Terms and Conditions

By signing a Service Agreement, submitting an appointment request, or using our website, you acknowledge that you have read, understood, and agree to these Terms and Conditions in full. If you are entering into these Terms on behalf of a medical practice, clinic, or organization, you represent that you have the authority to bind that entity.

These Terms apply to all visitors, clients, and others who access or use our services. Use of our services requires that authorized practice administrators or legal representatives agree on behalf of their organization.

Billing and Coding provides medical billing and revenue cycle management (RCM) services to licensed healthcare providers across the United States, including but not limited to:

The specific scope of services for each client is defined in the executed Service Agreement. We reserve the right to modify, suspend, or discontinue any service with reasonable notice.

To enable effective service delivery, the Client agrees to:

• Provide accurate, complete, and timely patient demographic, insurance, and clinical documentation
• Ensure all treating providers hold valid, current licenses and are properly credentialed with relevant payers
• Grant authorized access to practice management systems, EHR platforms, or billing software as required
• Review and approve coding and billing decisions when requested by our team
• Promptly notify us of any changes to provider information, payer contracts, or insurance credentialing
• Comply with all applicable federal and state healthcare laws, including HIPAA
• Designate a primary contact person authorized to make billing decisions on behalf of the practice

Fee structure

Our fees are outlined in the executed Service Agreement and may be structured as a percentage of collected revenue, a flat monthly rate, or a per-claim fee — depending on the scope of services agreed upon. All fee structures are agreed upon in writing prior to commencement of services.

Payment terms

• Invoices are issued on a schedule defined in the Service Agreement (typically monthly)
• Payment is due within 30 days of the invoice date unless otherwise agreed in writing
• Late payments are subject to a 1.5% monthly interest charge on the outstanding balance
• We reserve the right to suspend services for accounts overdue by more than 60 days

Disputes

Any billing disputes must be raised in writing within 15 days of receiving the invoice. Undisputed portions of an invoice remain due on the original payment date.

A formal Service Agreement governs the specific terms of each client engagement, including scope, fees, timelines, and special conditions. These Terms and Conditions are incorporated by reference into all Service Agreements.

• The initial service term is specified in each Service Agreement (typically 12 months)
• Agreements automatically renew on a month-to-month basis unless either party provides written notice of non-renewal at least 30 days before the end of the current term
• Any amendments to the Service Agreement must be made in writing and signed by authorized representatives of both parties

Termination for convenience

Either party may terminate the Service Agreement without cause by providing 30 days’ written notice. The Client remains responsible for all fees incurred through the effective termination date.

Termination for cause

We may terminate services immediately upon written notice if the Client:

• Fails to pay undisputed invoices within 60 days of the due date
• Engages in fraudulent, illegal, or unethical billing practices
• Materially breaches these Terms or the Service Agreement and fails to cure such breach within 15 days of written notice
• Violates HIPAA or other applicable healthcare regulations

Post-termination

Upon termination, we will return or securely destroy all Client data and PHI in accordance with the Business Associate Agreement and applicable law. Outstanding claims in progress will be transitioned to the Client or a successor billing company in good faith.

We warrant that our services will be performed in a professional, workmanlike manner consistent with industry standards for medical billing and coding.

To the maximum extent permitted by applicable law, we disclaim all warranties not expressly stated herein, including implied warranties of merchantability or fitness for a particular purpose.

Both parties acknowledge their obligations under HIPAA and agree to execute a Business Associate Agreement (BAA) prior to the exchange of any Protected Health Information (PHI). The BAA, once executed, is incorporated into and forms part of the Service Agreement.

• Each party agrees to keep the other’s proprietary, financial, and operational information strictly confidential
• Confidentiality obligations survive termination of the Service Agreement for a period of five (5) years
• PHI confidentiality obligations survive indefinitely in accordance with HIPAA
• Neither party shall use the other’s confidential information for any purpose other than fulfilling obligations under the Service Agreement

All materials, processes, software, templates, reports, and methodologies developed or used by Billing and Coding in connection with our services remain our exclusive intellectual property.

• Clients retain ownership of their own patient data, clinical records, and practice-specific information
• We retain ownership of all proprietary billing workflows, software configurations, and reporting tools
• No license to our intellectual property is granted beyond what is necessary to receive the agreed services
• The content on billingandcoding.us (text, images, logos) may not be reproduced without our written permission

To the fullest extent permitted by law, Billing and Coding’s total cumulative liability to the Client for any and all claims arising out of or related to the services shall not exceed the total fees paid by the Client in the three (3) months immediately preceding the claim.

We shall not be liable for any indirect, incidental, consequential, special, or punitive damages, including lost revenue, lost profits, or loss of data, even if we have been advised of the possibility of such damages. This limitation applies regardless of the legal theory under which the claim is asserted.

Each party agrees to indemnify, defend, and hold harmless the other party and its officers, directors, employees, and agents from and against any claims, liabilities, damages, and expenses (including reasonable attorney’s fees) arising from:

Client indemnifies us against claims arising from

• Inaccurate, fraudulent, or incomplete information provided by the Client
• The Client’s violation of any law, regulation, or payer contract
• Any unauthorized or improper billing practices directed by the Client

We indemnify the Client against claims arising from

• Our negligence or willful misconduct in performing the services
• Our material breach of the BAA or these Terms
• Unauthorized disclosure of PHI caused solely by our actions

In the event of a dispute arising from or relating to these Terms or any Service Agreement, the parties agree to the following resolution process:

• Step 1 — Good faith negotiation: The parties will attempt to resolve the dispute through direct discussion within 30 days of written notice
• Step 2 — Mediation: If unresolved, the parties agree to non-binding mediation in Wayne County, Michigan, with costs shared equally
• Step 3 — Arbitration: If mediation fails, disputes shall be resolved by binding arbitration under the American Arbitration Association (AAA) Commercial Arbitration Rules

Nothing in this section prevents either party from seeking emergency injunctive relief in a court of competent jurisdiction to prevent irreparable harm.

These Terms and Conditions and all Service Agreements shall be governed by and construed in accordance with the laws of the State of Michigan, without regard to its conflict of laws principles. Any legal proceedings not subject to arbitration shall be brought exclusively in the state or federal courts located in Wayne County, Michigan.

Both parties consent to personal jurisdiction in Michigan courts for such proceedings.

We reserve the right to update or modify these Terms and Conditions at any time. We will provide at least 30 days’ written notice of any material changes to existing clients via email to the address on file.

Continued use of our services after the effective date of changes constitutes your acceptance of the revised Terms. We encourage you to review this page periodically. The current version is always available at billingandcoding.us.

• Entire Agreement: These Terms, together with the executed Service Agreement and BAA, constitute the entire agreement between the parties and supersede all prior discussions
• Severability: If any provision is found unenforceable, the remaining provisions continue in full force
• Waiver: Failure to enforce any provision does not constitute a waiver of future enforcement rights
• Force Majeure: Neither party is liable for delays caused by circumstances beyond their reasonable control, including natural disasters, government actions, or system outages
• Assignment: The Client may not assign their rights or obligations without our prior written consent; we may assign our rights in connection with a merger or acquisition
• Notices: All formal notices must be in writing and sent to the addresses listed in the Service Agreement or to info@a2zbillings.com