Terms of Service

1. Agreement to Terms

These Terms of Service ("Terms") constitute a legally binding agreement between ClinicVerify Inc. ("ClinicVerify," "we," "us," or "our") and the healthcare entity, medical practice, or subscriber ("Customer," "you," or "your") accessing or using the ClinicVerify web applications, APIs, and real-time eligibility services (collectively, the "Services").

By creating an account, executing a subscription, or accessing the Services, you represent that you have the legal authority to bind Customer to these Terms and that Customer complies with all applicable U.S. federal and state laws regarding patient privacy and healthcare operations.

2. Services & HIPAA Compliance

ClinicVerify provides automated patient insurance card intake, Optical Character Recognition (OCR) data extraction, and real-time ANSI X12 EDI 270/271 eligibility verification against national clearinghouse networks.

If Customer is a Covered Entity or Business Associate under HIPAA, Customer agrees to execute and abide by the ClinicVerify Business Associate Agreement ("BAA"), available at clinicverify.health/baa, prior to uploading or transmitting any Protected Health Information ("PHI").

3. Subscriptions, Pricing & Overage Billing

• Free Trial: New practice accounts receive a 7-day free trial. Unless canceled before trial expiration, the account automatically transitions into the selected monthly subscription plan.
• Plan Monthly Limits: Starter ($49/mo includes 100 verifications), Professional ($149/mo includes 500 verifications), and Enterprise (custom limits).
• Overage Rates: Verifications exceeding monthly plan limits are billed transparently at $0.50 per check (Starter) or $0.40 per check (Professional) at the conclusion of each billing cycle.
• Cancellation & Refunds: Subscriptions renew automatically each month. You may cancel your subscription at any time inside your dashboard settings. Subscription fees are non-refundable except as required by law.

4. Eligibility Results Disclaimer

Insurance verification responses delivered via ClinicVerify represent real-time responses returned directly from third-party clearinghouse networks and health insurance carriers (ANSI X12 EDI 271).

⚠️ Carrier Disclaimer: Real-time eligibility checks are information queries returned by payers at the time of inquiry and do not constitute a guarantee of claim payment or authorization by the insurance carrier. Final benefit determination is made by the payer upon claim submission.

5. User Obligations & Account Security

Customer agrees to:

• Maintain the confidentiality of login credentials and enforce strong passwords across practice staff accounts.
• Obtain all necessary patient authorizations and consents required under applicable state and federal healthcare laws to upload insurance cards and query coverage.
• Not attempt to reverse engineer, scrape, decompile, or compromise the security of the ClinicVerify platform or APIs.

6. Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE U.S. LAW, CLINICVERIFY INC. AND ITS OFFICERS, DIRECTORS, AND SUPPLIERS SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING LOSS OF PROFITS, DATA, OR REVENUE, ARISING OUT OF OR IN CONNECTION WITH THE SERVICES OR ELIGIBILITY RESPONSES.

CLINICVERIFY'S TOTAL AGGREGATE LIABILITY FOR ANY CLAIMS ARISING UNDER THESE TERMS SHALL NOT EXCEED THE TOTAL AMOUNT PAID BY CUSTOMER TO CLINICVERIFY IN THE TWELVE (12) MONTHS PRECEDING THE CLAIM.

7. Governing Law & Dispute Resolution

These Terms are governed by and construed in accordance with the laws of the State of Delaware and applicable United States federal laws, without giving effect to conflict of laws principles. Any legal suit or proceeding arising under these Terms shall be resolved via binding arbitration under the rules of the American Arbitration Association (AAA).

8. Contact Information

For legal inquiries or notices regarding these Terms of Service, please reach out via our Contact Support Form or refer to our Privacy Policy and Business Associate Agreement (BAA):