Terms of Use

1. Acceptance of these Terms

These Terms of Use (“Terms”) govern your access to and use of claimorasolutions.com and any related pages, forms and content (the “Website”), operated by Claimora Solutions (“Claimora,” “we,” “us” or “our”). By using the Website, you agree to these Terms and to our Privacy Policy, which is part of these Terms. If you do not agree, please do not use the Website.

The Website is intended for healthcare organizations and the adults who work with them. You must be at least 18 years old to use it. If you use the Website on behalf of an organization, you confirm that you have authority to accept these Terms for that organization.

2. Our services and separate agreements

Claimora provides revenue cycle management, medical billing, medical coding, eligibility verification, credentialing and related administrative support services to healthcare organizations in the United States.

The Website describes our services for general information only. Nothing on the Website is an offer, a quote or a contract. We provide services only under a separate written service agreement signed by Claimora and the client (a “Service Agreement”) and, whenever we handle protected health information, a Business Associate Agreement (“BAA”). If these Terms conflict with a signed Service Agreement or BAA, the signed agreement controls.

3. What Claimora is, and is not

Claimora is an administrative and billing services vendor. Claimora is not:

• a healthcare provider, and we do not make clinical, diagnostic or medical-necessity decisions;
• a health insurer, payer or claims administrator, and we do not decide coverage or payment;
• a law firm, and we do not provide legal advice; or
• a holder of client funds.

4. Payments and fees

Payer and patient payments for our clients’ services are deposited directly into bank accounts or lockboxes owned and controlled by our clients. We post and reconcile those payments, but we never receive, hold or control client funds. Our fees are set out in each Service Agreement and are structured to comply with federal and state rules that apply to billing agents, including Medicare and Medicaid rules on the reassignment of payments.

5. Notice to patients

6. No medical, legal or professional advice

Content on the Website, including information about coding, billing, credentialing, reimbursement and payer rules, is general information for healthcare businesses. It is not medical, legal, financial, tax or compliance advice, and it may not reflect the latest changes in payer policies or regulations. Using the Website does not create a provider-patient, attorney-client or other professional relationship. Consult qualified professionals before acting on any information on the Website.

7. No guarantee of results

Reimbursement depends on factors outside our control, including payer policies, patient eligibility, clinical documentation and the timeliness and accuracy of information our clients provide. We do not guarantee any level of collections, reimbursement amounts, denial rates, payment timelines, credentialing approvals or effective dates. Industry statistics on the Website come from the third-party sources named beside them; they are not Claimora client results or a prediction of your results.

8. Client responsibilities

Each Service Agreement sets out the parties’ duties in full. In summary, our healthcare clients remain responsible for:

• the care they provide and the accuracy and completeness of their clinical documentation;
• reviewing and approving the codes and claims submitted in their name, as the provider of record who certifies each claim;
• giving us timely, accurate information and appropriate system access; and
• their own compliance with HIPAA, payer contracts and applicable federal and state healthcare laws.

Claimora codes and bills only what is supported by the provider’s documentation. We will not knowingly prepare or submit a false or unsupported claim, and we may decline any instruction we believe would violate the law.

9. Protected health information

Do not submit protected health information (PHI) through the Website. This includes our contact form, feedback form and general email addresses. Do not post or send information that identifies a patient or describes a patient’s condition, treatment or billing details. We receive PHI only through secure channels set up under a signed BAA, and we handle it as a business associate as required by HIPAA and that BAA. If PHI reaches us through the Website, we will handle it as described in our Privacy Policy.

10. Acceptable use

You may use the Website only for lawful purposes and in line with these Terms. You agree not to:

• submit false or misleading information, or information about another person without their permission;
• attempt to gain unauthorized access to the Website, our systems, accounts or data;
• upload or transmit viruses, malware or other harmful code;
• scrape, harvest or collect content or data from the Website by automated means without our written permission;
• interfere with, overload or disrupt the Website or its security features;
• use the Website to send spam or unsolicited messages; or
• use the Website to seek medical advice, diagnosis or treatment.

We may suspend or block access to the Website for anyone who violates these Terms.

11. Feedback and reviews

If you send us feedback, ratings, suggestions or ideas (“Feedback”), you confirm that it is truthful, reflects your own experience, and contains no PHI or confidential information of others. You grant Claimora a non-exclusive, royalty-free, perpetual license to use Feedback to improve our services. We will not publish your name, your organization or your Feedback as a testimonial without your express permission. When we publish a testimonial, it will reflect the client’s genuine experience, and we will disclose any material connection between Claimora and the reviewer.

12. Intellectual property

The Website and its content, including text, illustrations, graphics, the Claimora Solutions name and logo, and page design, are owned by Claimora or its licensors and are protected by U.S. copyright, trademark and other laws. You may view and print pages for your own business evaluation. You may not copy, modify, distribute, republish or create derivative works from Website content, or use our name or logo, without our prior written permission. Third-party names and logos shown on the Website belong to their owners and do not imply endorsement.

13. Third-party links and content

The Website may link to third-party websites and cite third-party data. We provide these links for convenience only. We do not control and are not responsible for third-party content, accuracy, availability or privacy practices, and a link does not mean we endorse the third party.

14. Electronic communications

By contacting us through the Website, you agree that we may reply by email or phone about your inquiry and that electronic communications satisfy any requirement that communications be in writing. Our marketing emails comply with the CAN-SPAM Act and include an unsubscribe option. We call or text a mobile number for marketing only with your prior express consent, and you may opt out at any time by replying STOP or contacting us.

15. Disclaimer of warranties

The Website and its content are provided “as is” and “as available,” without warranties of any kind, whether express or implied, including implied warranties of merchantability, fitness for a particular purpose, accuracy and non-infringement. We do not warrant that the Website will be uninterrupted, timely, secure or error-free, or that it is free of viruses or other harmful components. Your use of the Website is at your own risk.

Warranties for our services, if any, appear only in a signed Service Agreement.

16. Limitation of liability

To the fullest extent permitted by law, Claimora and its owners, officers, employees and contractors will not be liable for any indirect, incidental, special, consequential, exemplary or punitive damages, or for any loss of profits, revenue, data or goodwill, arising out of or related to your use of, or inability to use, the Website, even if advised of the possibility of such damages. Our total liability for any claim arising out of or related to the Website will not exceed one hundred U.S. dollars ($100).

Some states do not allow certain limitations of liability, so some of these limits may not apply to you. Liability for our services is governed by the signed Service Agreement.

17. Indemnification

You agree to defend, indemnify and hold harmless Claimora and its owners, officers, employees and contractors from any claims, damages, losses and expenses, including reasonable attorneys’ fees, arising out of your misuse of the Website, your violation of these Terms, or your violation of any law or the rights of a third party.

18. Governing law, venue and time limit

These Terms are governed by the laws of the State of Florida and applicable U.S. federal law, without regard to conflict-of-law rules. Any dispute arising out of or related to these Terms or the Website must be brought exclusively in the state or federal courts located in Okaloosa County, Florida, and you consent to the personal jurisdiction of those courts.

To the extent permitted by law, any claim arising out of or related to these Terms or the Website must be filed within one (1) year after the claim arose, or it is permanently barred.

19. Changes to these Terms and the Website

We may update these Terms at any time by posting the revised version on this page and changing the “Last updated” date above. Changes apply from the date they are posted, and your continued use of the Website after that date means you accept the updated Terms. We may also change, suspend or discontinue any part of the Website at any time without notice.

20. General

• Severability. If any provision of these Terms is found unenforceable, the remaining provisions stay in full effect.
• No waiver. Our failure to enforce any provision is not a waiver of our right to do so later.
• Assignment. You may not transfer your rights under these Terms. We may assign our rights and obligations, including in connection with a merger, acquisition or sale of assets.
• Entire agreement. These Terms and our Privacy Policy are the entire agreement between you and Claimora about the Website. They do not replace any signed Service Agreement or BAA.

21. Contact us

If you have questions about these Terms, please contact us: