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Provider Details

This Service Agreement (AGREEMENT) is entered into by and DENmaar mHealth, LLC on this day Apr 17, 2021.

Whereas, Service provides services to health care providers designed to effectuate the filing of medical insurance claims with governmental authorities and commercial carriers through electronic and manual means (Claims Processing), and also offers direct billing services to the patient (Billing Services); and Whereas Provider desires to engage Service to provide Claims Processing and/or Billing Services as set forth herein.

The parties hereto agree as follows:

  1. Service Responsibilities.
    1. Claims Processing.

      Service will receive claims information from Provider a minimum of every week via provider web portal, unless other arrangements have been made and both parties have agreed. Service will file and process Provider’s claims in a reasonable amount of time with a goal of two business days, excluding those containing errors or omissions.

    2. Billing Services.

      Service will bill patients for services rendered by Provider as requested by Provider, sending statements via mail, e-mail.

    3. Eligibility and Benefits.

      Electronic Eligibility and Benefits are a standard part of our offering and covered by Service. If claims reject or deny, we will verify and alert you to the fact and actions required to correct. Service is not held responsible for inaccurate information obtained from insurance company.

    4. Credentialing.

      Credentialing services may requested by Provider, standard fees apply unless approved by Service.

  2. Provider Responsibilities.
    1. Claims Processing.

      Provider agrees to provide certain information regarding patients and their insurance coverage to enable Service to file and process medical insurance claims. Service shall not be responsible for any delay in or inability to collect claims due to insufficient information provided by Provider. Provider to submit charges in a consistent manner, daily is preferable, no greater than 1 week after session.

    2. Billing Services.

      Although the goal of Service is to obtain all insurance payment information electronically, Provider agrees to submit in a timely manner, all available payment information to enable Service to bill patients in the time frame required by the provider.

  3. Provider’s Payment of Services.
    1. Provider agrees to pay Service per insurance claim filed and processed; at the rate of $5.00 per clean claim, (clean claim is one date of service with claim processing with insurance payment or toward a patient’s deductible). There is no charge for denied claims.
    2. Service reserves the right to change the rate of compensation at any time after the agreement has been in effect for one (1) year, upon submission of thirty (30) days written notice to Provider.
    3. If a claim or billing must be resubmitted due to an error by Service, the same shall be resubmitted at no additional cost to Provider.
    4. In the event that a claim or billing must be resubmitted without fault on the part of Service, the same shall be resubmitted by Service. It is the goal of the service to obtain accurate information in order to reduce inaccurate claim filing.
    5. Service will invoice Provider on the first day of each month for the previous month. Remittance for these charges will be due in full within fourteen (14) days. If payment has not been received by the 15th of the following month, service will not provide any further services until payment has been received. Accounts will be suspended after 60 days of non-payment, and account sent to collections.
    6. Additional fees incurred by Provider may include postage, telehealth, merchant account fees, and electronic prescription.
  4. Designation of Service as Provider’s Authorized Agent.

    Provider hereby appoints and designates Service as it’s agent for the limited purpose of billing and corresponding with insurers regarding processing and collection of insurance claims, and any insurer or payer of claims is authorized to rely upon this written delegation of authority in its dealings with Service as the agent of Provider for this limited purpose.

    We will submit standard insurance forms with a stamped signature of group owner. We require checking account routing and account number information so we can establish1 direct deposit. A copy of a cancelled check also for this purpose.

  5. Relationship of the Parties.
    1. Service and its employees and contractors shall always be independent contractors and not employees of Provider.
    2. Service shall not have any authority to compromise claims or otherwise to bind Provider except as expressly set forth above; and Provider shall have no authority to bind Service.
  6. Term of Agreement.
    1. DENmaar will maintain fee structure for 1 year, at which time if a change is to be made, we will give a 30day written notice to provider.
    2. Either party may terminate this Agreement at any time, with or without cause, by giving thirty (30) days written notice of termination to the other party. Upon termination of Agreement, Provider agrees to immediately remit to Service all charges and fees owing to date. Provider also agrees to remit all charges and fees resulting from claims submitted and/or billed by Service prior to termination immediately upon receipt of invoice.
  7. Confidentiality.
    1. Service agrees and covenants to keep all information concerning Provider and its patients, including personal and financial information, strictly confidential and adhere to HiPPA requirements; and Service agrees that it will not disclose any such information to any person or third party, except as may be reasonably necessary to file and process claims and/or bill patients.
    2. The foregoing provisions regarding confidentiality shall survive the termination of the Agreement. Furthermore, the foregoing provisions constitute independent covenants and shall not be discharged by any breach or default of the party seeking their enforcement.
    3. Service agrees to notify Provider promptly in the event of any breach of security of Service's computers, networks, business facility or information storage or transmission apparatus, or other disclosure of confidential information of Provider or it's patients.
  8. Warranty.

    Service’s warranty under this Agreement shall be limited to resubmitting, at its expense, any inaccurate reports or forms if the Provider gives verification of the inaccuracy of any such report or form, and if such inaccuracies were caused solely as a result of Service’s performance. Further, that Service shall receive written notice of such inaccuracies within ten (10) days of delivery of the inaccurate materials. Provider agrees that the foregoing constitutes its exclusive available remedy.

  9. Limitations of Liability.
    1. Provider agrees that the foregoing warranty is in lieu of all other warranties, express or implied.
    2. Service shall return all Provider information promptly in the event of a termination, but in no event later than 30 days of termination of contract.
    3. Service has no liability to Provider if data or records are destroyed by fire, strike, acts of God, or any other cause. In the event of system malfunction, for whatever reasons, or inability to access computer, Service shall not be liable for damage to or loss of any Provider data which has been entered into the computer system. However, Service will use its best efforts to minimize the possibility of such damage to or loss of Provider data by use of regular backup procedures.
    4. Provider hereby agrees to hold Service harmless from any and all such claims, causes of action, or judgments resulting from Provider's authorized use of Service, and in such event, Provider shall defend Service at its sole cost and expense. Service shall not subject Provider to such claims by its unauthorized and wrongful conduct. If it does, service shall the hold Provider harmless and defend Provider at its sole cost and expense, from any and all claims, suits, actions, causes of actions, award, damages or judgments resulting there from.

DENmaar mHealth, LLC