Agreement to Terms

These Terms of Service ("Terms") constitute a legally binding agreement between you ("Client," "you," or "your") and PrismIQ Labs, Inc. ("PrismIQ," "we," "us," or "our") governing your access to and use of our AI-powered denial management platform, website, and related services (collectively, the "Services"). By accessing or using our Services, you agree to be bound by these Terms.

Description of Services

PrismIQ provides AI-powered denial management services for healthcare providers, practices, and billing companies. Our platform analyzes denied claims, cross-references payer policies, and generates policy-cited appeal letters to help recover revenue from improperly denied claims.

Eligibility

Our Services are intended for use by healthcare providers, medical practices, billing companies, and their authorized representatives. By using our Services, you represent that you have the authority to bind your organization to these Terms and that your use complies with all applicable laws and regulations.

HIPAA Compliance and BAA Requirement

PrismIQ operates as a Business Associate under the Health Insurance Portability and Accountability Act ("HIPAA"). Before any Protected Health Information ("PHI") is transmitted to or processed by our platform:

• A Business Associate Agreement ("BAA") must be executed between your organization and PrismIQ
• You must ensure you have proper authorization to share PHI with us
• You must comply with all applicable HIPAA requirements as a Covered Entity or Business Associate

A BAA is available upon request and will be provided as part of our pilot onboarding process.

Pilot Program

Our pilot program allows you to evaluate PrismIQ's services with a limited set of denied claims. During the pilot:

• A BAA must be signed before any PHI is shared
• We will process a mutually agreed-upon volume of denied claims
• You will receive AI-generated appeal letters within 24 hours of submission
• The pilot period and terms will be specified in a separate pilot agreement

Your Responsibilities

You agree to:

• Provide accurate and complete information when using our Services
• Maintain the confidentiality of your account credentials
• Ensure all users accessing the platform on your behalf are properly trained
• Review and verify all appeal letters before submission to payers
• Comply with all applicable laws, regulations, and payer requirements
• Not use our Services for any unlawful or fraudulent purpose

Intellectual Property

PrismIQ retains all rights, title, and interest in and to our platform, algorithms, and technology. You retain ownership of your data, including PHI and claim information. You grant us a limited license to use your data solely to provide the Services and improve our platform (in de-identified, aggregated form for improvements).

Disclaimer of Warranties

THE SERVICES ARE PROVIDED "AS IS" AND "AS AVAILABLE" WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED. PRISMIQ DOES NOT GUARANTEE:

• That any particular appeal will be successful
• Any specific recovery rate or financial outcome
• Uninterrupted or error-free operation of the platform
• That payer policies referenced are current or complete

Appeal letters generated by our AI are tools to assist your appeals process. You are responsible for reviewing, modifying, and approving all appeals before submission.

Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY LAW, PRISMIQ SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING LOST REVENUE, LOST PROFITS, OR LOSS OF DATA. OUR TOTAL LIABILITY SHALL NOT EXCEED THE AMOUNTS PAID BY YOU TO PRISMIQ IN THE TWELVE (12) MONTHS PRECEDING THE CLAIM.

Indemnification

You agree to indemnify and hold harmless PrismIQ and its officers, directors, employees, and agents from any claims, damages, losses, or expenses arising from your use of the Services, violation of these Terms, or infringement of any third-party rights.

Termination

Either party may terminate these Terms upon written notice. Upon termination, your access to the Services will cease, and we will handle any PHI in accordance with our BAA and applicable law. Provisions that by their nature should survive termination shall remain in effect.

Governing Law

These Terms shall be governed by and construed in accordance with the laws of the State of Delaware, without regard to its conflict of law provisions. Any disputes shall be resolved in the state or federal courts located in Delaware.

Changes to Terms

We reserve the right to modify these Terms at any time. We will provide notice of material changes by posting the updated Terms on our website and updating the "Last Updated" date. Your continued use of the Services after such changes constitutes acceptance of the new Terms.

Contact Us

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

PrismIQ Labs, Inc.
Email: hello@prismiqlabs.ai
Legal: legal@prismiqlabs.ai