Denials Management, Inc. (The Company) publishes and maintains FixMyClaim.com an educational resource, subject to the following Terms of Membership and usage. Use of FixMyClaim.com service constitutes acceptance and agreement to Terms of Membership (TOM). All provisions of this contract are subject to the TOM of FixMyClaim.com, Inc. This Agreement shall be construed in all respects in accordance with the laws of the state of Utah, county of Salt Lake applicable to contracts enforceable in that state. Venue will be Salt Lake County, Utah.
Inital billing is submitted upon the completion of the registration process, at which point billing begins based on the selected period (single 180 day, monthly or annually). Service levels are as follows:
-$250.00-Premier Plan (180 day access to site resources from last payment, phone support and first 2 hours of in-house claim support. Additional claim support is billed on a recurring basis at a cost of $250.00 for each additional 2 hours)
-Contact For Pricing – Business Monthly Plan (monthly access fee to all denial types for healthcare industry)
-Contact For Pricing – Business Annual Plan (yearly access fee to all denial types for healthcare industry)
Prices are subject to change; however, you will be notified via the supplied contact e-mail address within 30 days before any changes go into effect. You will be given the opportunity to cancel your membership at that time subject to the Termination of Services provision noted below.
Additional Claim Support Payment (Premier Plan Only)
After registering for the Premier service package, FixMyClaim.com will automatically begin our in-house services including, but not limited to, appeals, claim billing, verification of benefits, document control and follow up. Once the intial 2 hours of claim support are used, the Company will bill Members in advance in 2 hour increments for additional support. Each 2 hour increment is billed just before the previous alloted time is finished to ensure continuity of work on your claim(s).
IMPORTANT NOTE: First level appeals may take 6-8 additional working hours. This estimate may change based on the denial type or if multiple claims are appealed at the same time. Your plan may have several levels of appeal which may affect the work time needed. Each 2 hour period is billed at the rate of $180.00 using the Member’s previous method of payment.
Claim Processing (Premier Plan Only)
Once a Member registers for the Premier Plan service level, DMI’s healthcare advocates enter your claim(s) data into DMI&rsquote;s Claim Saver Pro© system and establish a plan of action with you. Activity on your claim(s) is detailed and recorded in minutes which are then subtracted from the first 2 hours of claim support. In order to maintain continous and timely work on the claim, additional claim support hours will be charged to your account on file just BEFORE the first or last two hours has completely run out. Additional charges for postage and copies will be deducted as needed.
By agreeing, Premier Members authorized via electronic signature, their enrollment into a program with recurring billing. To continue work on their claim(s), Members agree to periodic charges to their account on file after registering. This authorization may be canceled at any time and is subject to the Termination of Services provision noted below.
Accounts will remain active from the date of registration until the date at which the account ends, in accordance with your service level. 180 day accounts will terminate 180 days after registration. Premier Members continue to have access to site resources as long as they are paying for additional claim support. Annual Business accounts will terminate one year after registration date. Monthly Business accounts will be charged monthly from the date of registration until the user requests termination in writing. See Termination of Services.
Accurate Contact Information
It is the Members’ responsibility to provide FixMyClaim.com with up-to-date e-mail, fax, and telephone contacts, in that order of preference. The Company is not responsible for any interference in correspondence due to false or inaccurate contact information.
Termination of Services
If a Member is unsatisfied with the services provided by FixMyClaim.com, they may cancel their membership by submitting a written request to Denials Management, Inc. Please allow 10 business days before the request can be fully processed. By agreeing to the Terms of Membership, Members agree to pay the final bill of claim support services at the end of the 10 day period.
Requests may be sent to:
Denials Management, Inc.
4424 South 700 East
Salt Lake City, Utah 84107
Website Usage as Members
By using the Appeal Letter Database, the Member agrees that the following actions constitute a material breach of these Terms of Membership:
Members shall not use the Database in connection with or to promote any products, services, or materials that violate local, state, national or international law. Members shall not post materials which constitute, promote or are used primarily for the purpose of dealing in spyware, adware, or other malicious programs or code, counterfeit goods, unsolicited mass distribution of e-mail (spam), multi-level marketing proposals, hate materials, hacking/surveillance/interception/descrabling equipment, and libelous, defamatory, obscene, pornographic, abusive or otherwise offensive content. Members may not post material that infringes on the intellectual property rights or on the personal/publicity rights of others, nor advertise or solicit business. Members shall not allow other persons or parties to use his or her identification to view or post in the Appeal Letter Database. Engaging in any conduct which restricts or inhibits any other person from using and enjoying the Database or site, or which exposes the Company, its customers or suppliers to any liability or detriment of any type, shall constitute a material breach of the agreed to Terms of Membership.
The Company reserves the right (but is not obligated) to do any or all of the following if a violation occurs:
-Investigate allegations that communications or posts do not conform to the aforementioned Terms and determine to remove or request the removal of the communications or posts.
-Remove communications which are abusive, illegal, or disruptive, or that otherwise fail to conform with the agreed to Terms of Membership.
-Terminate a Member’s access to FixMyClaim.com upon any breach of these Terms of Membership.
-Monitor, edit, or disclose any communication in the Public Areas.
-Edit or delete any communications posted on FixMyClaim.com, regardless of whether such communication violates these standards.
The Company reserves the right to take any action it deems necessary to protect the personal safety of our guests or the public. The Company has no liability or responsibility to users of FixMyClaim.com or any other person or entity for the performance or nonperformance of the aformentioned activities.
All Appeal Letters drafted within DMI are exclusive products created by the Company for use in your claims process. Information contained therein may constitute proprietary, intellectual and trade secrets of the Company which may not be shared with any parties without the express written consent of the Company.
Members may submit content or communications to FixMyClaim.com for inclusion in the Appeal Letter Database or as a part of the Member forums. The Company retains full editorial control and may refuse to accept any submission for any reason. Every submitted content or communication is reviewed for compliance with applicable state and federal law and editorial changes may be made at our discretion. Once a content or communication is accepted, it becomes the property of the Company and may be distributed by the Company as desired. Members who proceed with submission of a content or communication must agree that he or she will not upload or transmit any communications or content of any type that infringes or violates any of the above Terms of Membership.
By submitting content or communications, Members agree that such submission is non-confidential for all purposes and is original work. Members who make any submission to any area of FixMyClaim.com automatically warrants that the owner of such content or intellectual property has granted the Company a royalty-free, perpetual, irrevocable, world-wide nonexclusive license to use, reproduce, create derivative works from, modify, publish, edit, translate, distribute, perform, and display the communication or content in any media or medium, or any form, format, or forum now known or hereafter developed. The Company may sublicense its rights through multiple tiers of sublicenses.
If you wish to keep any business information, ideas, concepts or inventions private or proprietary, do not submit them to FixMyClaim.com or to the Company.
Case Study/Return on Investment Release
By registering, Members grant the Company the right to publish non-personally identifiable summary information for promotional purposes or for the use as Case Study examples on FixMyClaim.com. Members have the opportunity to be featured for positive Returns on Investments (ROI) if their appeal outcomes are successful. First names, age, location, providers, claim types, processing dates, services paid and final outcome may be among the information featured to potential Members on the ROI section of the site.
Members agree that all documentation, articles, case studies, techniques, appeal letters, and processes contained at FixMyClaim.com are the exclusive property of Denials Management, Inc. and you agree these items constitute copyrighted and/or patented material of Denials Management, Inc., and will be safeguarded by you. You may not reproduce any of these materials, except as provided herein, or with the written permission of Denials Management, Inc. ( not its agents, distributors, or resellers).
You may not transfer, sub-license, lease, rent, time-share or lend this information, your copies, or any related material without prior written consent from Denials Management, Inc. itself. You may not reverse engineer, decompile, or disassemble the software. You may not remove or obscure Denials Management, Inc. copyright or trademark notices in either hardcopy or machine readable portions of the website. Any distribution of original or reproduced materials, whether for profit or not, is copyright infringement and is protected and administered by criminal and civil statutes.
You may print or modify the appeal letters contained within FixMyClaim.com only if this usage is solely for the personal use of the licensed user on behalf of the purchasers own business claim appeal practice. Any unauthorized reproduction, modification, distribution, derivative works from, or any exploitation of its contents in part or in whole is prohibited and will be considered a violation of the user license.
Any access to the Appeal Letter Database contained within FixMyClaim.com by any means other than that provided at FixMyClaim.com, for any purpose, is strictly prohibited.
Copyright infringement is a serious crime covered by Federal copyright laws, criminal and civil statutes. This Agreement is provided to protect both the rights of The Company and the legitimate, licensed subscriber. Your registering as a member indicates your acceptance to the terms and conditions of this Agreement.
Limits of Liability
The Company takes no responsibility for any material input by others and not posted to the FixMyClaim.com website by the Company. The Company is not responsible for the content of any other websites linked to the FixMyClaim.com website. Links are provided as Internet navigation tools only. The Company disclaims any responsibility for any such inappropriate use and any liability to any person or party for any other person or party’s violation of this policy.
The Company is not responsible for any damages your business may suffer from information obtained from FixMyClaim.com.
Members agree that the Company has made no implied or written promises or guarantees regarding the outcome of your claim(s). The Company denies any warranty or merchantability for our services.
If you use FixMyClaim.com’s Appeal Letter Database or any other information at FixMyClaim.com, you are solely responsible for your own communications, the consequences of those communications, and your reliance on any information found in this area. The Company is not responsible for the consequences of any communications related to your submission.
A waiver by the Company of any breach of any provision of this Agreement by Members shall not be construed as a continuing or subsequent waiver thereof, or as a waiver of any breach of any other provisions.
Members shall not transfer or assign this Agreement without the prior written consent of the Company. The Company reserves the right to modify this Agreement at any time without notice, it is the Member’s responsiblity to review and become familiar with any modifications. The Company reserves the right to cancel customers rights under this contract at anytime without further obligation.
FixMyClaim.com is designed to assist individuals and medical providers with appealing wrongfully denied insurance claims. We are not extending legal advice regarding any subject matter. If you are unsure about your legal rights in any dispute, you should consult an attorney.
The Company may receive from Members health information protected under all applicable local, state, and federal laws in the performance of their obligations, including but not limited to, the applicable provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, as amended, and regulations promulgated there under.
DMI may disclose Protected Health Information (PHI) as necessary to perform its obligations under the Member Agreement as permitted by law. DMI understands the importance and sensitivity of your health information and shall use all appropriate safeguards to prevent the disclosure of PHI other than as expressly permitted under this Agreement. The Company ensures that all disclosures are only the minimum PHI used to accomplish the intended purpose.
The Company may request a signature authorizing access to the necessary PHI in order to perform the claims services purchased on FixMyClaim.com. The Company may use PHI solely for the Member’s benefit, only as authorized in this Agreement.
Description of Information Collected & Usage
FixMyClaim.com is committed to protecting its customers. FixMyClaim.com provides online purchasing to make our Member’s experience more convenient. The Company only uses the information from Members to correctly process registration and to improve our understanding of our customer’s claim support needs.
FixMyClaim.com stores the information that is provided by the Member when a membership is purchased from FixMyClaim.com. This information is stored in a secure site with access limited to a small number of individuals within Denials Management, Inc. This information is used for internal purposes only and will never be shared with any third-party.
Information Collected for Internal Feedback
FixMyClaim.com reserves the right to aggregate the data collected and use it for market research purposes in order to improve FixMyClaim.com’s customer service and products. This aggregated data will not include information that would personally identify a customer.
Policies Regarding Third Parties
FixMyClaim.com’s policy is to not sell, rent or trade personal information to others.