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Terms and Conditions

1. Definitions

  • Affiliate: Refers to any other entity directly or indirectly controlled by, or under common control with, the client.
  • Authorized Providers: The number of physicians and physician extenders authorized to use the RCM services.
  • Authorized Rooms: The number of rooms authorized for use in conjunction with RCM services.
  • Billing Implementation Fee: The fee for implementing billing services.
  • Billing Information: Includes patient demographics, insurance details, service dates, CPT codes, ICD-9/ICD-10 codes, and other necessary information for reimbursement.
  • Client Data: Electronic data related to patients, entered into the ModMed Software.

2. Services

  • We provide expert medical billing and coding services to optimize revenue for healthcare providers.
  • Our team submits claims accurately and efficiently, follows up on pending claims, and appeals denied or underpaid claims.
  • Coding experts ensure precise codes for optimal reimbursement.
  • We audit all claims for accuracy and compliance.

3. Responsibilities

  • The client agrees to provide complete and accurate billing information promptly.
  • We maintain confidentiality and security of client data.
  • The client is responsible for authorized providers and rooms.
  • Billing implementation fees are outlined in Schedule “B.”

4. Payment

  • Fees are invoiced as per the RCM Agreement.
  • Payment terms are specified in the agreement.
  • Late payments may incur additional charges.

5. Termination

  • Either party may terminate the agreement with notice.
  • Upon termination, client data will be returned or securely disposed of.

6. Miscellaneous

  • These terms and conditions were last updated on June 1, 2021.
  • Any disputes will be resolved according to the RCM Agreement.