medication order is for a lower amount than we charged you, or if you do not end up placing any medication order, the full amount charged will be assigned to your account as credit to be used for future appointment(s) and/or order(s) as long as you are an active patient.
1.1.4.5. Credit Card Authorization Requirement
You agree to have a Credit Card Authorization form with a valid credit card or form of payment on file with us at all times. If you do not maintain sufficient funds on your preferred and/or authorized payment card, we reserve the right to charge any other payment card on file. You cannot revoke authorization for a charge to your card after it has already been charged. Adding a card(s) on file does not automatically remove authorization of any other card(s) on file.
1.1.4.6. No Refunds Once Paid
You agree that you will not be refunded or reimbursed for any portion of the payment for any appointment, or pharmacy partner orders that have already been made for any reason.
1.1.5. Charge Disputes and Authorization Challenges
You acknowledge and agree that initiating charge disputes or authorization challenges related to completed appointments, rendered services, delivered orders, or incurred fees—without valid documented evidence of Company error or misconduct—can materially harm the Company’s business operations, reputation, and financial stability.
If you believe a charge has been processed in error, you must first notify the Company in writing at ml@captainmd.com, providing:
(a) A detailed explanation of the alleged error; and
(b) All supporting documentation that you contend proves you were charged incorrectly.
Upon receipt, the Company will make a good faith effort to investigate and, where appropriate, correct or resolve the matter. You agree to allow the Company a period of 5 business days to respond to and/or resolve the matter before potentially filing a charge dispute.
If you fail to provide supporting documentation that reasonably demonstrates an incorrect charge, you agree that any related charge dispute or authorization challenge shall be automatically resolved in favor of the Company and that you remain fully responsible for the charge.
You further acknowledge and agree that a written narrative or statement submitted to your bank or card issuer, without supporting documentation that contradicts the Company’s records, is not legally or financially verifiable, and does not constitute sufficient evidence of an incorrect charge. In any charge dispute or authorization challenge, you agree that the Company’s records and documentation—including, without limitation, electronic logs, invoices, receipts, service records, clinical notes, prescription and order records, consent forms, communications, and/or system records, which are automatically electronically timestamped—shall be deemed reliable and sufficient evidence of the validity of the charges. In such cases, you agree that the dispute shall be resolved in the Company’s favor. Further, you agree that are responsible for all related costs, fees, and chargeback amounts assessed to the Company as a result of any charge disputes you filed.
You acknowledge that charge disputes, including for completed appointments, services, orders, and/or for fees incurred, or if otherwise frivolous or wrongfully filed without documented proof of wrongdoing by the Company, can disrupt or negatively affect the reputation, finances, and operations of the Company.
If you suspect any incorrect charges or financial adjustments required, you agree to contact ml@captainmd.com with full details, documented proof of any incorrect charges, and any requests for resolution so that we may make our best attempt to address and/or resolve the matter with you, before potentially filing any charge disputes or related claims. Failure to follow the specified contact and resolution procedure before filing any charge disputes automatically invalidates the associated charge dispute claims filed, and means you agree that your charge dispute is false, hence the charge dispute should be resolved in the Company's favor and you agree to pay all costs associated with the charge dispute immediately to the Company.
1.1.5.1. Credit Card Authorization Form and Charge Approval
If you have signed a Credit Card Authorization Form, you authorize the associated payment card to be charged in advance in a card absent environment for any appointment fees, services, and orders associated with a scheduled, completed, missed (no show), or cancelled appointment. Any such charges are valid, and not fraudulent.
Your authorization of payments owed is in perpetuity unless you can prove in writing that you have:
A. Withdrawn approval of charging the associated payment card in advance of the charge being made
and
B. You have provided a different and valid payment card on file that has sufficient balance in order to cover 100% of the payment owed in advance of the charge being made.
- Authorization of card on file: By maintaining a payment card or other form of payment on file, you expressly authorize us to charge that card or payment method for any and all services, appointments, subscriptions, medications, or other charges associated with your care in perpetuity until you request to revoke its authorization in writing to ml@captainmd.com.
- Any dispute, claim, or chargeback alleging that you did not authorize charges to your card, or that we had no right to charge your card, will fail if (1) you or your guarantor placed that card or payment method on file, and (2) you did not first request in writing to change or revoke its authorization status while simultaneously maintaining a valid form of payment on file.
- Personal financial and/or card issues: Running out of funds, reaching credit limits, or other personal financial issues do not invalidate charges properly authorized and processed. You are solely responsible for ensuring sufficient funds and/or credit availability for payments due.
- If your appointment documentation indicates upcoming services with associated charges, but you later claim to have not authorized those services or charges, the charges remain valid and enforceable.
- If you have been provided the services listed in your appointment notes, as documented in timestamped clinical notes for that appointment, all associated charges are deemed approved and guaranteed by you and/or your guarantor, regardless of any subsequent claim to the contrary.
1.1.5.2. Mandatory Pre-Dispute Contact Requirement
Before initiating any charge dispute or chargeback with your bank or financial institution regarding a payment, you agree to first contact our Customer Service team to attempt to resolve the matter directly.
All inquiries or concerns regarding charges must be submitted in writing via email to ml@captainmd.com. You must provide a reasonable opportunity for resolution before pursuing a dispute through your financial institution.
Any charge dispute or chargeback initiated without prior written contact and a documented attempt to resolve the issue with our Customer Service team will be considered invalid and a breach of these Terms.
1.1.5.3. Charge Dispute Time Requirement
In the event that you initiate a charge dispute, we must receive it within 24 hours of the corresponding initial charge, payment, request for payment, invoice, or order submission being made. If we do not receive the charge dispute within that timeframe, the charge dispute is invalid and you will not receive any payment, refund, charge reversal, credit, or other compensation.
1.1.5.4. Invalid Charge Disputes
Charge disputes for appointments that were already scheduled and/or confirmed for a patient, and/or for orders that were already submitted to any pharmacy partner are not valid.
By agreeing to these Terms and submitting payment, you acknowledge and accept the following conditions regarding billing disputes and chargebacks:
Charge disputes (including chargebacks or payment reversals) are strictly prohibited and considered invalid in the following circumstances:
A. Signed Authorization: You have completed and submitted a credit card authorization form approving charges for services, medications, or products.
B. Completed Appointment: You received services during a scheduled and completed appointment.
C. Scheduled Appointment: You did not reschedule or cancel an appointment in the allowable timeframe. There are no refunds for such.
D. No Show Appointment: You did not attend an appointment that was scheduled. There are no refunds for such.
E. Duplicate Charge Claims: You claim a duplicate charge, but our records confirm that each charge corresponds to a separate, valid service, appointment, or transaction.
F. Medication Orders: You placed an order for a medication—verbally, electronically, or in writing—and later claimed you did not authorize it, despite documentation of your consent.
G. Product Delivery Disputes: You claim non-receipt of a product that was shipped, and we provide valid tracking information confirming delivery to the address you provided.
H. Late Appointment, Subscription, or Order Cancellations: You claim to have canceled a subscription but failed to do so within the required cancellation period as outlined in these Terms.
In any of the above circumstances, you agree not to initiate a charge dispute or chargeback with your financial institution. Doing so constitutes a breach of these Terms of Service.
If a chargeback is filed under any of these invalid conditions, the Company reserves the right to:
- Challenge the dispute with your bank or card issuer using all relevant documentation;
- Recover associated fees and administrative costs;
- Suspend or terminate your account and refuse future services;
- Pursue legal remedies, including collections, if necessary
We will not pay, refund, reverse charges, credit or compensate for any portion of such charge disputes.
To resolve any billing concerns, you must first contact our Customer Service team at ml@captainmd.com.. We are committed to resolving matters promptly and fairly when approached in good faith.
1.1.5.5. Submitted Pharmacy Orders
- Pharmacy orders and charges: Once we submit an order for a patient to a pharmacy partner, we are not responsible for any aspects of the order including: timely receipt, transcription, shipment, fulfillment, packaging, medication instructions, delivery, correction, cancellation, completion, completeness, quality, spoilage, loss, accuracy, substitution, stock issues, return, replacement, customer service, receipt by the intended recipient, impact of federal, FDA, state, local, or other applicable regulations or restrictions.
- We are not responsible for any payment charges made to you by third parties including pharmacy partners and other companies.
1.1.5.6. Administrative Fee for Disputes and Processing Costs
By accepting these Terms or receiving services/products from Company-affiliated providers, you agree:
Prior Resolution Requirement: For any billing questions on your account (or accounts you're responsible for), you agree to first email ml@captainmd.com with full details and documentation. We will respond within 5 business days and work in good faith to resolve per our records, Terms, and applicable law(s).
Administrative Fee if Requirement Not Met: Any payment dispute requires significant time from our staff to review, process, document, and respond to, and may incur additional merchant fees. If you initiate a payment dispute (chargeback) without proof of prior email resolution attempt (e.g., authentic timestamped receipt of email being successfully sent), and/or for scheduled or completed services and/or orders that were not revised, rescheduled, or cancelled in the agreed upon timeframe, you authorize a one-time fee that covers any merchant fees charged, plus a $100 administrative processing fee per dispute to cover the required staff time costs as documented. The dispute fee may be increased reasonably to cover all costs if justified, at a staff rate of $200 per hour spent on matters involving a dispute, plus any merchant fees and any other fees incurred. This fee applies only if timestamped documentation confirms the services and/or products associated with the charge(s) were submitted, initiated, processed, completed, shipped and/or delivered as agreed.
Payment and Evidence: The fee is charged to your payment method post-dispute. If a dispute resolves against us but documentation proves validity (e.g., agreement to Terms, signed consent, signed Credit Card Authorization, completed intake form, timestamped doctors notes, timestamped prescription records and/or pharmacy records, order tracking number, delivery confirmation, appointment status, written communication), you agree to repay the original amount plus the admin fee within 30 days of our invoice. Late payments accrue standard interest. Unpaid dispute fees may be sent to collections and reported to authorities as applicable.