Terms & Conditions

1. Acceptance of Terms

Welcome to Cardio Billing Solutions. These Terms and Conditions ("Terms") govern your use of our website and services. By accessing our website at cardiomedicalbilling.com, requesting a consultation, or engaging our medical billing services, you agree to be bound by these Terms. If you do not agree with any part of these Terms, please do not use our services.

These Terms constitute a legally binding agreement between you ("Client," "you," or "your") and Cardio Billing Solutions ("Company," "we," "our," or "us"). We reserve the right to modify these Terms at any time, and such modifications will be effective immediately upon posting to our website.

2. Services Description

Cardio Billing Solutions provides comprehensive revenue cycle management and medical billing services specifically for cardiology practices, including but not limited to:

• Eligibility and benefits verification
• Medical coding (CPT, ICD-10, HCPCS)
• Claim submission and follow-up
• Denial management and appeals
• Prior authorization services
• Medical Billing and payment processing
• Accounts receivable management
• Compliance and regulatory reporting
• Analytics and performance reporting

The specific services to be provided will be outlined in a separate Service Agreement or Statement of Work executed between the parties. These Terms supplement, but do not replace, any such service-specific agreements.

3. Eligibility and Registration

To use our services, you must:

• Be a licensed healthcare provider or authorized representative of a healthcare organization
• Have the legal authority to enter into binding contracts
• Provide accurate, current, and complete information during registration
• Maintain and promptly update your account information
• Maintain the confidentiality of your account credentials
• Accept responsibility for all activities under your account

You agree to immediately notify us of any unauthorized use of your account or any other breach of security.

4. Client Responsibilities

4.1 Information Provision

You agree to provide us with:

• Accurate and complete patient demographic information
• Valid insurance information and authorizations
• Complete and legible clinical documentation
• Timely access to your practice management system
• Cooperation in resolving claim issues and denials
• Prompt responses to our inquiries and requests

4.2 Clinical Responsibility

You acknowledge that:

• You retain sole responsibility for all clinical decisions and patient care
• We do not provide medical advice or influence clinical judgment
• Our coding suggestions are based on documentation provided
• Final responsibility for coding accuracy rests with the rendering provider
• You must review and approve all claims before submission

4.3 Compliance

You agree to maintain compliance with all applicable healthcare laws, regulations, and payer requirements, including but not limited to HIPAA, Medicare, Medicaid, and private insurance guidelines.

5. Fees and Payment

5.1 Service Fees

Fees for our services will be specified in your Service Agreement. Fee structures may include:

• Percentage of collections
• Per-claim fees
• Flat monthly fees
• Hourly rates for specific services
• Setup and implementation fees

5.2 Payment Terms

Unless otherwise specified:

• Invoices are due within 30 days of issuance
• Late payments may incur interest charges of 1.5% per month (18% annually)
• We reserve the right to suspend services for non-payment
• You are responsible for all collection costs and legal fees
• Setup fees are non-refundable

5.3 Disputed Charges

Any billing disputes must be reported in writing within 30 days of invoice date. Undisputed portions of invoices remain due and payable.

6. Term and Termination

6.1 Service Term

The initial term and renewal provisions will be specified in your Service Agreement. Most agreements require 60-90 days written notice for termination.

6.2 Termination for Cause

Either party may terminate immediately upon written notice if:

• The other party materially breaches these Terms
• The other party becomes insolvent or files for bankruptcy
• The other party loses necessary licenses or certifications
• Continued performance becomes illegal or impossible

6.3 Effects of Termination

Upon termination:

• All outstanding fees become immediately due and payable
• We will provide transition assistance as specified in the Service Agreement
• We will return or destroy all client data as requested
• Claims in process will be handled according to termination provisions
• Confidentiality obligations continue indefinitely

7. HIPAA and Data Security

7.1 Business Associate Relationship

We act as a Business Associate under HIPAA. A separate Business Associate Agreement (BAA) will be executed, which forms part of these Terms. We agree to:

• Use and disclose PHI only as permitted by the BAA and HIPAA
• Implement appropriate administrative, physical, and technical safeguards
• Report any security incidents or breaches
• Make PHI available to individuals as required by HIPAA
• Ensure our subcontractors comply with HIPAA requirements

7.2 Data Security

We maintain comprehensive security measures including:

• 256-bit encryption for data transmission and storage
• Multi-factor authentication for system access
• Regular security audits and penetration testing
• Employee background checks and HIPAA training
• Disaster recovery and business continuity plans
• SOC 2 Type II compliance (if applicable)

8. Intellectual Property

8.1 Our Property

We retain all rights to:

• Our website, software, and technology platforms
• Our trademarks, logos, and branding materials
• Our proprietary processes, templates, and workflows
• Our training materials and documentation
• Analytics tools and reporting methodologies

8.2 Your Property

You retain all rights to your patient data, clinical documentation, and proprietary practice information. We claim no ownership over your data.

8.3 License Grant

You grant us a limited, non-exclusive license to use your data solely for the purpose of providing services under our agreement.

9. Warranties and Disclaimers

9.1 Our Warranties

We warrant that:

• Services will be performed in a professional and workmanlike manner
• Our staff is trained and qualified to perform medical billing services
• We maintain appropriate professional liability insurance
• We comply with applicable laws and regulations

9.2 Disclaimer of Warranties

EXCEPT AS EXPRESSLY STATED, OUR SERVICES ARE PROVIDED "AS IS" WITHOUT WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NON-INFRINGEMENT. WE DO NOT GUARANTEE:

• Specific collection rates or revenue increases
• Approval of any particular claim
• Elimination of all denials
• Uninterrupted or error-free service
• Results from any particular payer or insurance company

10. Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY LAW:

• OUR TOTAL LIABILITY SHALL NOT EXCEED THE FEES PAID BY YOU IN THE 12 MONTHS PRECEDING THE CLAIM
• WE SHALL NOT BE LIABLE FOR INDIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, OR PUNITIVE DAMAGES
• WE SHALL NOT BE LIABLE FOR LOST PROFITS, LOST REVENUE, OR LOST DATA
• WE SHALL NOT BE LIABLE FOR DELAYS OR FAILURES CAUSED BY PAYERS, CLEARINGHOUSES, OR THIRD PARTIES
• WE SHALL NOT BE LIABLE FOR CODING OR BILLING ERRORS RESULTING FROM INCOMPLETE OR INACCURATE DOCUMENTATION

These limitations apply regardless of the theory of liability (contract, tort, negligence, strict liability, or otherwise).

11. Indemnification

You agree to indemnify, defend, and hold harmless Cardio Billing Solutions, its officers, directors, employees, and agents from any claims, damages, losses, liabilities, and expenses (including attorneys' fees) arising from:

• Your breach of these Terms or any applicable law
• Your provision of inaccurate or incomplete information
• Your clinical decisions or patient care
• Medical malpractice or professional liability claims
• Unauthorized use of our services
• Your violation of any third-party rights

12. Confidentiality

Both parties agree to:

• Maintain the confidentiality of all proprietary and confidential information
• Use confidential information only for purposes of the business relationship
• Not disclose confidential information to third parties without consent
• Return or destroy confidential information upon termination
• Implement reasonable security measures to protect confidential information

Confidential information does not include information that is publicly available, independently developed, or lawfully obtained from third parties.

13. Force Majeure

Neither party shall be liable for delays or failures in performance resulting from causes beyond their reasonable control, including acts of God, natural disasters, war, terrorism, labor disputes, governmental actions, internet or telecommunications failures, or pandemics. The affected party must provide prompt notice and use reasonable efforts to resume performance.

14. Dispute Resolution

14.1 Informal Resolution

Before initiating formal proceedings, the parties agree to attempt good faith negotiations to resolve any dispute.

14.2 Arbitration

Any dispute not resolved through negotiation shall be settled by binding arbitration in accordance with the rules of the American Arbitration Association. Arbitration shall take place in Brooklyn, New York. The prevailing party shall be entitled to recover reasonable attorneys' fees and costs.

14.3 Exceptions

Either party may seek injunctive relief in court for breaches involving confidentiality, intellectual property, or data security.

15. General Provisions

15.1 Governing Law

These Terms shall be governed by the laws of the State of New York, without regard to conflict of law principles.

15.2 Entire Agreement

These Terms, together with any Service Agreement and BAA, constitute the entire agreement between the parties and supersede all prior agreements and understandings.

15.3 Amendments

We may modify these Terms at any time by posting updated terms on our website. Material changes will be communicated via email. Continued use of services after changes constitutes acceptance.

15.4 Severability

If any provision is found unenforceable, the remaining provisions shall remain in full force and effect.

15.5 Waiver

Failure to enforce any provision does not constitute a waiver of that provision or any other provision.

15.6 Assignment

You may not assign these Terms without our prior written consent. We may assign these Terms in connection with a merger, acquisition, or sale of assets.

15.7 Notices

All notices must be in writing and sent to:

16. Website Use

When using our website, you agree to:

• Not use the website for any unlawful purpose
• Not attempt to gain unauthorized access to our systems
• Not interfere with or disrupt the website or servers
• Not transmit viruses, malware, or harmful code
• Not collect user information without consent
• Not use automated systems (bots, scrapers) without permission
• Not impersonate any person or entity
• Not violate any applicable laws or regulations