Terms of Service
Professional healthcare revenue cycle management services agreement and compliance guidelines
Service Agreement Overview
Welcome to MedCore Revenue Cycle Management. These Terms of Service govern your use of our healthcare billing and RCM services. By engaging our services, you agree to comply with these terms and applicable healthcare regulations.
1Healthcare RCM Service Definitions
Our revenue cycle management services encompass comprehensive medical billing, credentialing, and practice management solutions designed specifically for healthcare providers operating in the United States healthcare system.
Core Services Include:
- • Medical claims processing and submission
- • Provider credentialing and enrollment
- • Denial management and appeals
- • Patient billing and collections
- • Revenue cycle analytics and reporting
Compliance Standards:
- • HIPAA Privacy and Security Rules
- • CMS billing guidelines
- • State healthcare regulations
- • Insurance payer requirements
- • ICD-10 and CPT coding standards
2Client Responsibilities and Service Usage
Healthcare Provider Obligations
Healthcare providers must maintain valid licenses, provide accurate patient information, ensure proper documentation, and comply with all applicable healthcare regulations and payer requirements.
Service Usage Guidelines:
- ✓Provide timely and accurate patient demographic and insurance information
- ✓Maintain current provider credentials and certifications
- ✓Ensure proper clinical documentation supports billing activities
- ✓Comply with all federal and state healthcare regulations
3HIPAA Compliance and Data Protection
Protected Health Information (PHI) Safeguards
MedCore RCM operates as a Business Associate under HIPAA regulations. We implement comprehensive administrative, physical, and technical safeguards to protect patient health information.
Administrative Safeguards
- • HIPAA training programs
- • Access control procedures
- • Incident response protocols
- • Regular compliance audits
Physical Safeguards
- • Secure facility access
- • Workstation security
- • Device and media controls
- • Environmental protections
Technical Safeguards
- • 256-bit SSL encryption
- • Multi-factor authentication
- • Audit logs and monitoring
- • Secure data transmission
4Service Level Agreements and Performance Standards
Our Performance Commitments
Claims Processing Standards
- • 48-hour claim submission turnaround
- • 95% clean claims submission rate
- • 24-hour denial management response
- • Monthly performance reporting
Support and Communication
- • Dedicated account management
- • 24/7 technical support availability
- • Weekly status updates
- • Quarterly business reviews
5Financial Terms and Billing Arrangements
Service fees are based on percentage of collections or flat-rate arrangements as specified in individual service agreements. Payment terms and performance incentives are customized based on practice size and service requirements.
Standard Payment Terms:
- • Monthly invoicing with detailed reporting
- • Net 30-day payment terms
- • Performance-based fee structures available
- • Transparent cost breakdown and analytics
6Limitation of Liability and Risk Management
While MedCore RCM maintains comprehensive professional liability insurance and follows industry best practices, our liability is limited to the scope of services provided under our service agreements.
Important Limitations:
- • Services limited to administrative billing functions
- • No clinical decision-making or patient care responsibilities
- • Liability capped at service fees paid in preceding 12 months
- • Force majeure protections for uncontrollable circumstances
7International Operations and Compliance
Global Service Delivery Model
MedCore RCM operates from India while serving US healthcare providers. Our international operations maintain full compliance with US healthcare regulations and data protection standards.
US Compliance Standards
- • HIPAA Business Associate Agreement
- • SOC 2 Type II certification
- • US healthcare regulation adherence
- • American coding and billing standards
Operational Benefits
- • 24/7 service availability
- • Cost-effective service delivery
- • Experienced US healthcare specialists
- • Time zone advantage for processing
8Service Termination and Data Handling
Termination Procedures
Either party may terminate services with 30-day written notice. Upon termination, we ensure smooth transition of all billing activities and secure return or destruction of protected health information.
Transition Support
- • 30-day transition assistance
- • Complete records transfer
- • Outstanding claims follow-up
- • Final reporting and reconciliation
Data Security
- • Secure data return or destruction
- • HIPAA-compliant disposal methods
- • Certificate of destruction provided
- • Ongoing confidentiality obligations
9Contact Information and Legal Notices
Service Inquiries
Email: info@medcorercm.com
Business Hours: Monday - Friday, 9:00 AM - 6:00 PM IST
Response Time: Within 24 hours for all inquiries
Legal and Compliance
Location: Jaipur, Rajasthan, India
Service Area: United States Healthcare Market
Governing Law: US Healthcare Regulations and Indian Business Law
These Terms of Service are effective as of January 1, 2024, and supersede all previous agreements. MedCore RCM reserves the right to update these terms with 30-day advance notice to all clients.
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