1. Service Usage

Welcome to Billing Physician Inc. By accessing or using our medical billing services, website, software, or other offerings (collectively, the "Services"), you agree to be bound by these Terms of Service ("Terms"). Please read these Terms carefully before using our Services.

1.1 Service Description

Billing Physician Inc provides medical billing services, revenue cycle management, credentialing, and related services for healthcare providers. Our Services may include, but are not limited to:

• Medical claims processing and submission
• Insurance eligibility verification
• Accounts receivable management
• Denial management and appeals
• Provider credentialing and enrollment
• Reporting and analytics
• Consultation on billing practices and compliance

1.2 Service Eligibility

Our Services are available only to healthcare providers, medical practices, and healthcare organizations operating legally within the United States. By using our Services, you represent and warrant that:

• You are a licensed healthcare provider or authorized representative of a healthcare organization
• You have the authority to enter into this agreement on behalf of yourself or your organization
• You will comply with all applicable laws and regulations
• All information you provide to us is accurate, complete, and current

1.3 Account Creation and Security

To use certain aspects of our Services, you may need to create an account. You are responsible for:

• Maintaining the confidentiality of your account credentials
• Restricting access to your account
• All activities that occur under your account
• Notifying us immediately of any unauthorized access or use of your account

We reserve the right to disable any user account at any time if, in our opinion, you have failed to comply with these Terms or if we suspect unauthorized or fraudulent use of your account.

1.4 Service Modifications

We reserve the right to modify, suspend, or discontinue any part of our Services at any time, with or without notice. We will not be liable to you or any third party for any modification, suspension, or discontinuation of the Services.

2. User Responsibilities

When using our Services, you agree to certain responsibilities that are essential to maintaining a productive and compliant relationship.

2.1 Accurate Information

You are responsible for providing accurate, complete, and up-to-date information, including but not limited to:

• Provider credentials and licensing information
• Patient demographic and insurance information
• Service and procedure documentation
• Diagnosis and treatment codes
• Practice information and tax identification numbers

We rely on the accuracy of this information to provide our Services effectively. Inaccurate or incomplete information may result in claim denials, delayed payments, or compliance issues.

2.2 Timely Communication

You agree to respond promptly to our requests for information, clarification, or documentation needed to process claims or resolve billing issues. Delays in communication may impact our ability to submit claims within timely filing deadlines or appeal denied claims.

2.3 Compliance with Laws and Regulations

You are responsible for ensuring that all services billed through our platform:

• Were actually provided to the patient as documented
• Were medically necessary and appropriate
• Are properly documented in the patient's medical record
• Comply with all applicable federal, state, and local laws and regulations
• Adhere to payer policies and requirements
• Comply with the Health Insurance Portability and Accountability Act (HIPAA)

2.4 Prohibited Activities

When using our Services, you agree not to:

• Submit claims for services not actually rendered
• Misrepresent the nature or extent of services provided
• Engage in any form of healthcare fraud or abuse
• Violate any applicable laws, regulations, or payer policies
• Infringe on the intellectual property rights of others
• Use our Services to transmit malicious code or attempt to gain unauthorized access
• Share your account access with unauthorized individuals

2.5 Cooperation with Audits

You agree to cooperate fully with any audits or investigations by payers, regulatory agencies, or Billing Physician Inc. This includes providing requested documentation in a timely manner and addressing any identified issues promptly.

3. Payment Terms

The following terms govern the payment arrangements between you and Billing Physician Inc for our Services.

3.1 Fee Structure

Our fees for Services may be structured in one or more of the following ways, as specified in your Service Agreement:

• Percentage-based fees: A percentage of collections received from claims we process
• Per-claim fees: A fixed fee for each claim submitted
• Monthly subscription: A recurring fee for ongoing services
• One-time fees: For specific projects or services (e.g., credentialing)
• Hourly rates: For consulting or specialized services

All fees are exclusive of any applicable taxes, which will be your responsibility unless otherwise specified.

3.2 Invoicing and Payment

Unless otherwise specified in your Service Agreement:

• Invoices will be issued monthly for services rendered in the previous month
• Payment is due within 30 days of the invoice date
• Payments can be made by check or ACH transfer.
• Recurring payments may be set up for convenience

3.3 Late Payments

If payment is not received by the due date:

• A late fee of 1.5% per month (or the maximum rate permitted by law, if lower) may be applied to the outstanding balance
• We reserve the right to suspend Services until payment is received
• You will be responsible for any costs incurred in collecting overdue payments, including reasonable attorney fees

3.4 Disputed Charges

If you believe an invoice contains errors, you must:

• Notify us in writing within 15 days of receiving the invoice
• Provide specific details about the disputed charges
• Pay all undisputed portions of the invoice by the due date

We will investigate disputed charges promptly and work with you to resolve any issues. If a dispute is resolved in your favor, we will issue a credit or refund as appropriate.

3.5 Fee Changes

We may modify our fees and payment terms by providing at least 30 days' advance written notice. Your continued use of our Services after such notice constitutes acceptance of the new fees or terms. If you do not agree to the changes, you may terminate your Service Agreement as provided in the Termination section.

4. Intellectual Property

This section outlines the ownership and permitted use of intellectual property in connection with our Services.

4.1 Our Intellectual Property

Billing Physician Inc and its licensors own all right, title, and interest in and to:

• Our website, software, and platform
• Our proprietary methodologies and processes
• Our trademarks, service marks, and logos
• Content we create, including reports, templates, and educational materials
• The design, structure, selection, coordination, and arrangement of our Services

These materials are protected by copyright, trademark, trade secret, and other intellectual property laws. All rights not expressly granted to you are reserved by us and our licensors.

4.2 Limited License to You

Subject to these Terms and your compliance with them, we grant you a limited, non-exclusive, non-transferable, non-sublicensable license to:

• Access and use our Services for your internal business purposes
• View and download materials we specifically make available for download
• Use reports and analytics we generate for your practice management

4.3 Restrictions

You may not:

• Copy, modify, or create derivative works based on our Services or content
• Reverse engineer, decompile, or disassemble any aspect of our Services
• Remove or alter any copyright, trademark, or other proprietary notices
• Rent, lease, lend, sell, sublicense, or transfer your rights to use our Services
• Use our Services or content for any commercial purpose beyond your practice
• Use our trademarks or service marks without our prior written consent

4.4 Your Content

You retain all rights to the content you provide to us, including patient information, practice data, and any other materials you submit through our Services ("Your Content"). By providing Your Content, you grant us a non-exclusive, worldwide, royalty-free license to use, reproduce, process, and display Your Content solely to:

• Provide and improve our Services to you
• Process claims and perform billing services
• Generate reports and analytics for your benefit
• Comply with legal obligations

4.5 Feedback

If you provide suggestions, ideas, or feedback about our Services ("Feedback"), you grant us a non-exclusive, perpetual, irrevocable, fully-paid, royalty-free license to use, exploit, reproduce, modify, adapt, publish, distribute, and otherwise disclose the Feedback for any purpose without restriction or compensation to you.

5. Limitation of Liability

This section outlines the limits of our liability to you under these Terms.

5.1 Disclaimer of Warranties

TO THE MAXIMUM EXTENT PERMITTED BY LAW, OUR SERVICES ARE PROVIDED "AS IS" AND "AS AVAILABLE" WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, AND NON-INFRINGEMENT.

WE DO NOT WARRANT THAT:

• OUR SERVICES WILL MEET YOUR SPECIFIC REQUIREMENTS
• OUR SERVICES WILL BE UNINTERRUPTED, TIMELY, SECURE, OR ERROR-FREE
• THE RESULTS OBTAINED FROM USING OUR SERVICES WILL BE ACCURATE OR RELIABLE
• ALL CLAIMS SUBMITTED THROUGH OUR SERVICES WILL BE PAID
• ANY ERRORS IN OUR SERVICES WILL BE CORRECTED

5.2 Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY LAW, IN NO EVENT SHALL BILLING PHYSICIAN INC, ITS AFFILIATES, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, OR LICENSORS BE LIABLE FOR ANY INDIRECT, PUNITIVE, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR EXEMPLARY DAMAGES, INCLUDING WITHOUT LIMITATION DAMAGES FOR LOSS OF PROFITS, GOODWILL, USE, DATA, OR OTHER INTANGIBLE LOSSES, THAT RESULT FROM:

• THE USE OF, OR INABILITY TO USE, OUR SERVICES
• UNAUTHORIZED ACCESS TO OR ALTERATION OF YOUR TRANSMISSIONS OR DATA
• STATEMENTS OR CONDUCT OF ANY THIRD PARTY ON OUR SERVICES
• DENIAL OR DELAY OF PAYMENT FOR CLAIMS SUBMITTED
• ANY OTHER MATTER RELATING TO OUR SERVICES

IN NO EVENT SHALL OUR TOTAL LIABILITY TO YOU FOR ALL CLAIMS, DAMAGES, LOSSES, AND CAUSES OF ACTION EXCEED THE AMOUNT PAID BY YOU TO US FOR THE SERVICES DURING THE TWELVE (12) MONTHS PRIOR TO THE EVENT GIVING RISE TO THE LIABILITY.

5.3 Exclusions

SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF CERTAIN WARRANTIES OR THE LIMITATION OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES. ACCORDINGLY, SOME OF THE ABOVE LIMITATIONS MAY NOT APPLY TO YOU.

5.4 Indemnification

You agree to defend, indemnify, and hold harmless Billing Physician Inc, its affiliates, officers, directors, employees, agents, and licensors from and against any claims, liabilities, damages, judgments, awards, losses, costs, expenses, or fees (including reasonable attorneys' fees) arising out of or relating to:

• Your violation of these Terms
• Your use of our Services
• Your Content or information provided to us
• Your violation of any laws, regulations, or third-party rights
• Any claims related to patient care or medical services you provide

5.5 Force Majeure

We will not be liable for any failure or delay in performance resulting from causes beyond our reasonable control, including but not limited to acts of God, natural disasters, pandemic, epidemic, war, terrorism, riots, civil unrest, government action, labor disputes, or Internet service provider failures or delays.

6. Termination

This section outlines the conditions under which our Service relationship may end and the consequences of termination.

6.1 Term

These Terms will remain in effect until terminated by either you or Billing Physician Inc as described below. The initial term of your Service Agreement may be specified in your contract, after which it may continue on a month-to-month basis unless otherwise stated.

6.2 Termination by You

You may terminate your Service Agreement with us:

• By providing written notice according to the notice period specified in your Service Agreement (typically 30-90 days)
• Immediately if we materially breach these Terms and fail to cure such breach within 30 days of receiving written notice from you

6.3 Termination by Us

We may terminate your access to all or any part of our Services:

• By providing written notice according to the notice period specified in your Service Agreement
• Immediately if you breach any provision of these Terms
• Immediately if you fail to pay any amounts due within 30 days of the due date
• Immediately if you become insolvent, make an assignment for the benefit of creditors, or become subject to bankruptcy proceedings
• Immediately if required to do so by law or regulatory action

6.4 Effects of Termination

Upon termination of your Service Agreement:

• We will cease providing Services to you
• You will remain responsible for paying all outstanding fees for Services rendered prior to termination
• You will remain responsible for any claims in process at the time of termination
• We will provide you with a final report of claims status and accounts receivable
• We will cooperate with the transition of your billing services to another provider

6.5 Data Retention and Transfer

Following termination:

• We will retain your data for a period of time in accordance with our data retention policies and applicable laws
• Upon your written request and payment of any applicable fees, we will provide you with a copy of your data in a standard format
• After our retention period, we will securely delete or anonymize your data in accordance with our privacy policy

6.6 Survival

The following provisions will survive termination of these Terms: Payment Terms (for amounts owed), Intellectual Property, Limitation of Liability, Indemnification, Dispute Resolution, and any other provision that by its nature should survive termination.

7. Dispute Resolution

This section outlines how disputes between you and Billing Physician Inc will be resolved.

7.1 Informal Dispute Resolution

Before filing a claim against Billing Physician Inc, you agree to attempt to resolve the dispute informally by contacting us at legal@billingphysician.com. We will attempt to resolve the dispute by contacting you via email. If the dispute is not resolved within 30 days of submission, either party may proceed with formal dispute resolution.

7.2 Arbitration Agreement

Except for disputes in which either party seeks injunctive or other equitable relief for the alleged unlawful use of intellectual property, you and Billing Physician Inc agree to resolve any disputes through binding arbitration rather than in court.

The arbitration will be conducted by the American Arbitration Association (AAA) under its Commercial Arbitration Rules. The arbitration will be conducted in New Jersey unless you and we agree otherwise. Each party will be responsible for paying any AAA filing, administrative, and arbitrator fees in accordance with AAA rules.

The arbitrator will have exclusive authority to resolve any dispute relating to the interpretation, applicability, or enforceability of these Terms, including this arbitration agreement.

7.3 Class Action Waiver

YOU AND BILLING PHYSICIAN INC AGREE THAT EACH MAY BRING CLAIMS AGAINST THE OTHER ONLY IN YOUR OR ITS INDIVIDUAL CAPACITY AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING.

Further, unless both you and Billing Physician Inc agree otherwise, the arbitrator may not consolidate more than one person's claims and may not otherwise preside over any form of a representative or class proceeding.

7.4 Opt-Out Right

You have the right to opt out of the arbitration agreement and class action waiver described above by sending written notice of your decision to opt out to legal@billingphysician.com within 30 days of first accepting these Terms.

7.5 Governing Law

These Terms and any disputes arising out of or related to these Terms or our Services will be governed by and construed in accordance with the laws of the State of New Jersey, without regard to its conflict of law principles.

7.6 Limitation Period

Any cause of action or claim you may have arising out of or relating to these Terms or our Services must be commenced within one (1) year after the cause of action accrues; otherwise, such cause of action or claim is permanently barred.

8. Email & SMS Communications

This section outlines our policies regarding electronic communications with you.

8.1 Consent to Electronic Communications

By using our Services, you consent to receive communications from us electronically, including emails, text messages, and notifications through our platform. You agree that all agreements, notices, disclosures, and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

8.2 Types of Communications

We may send you various types of electronic communications, including:

• Service-related communications: Information about your account, billing, claims status, and service updates
• Educational content: Information about medical billing best practices, regulatory updates, and industry news
• Marketing communications: Information about new services, features, or special offers (subject to your marketing preferences)
• Alerts and notifications: Time-sensitive information about claim issues, payment receipts, or account activity

8.3 SMS/Text Message Terms

If you provide a mobile phone number and opt in to text message communications:

• You consent to receive text messages at the phone number provided
• Message frequency varies based on your account settings and service usage
• Standard message and data rates may apply as charged by your mobile carrier
• Text messages may be sent using automated technology
• Text message consent is not required as a condition of purchasing any goods or services

8.4 Opting Out

You may opt out of receiving certain communications from us:

• Email marketing: Click the "unsubscribe" link in any marketing email
• SMS/Text messages: Reply STOP to any text message
• All marketing communications: Update your communication preferences in your account settings or contact us directly

Please note that even if you opt out of marketing communications, you will still receive service-related and transactional communications related to your account and our Services.

8.5 Communication Preferences

You can manage your communication preferences by:

• Updating your account settings in our platform
• Contacting our customer support team
• Responding to communications with specific preference requests

8.6 Contact Information Updates

You are responsible for keeping your contact information current. To update your email address, phone number, or other contact information, please:

• Log in to your account and update your profile
• Contact your account representative
• Email updates@billingphysician.com with your new information

9. Changes to Terms

We may modify these Terms from time to time to reflect changes in our Services, business practices, or legal requirements.

9.1 Notification of Changes

When we make changes to these Terms, we will:

• Post the updated Terms on our website
• Update the "Last Updated" date at the top of these Terms
• Provide notice through our platform, via email, or other communication methods for significant changes

9.2 Acceptance of Updated Terms

Your continued use of our Services after the effective date of the revised Terms constitutes your acceptance of the changes. If you do not agree to the updated Terms, you must stop using our Services and terminate your account.

9.3 Material Changes

For material changes to these Terms that significantly affect your rights or obligations:

• We will provide at least 30 days' notice before the changes take effect
• We may require you to provide explicit consent to the updated Terms before continuing to use our Services
• If you do not accept the changes, you may need to terminate your use of our Services

9.4 Reviewing Terms

We encourage you to review these Terms periodically to stay informed about our legal agreement with you. The current version of these Terms will always be available on our website.

10. Contact Information

If you have any questions, concerns, or feedback regarding these Terms of Service or our Services, please contact us using the information below:

For urgent matters related to these Terms, please contact our Legal Department at 201-503-7824.