These are general conditions for using the Claimly website.
Claimly: Terms and Conditions
These terms and conditions represent the agreement between you (“you”) and between Claimly ("us", "we" or the "Company") with regard to your use of the website (the “Website”) and online services provided through the website (collectively: the “Services").
For purposes of this Agreement:
- "HIPAA" means the Health Insurance Portability and Accountability Act of 1996;
- "Protected Health Information" or "PHI" means protected health information as defined by HIPAA.
2. Eligibility and Geographic Restrictions
You may not access or use the Services if you are under eighteen (18) years of age or if you are legally unable (under the applicable laws and regulations) to enter into these Terms. By accessing or using the Services you represent that you have reached the age of 18 years. We reserve the right at any time to terminate your use or access to the Service if we are aware that you have not reached the age of 18 years.
We provide the Services for use only by individuals located within the United States. The Company incurs no liability as regards to use of Services by any individual or entity outside the United State and the user will be thereby responsible for conforming to local laws. The Company does not promote the use of Website, Services and content available therein outside the United States.
3. The Services
We aim to facilitate health care providers (“Providers”) and patients to obtain reimbursement(s) for patients’ healthcare claims, estimating and obtaining out-of-network benefits and providing support.
As part of the Services, we facilitate different solutions, including:
- Enabling Providers and patients to file healthcare claims.
- Enabling patients to obtain reimbursement(s) from insurance companies for their healthcare claims (“Refunds”), either directly by engaging with us or via their respective Providers.
- Offering Providers to receive an immediate advance on Refunds.
- Enabling patients to receive relevant information and verification on their insurance coverage.
Please note that the term “you” shall refer in the Terms to website users, Providers and patients who use our Services, as applicable.
4. Intellectual Property and License
4.1. Subject to your full compliance with all of these Terms, the Company hereby grants to you a limited, non-exclusive, non-transferable, royalty-free, revocable license to access and use the Website and Services in legally authorized jurisdiction, for the sole purpose of your personal use of the Services in connection with the Terms. We reserve all right, title and interest not expressly granted under this license to the fullest extent possible under applicable laws.
4.2. We reserve the right to reject or cancel your registration to our Services at our absolute discretion and without providing any reason for this, subject to any legal obligations we may have. We are entitled, without any liability, to refuse, restrict, limit, suspend, interfere or interrupt the Services or any part thereof, without any notice to you for the purpose of repairing, improving, or upgrading the Services or for any of the reasons for termination as mentioned below.
4.3. All our intellectual property assets (“IP“) including but not limited to all copyrights, trademarks, patents, service marks, trade names, software code, icons, logos, characters, layouts, trade secrets, buttons, color scheme and graphics are our sole and exclusive IP and are all protected by local and international intellectual property laws and treaties including all copyright laws and regulations. Our Services may contain third-party trademarks, service marks, graphics, and logos. You are not granted any right or license with respect to our trademarks or the trademarks of any third party.
4.4. Except as expressly stated herein, you may not copy, alter, adapt, modify, reproduce, distribute or commercially exploit any materials, including text, graphics, video, audio, software code, user interface design or logos, from our Portal, without our prior written permission. You hereby warrant that you will not make any copies of, modify, adapt, disassemble, translate, decompile, distribute or otherwise transfer, rent, lease, loan, resell, sublicense or reverse engineer our Services or any part thereof.
4.5. You acknowledge and give us a worldwide license to use, host, store, display, reproduce, modify, create derivative works (such as those resulting from translations, adaptations or other changes we make so that your content works better with our Services), communicate, publish, publicly perform, publicly display and distribute any content provided by you on our Website and Services.
4.6 If you link from another website to one or more of our Services, the website, as well as the link itself, may not, without our prior written permission, suggest that we endorse, sponsor or are affiliated with any non-Company website, entity, service or product, and may not make use of any of our IP other than those contained within the text of the link.
5. Establishing an Account
In order to use our Services, you may be required to establish an account in our Website and sign a separate agreement with us. You acknowledge that your account is personal to you and you are expected to treat your account as confidential. You agree to provide accurate, current and complete information about yourself as prompted by the registration form.
By establishing an account with us or signing a separate agreement with us, as applicable, you authorize us to sign the Electronic Remittance Advice (ERA) Enrollment Form on your behalf and to release any information considered essential to the Services (e.g. processing Refunds on behalf of patients and Providers). This also creates a right in favor of the Company to contact insurance companies on your behalf, exchanging information with applicable health plans, healthcare providers and others service providers involved in the medical treatment, payment or health care operations.
6. Privacy and Protected Health Information
6.1. You acknowledge that you may be asked to share certain personal information before activating or during your use of the Services. We may also collect such information in order to provide you proposals regarding your use of our Services.
6.3. The Company will make no use of PHI that is prohibited by applicable law, including but not limited to HIPAA. We may collect and process PHI and Superbills which are collected from Providers (i.e. if a patient wishes and agrees to share with us such information), only if the relevant Provider signs a specific agreement with us, stipulating the different responsibilities applicable to processing of PHI under HIPAA. By providing us patient’s PHI, the Provider represents and warrants that he/ she have obtained all relevant authorizations and consents from the patient in connection with such collection, use and disclosure of PHI, in accordance with our Terms.
6.4. In case we collect PHI directly from patients who use our Services, the patient explicitly consents to the collection, use and disclosure of PHI in accordance with these Terms.
6.5. The Company ensures the accessibility, integrity and security of PHI. In the event that the Company receives a subpoena or other order issued by or under authority of a court of competent jurisdiction compelling the disclosure of any PHI related to you, the Company will notify you of the subpoena or order prior to disclosing the PHI to provide you with an opportunity to intervene or otherwise prevent the disclosure.
7. Payment and Charges
You acknowledge and understand that some of the Services provided to you by us may incur fees and charges, and you agree to pay these fees and charges. These fees and charges will be communicated clearly ahead-of-time for the services you elect to receive from us.
Some of the fees and charges may be presented as a percentage of transactions handled; For the purpose of this agreement, such presentation would be considered "clearly communicated". Some services may be recurring in nature; Such services may incur recurring fees and charges. When signing up for such a service, you agree to pay such recurring fees and charges as communicated to you.
8. Your Representations and Undertakings
8.1. You shall use our Services in complete accordance with the Terms, as amended from time to time.
8.2. The Company shall not be responsible for any telecommunications networks and Internet access services and other consents and permissions required in connection with your use of the Services. The Company shall not be responsible for any access and service fees necessary to connect to the Services and assume all charges incurred in accessing such systems.
8.3. The information (including without limitation advice, recommendations and proposals) presented on this Website does not constitute a recommendation of any kind by the Company. You represent that any decisions you made in this regard, will be based solely on your own discretion and evaluation.
8.4. While adequate care would be taken to ensure completeness and accuracy of the information and services provided, we shall in no circumstance be liable for any loss or damage caused by your reliance on information obtained through this Website. It is your sole responsibility to evaluate the completeness, accuracy or usefulness of any opinion, guidance or other content made available on this Website.
8.5. You should consult your own legal counsel, business advisor and tax advisor as to the legal, business, tax and related matters concerning any policies and proposals with respect to the services which we provide. We are not liable for any incorrect estimates regarding reimbursement or Refunds including but not limited to the event of calculation of out-of-network-benefits.
8.6. You acknowledge that you are responsible for any information that you submit or transmit through the Services and any other communications options available by us, including your responsibility as to the legality, reliability, appropriateness, originality and copyright of any such information.
8.7. You acknowledge that we may report to government authorities any actions that may be considered illegal or which may be required by such authorities. When requested, we may cooperate with government authorities in any investigation of alleged illegal activity. You further confirm and acknowledge that we may also maintain records of all such content.
8.8. You will not transmit to or in any way, whether directly or indirectly, expose the Company or any of the Company’s online service providers to any computer virus or other similarly harmful or inappropriate material or device.
8.9. You shall not use any electronic communication feature on the Services for any purpose that is unlawful, tortuous, abusive and intrusive on another's privacy, harassing, libelous, defamatory, embarrassing, obscene, threatening or hateful.
9. Warranty Disclaimer
9.1. THE SERVICES IS PROVIDED ON AN "AS IS" BASIS, WITHOUT WARRANTY OF ANY KIND. TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, THE COMPANY DISCLAIMS ALL WARRANTIES, INCLUDING ANY IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NONINFRINGEMENT. YOUR ONLY RIGHT OR REMEDY WITH RESPECT TO ANY DISSATISFACTION WITH THE SERVICES IS TO IMMEDIATELY CEASE USE OF THE SERVICES. THE COMPANY DOES NOT REPRESENT OR WARRANT THAT THE SERVICES WILL OPERATE CONTINUOUSLY, UNINTERRUPTED, OR BE ERROR-FREE.
9.2. THE COMPANY MAKES NO WARRANTY THAT THE SERVICES WILL MEET YOUR REQUIREMENTS, BE UNINTERRUPTED, TIMELY, SECURE OR ERROR-FREE, THAT DEFECTS WILL BE CORRECTED, OR THAT THE SERVICES OR THE SERVER THAT MAKES IT AVAILABLE ARE FREE OF VIRUSES OR BUGS OR REPRESENTS THE FULL FUNCTIONALITY, ACCURACY, RELIABILITY OF THE MATERIALS OR AS TO RESULTS OR THE ACCURACY OF ANY INFORMATION OBTAINED BY YOU.
9.3. THE COMPANY SHALL IN NO WAY BE LIABLE TO YOU IN THE EVENT OF SYSTEMS OR COMMUNICATIONS ERRORS, BUGS OR VIRUSES RELATING TO THE SERVICES OR RESULTING IN LOSS OF DATA BY YOU OR ANY OTHER DAMAGE TO YOUR DEVICE OR YOUR ABILITY TO USE IT, AND THE COMPANY RESERVES THE RIGHT TO TAKE ANY OTHER ACTION TO CORRECT SUCH ERRORS (IF ANY) SAVE THAT THE COMPANY IS NOT REQUIRED TO PROVIDE ANY BACK UP NETWORK OR SYSTEMS OR SIMILAR SERVICES.
9.4. THE COMPANY SHALL NOT BE LIABLE FOR ANY ACTS OR OMISSIONS MADE BY YOUR INTERNET SERVICE PROVIDER OR OTHER THIRD PARTY WITH WHOM YOU HAVE CONTRACTED TO GAIN ACCESS TO THE SERVER THAT HOSTS THE SERVICES.
10. LIMITATION OF LIABILITY
THE COMPANY SHALL NOT BE LIABLE FOR ANY DIRECT OR INDIRECT CLAIM, LOSS OR DAMAGE RESULTING FROM YOUR USE OF THE SERVICES. YOU ACKNOWLEDGE AND UNDERSTAND THAT THE COMPANY, IN NO WAY, GUARANTEES OR PROVIDE WARRANTIES ON THE ESTIMATED OR ACTUAL CLAIM OR TIME OF REFUNDS. YOU ACKNOWLEDGE AND UNDERSTAND THAT FAILURE TO RECOVER A HEALTHCARE CLAIM AND REFUNDS DOES NOT GIVE RISE TO ANY LIABILITY ON PART OF THE COMPANY.
IN NO EVENT SHALL THE COMPANY’S LIABILITY UNDER, ARISING OUT OF OR RELATING TO THESE TERMS, EXCEED AN AMOUNT OF $1,000. IN NO EVENT WILL THE COMPANY BE LIABLE FOR LOST PROFITS, LOSS OF USE, LOSS OF DATA, COST OF PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES, OR ANY OTHER SPECIAL, INCIDENTAL, INDIRECT, OR CONSEQUENTIAL DAMAGES, HOWEVER CAUSED, AND ON ANY THEORY OF LIABILITY, WHETHER FOR BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE AND STRICT LIABILITY), OR OTHERWISE, WHETHER OR NOT THE COMPANY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
11. Duration and Termination
11.1. The Terms shall come into force immediately upon using the Services and shall continue in force unless and until terminated in accordance with the Terms.
11.2. The Company reserves the right to suspend the operation of the Services or any part thereof upon its sole discretion without giving notice of suspension to you.
11.3. Your failure to comply with the Terms shall terminate the license that has been granted to you.
You agree to defend, indemnify and hold harmless the Company and its affiliates, and respective officers, directors, employees and agents from any third party claims, damages, liabilities, costs, and expenses (including reasonable attorney’s fees) arising from (i) your unlawful use of the Services; and (ii) your breach of these Terms or applicable law.
13. Governing Law
The Terms and any matters relating thereto and hereto shall be governed by the law prevalent in the State of California, USA. Any disputes that might be arising as to the interpretation of the Terms herein shall be settled by way of referring such dispute to the arbitration of the sole arbitrator to be appointed by the Company.
You agree to submit in that event to the exclusive jurisdiction and venue of the state and federal courts located in the State of California. You agree that these Terms and the relationship between you and the Company shall be governed by the laws of the State of California.
14.1. The Terms contain the entire agreement between the Company and you relating to your use of the Website. You hereby waive any rights or requirements under any laws or regulations in any jurisdiction which require an original (non-electronic) signature or delivery or retention of non-electronic records, to the extent permitted under applicable mandatory law.
14.2. Our failure or neglect to perform or enforce any of any rights or conditions under the Terms shall not be considered as a waiver of such a right or condition. Should any provision under these Terms be held to be void, invalid or inoperative, the remaining provisions under these Terms shall not be affected and shall continue in effect. In addition, if any particular provision contained under these Terms shall, for any reason, be held to be excessively broad with regard to time, geographic scope or activity, the term shall be construed in a manner to enable it to be enforced to the extent compatible with applicable law.
14.3. The Company reserves the right to transfer, assign, sublicense or pledge the Terms, in whole or in part, in the event of a merger, sale of assets or other similar corporate transaction in which the Company may be involved in.
14.4. You may not transfer, assign, sublicense or pledge any of your or your rights or obligations under the Terms without the Company’s prior written approval.
15. Amendments to the Terms
The Company reserves the right, at its sole discretion, to periodically amend or revise the Terms. Material changes will be effective immediately upon the publication of the amended Terms. Your continued use of the Website, following the amendment of the Terms, constitutes your acknowledgement and consent of such amendments to the Terms. The last revision will be reflected in the "Last modified by" heading above. In the event of a material change to these Terms, the User may be notified within the Website.
If you have any questions, complaints or comments about us or the Website, please contact us by email using email@example.com.
2680 Fayette Dr, Unit 204