Terms and Conditions for TBC Solutions Pvt Ltd

These Terms and Conditions (“Terms”) govern the relationship between [Medical Billing Company Name] (“Company,” “we,” “us,” or “our”) and our clients (“Client,” “you,” or “your”) who utilize our medical billing services. By engaging our services, you agree to be bound by these Terms.

Services Provided

We offer comprehensive medical billing services, including but not limited to:

Claims preparation and submission (electronic and/or paper)

Insurance verification and eligibility checks

Payment posting and reconciliation

Denial management and appeals

Patient billing and collections

Regular reporting and analysis

The specific services provided will be detailed in a separate Service Agreement or Contract.

Client Responsibilities

You are responsible for providing accurate and complete patient information, including demographics, insurance details, and medical records.

You must ensure the accuracy and completeness of all coding and documentation in accordance with applicable regulations and guidelines (e.g., ICD-10, CPT).

You are responsible for obtaining all necessary patient consents and authorizations for billing and collection activities.

You agree to promptly notify us of any changes in patient information, insurance coverage, or other relevant details.

You are responsible for the costs of any services requested by you that are not included in the agreed scope of services.

Fees and Payment

Our fees for services will be outlined in the Service Agreement.

Fees may be based on a percentage of collections, a flat monthly fee, or a combination thereof.

Payment terms will be specified in the Service Agreement. Late payments may be subject to interest charges.

You are responsible for any costs associated with denied claims due to incorrect information you provided.

HIPAA Compliance and Confidentiality

We are committed to complying with the Health Insurance Portability and Accountability Act (HIPAA) and all other applicable laws and regulations regarding the privacy and security of Protected Health Information (PHI).

We will maintain strict confidentiality of all patient information and will only use and disclose PHI as necessary to provide our services or as required by law.

Both parties will execute a Business Associate Agreement (BAA) to ensure compliance with HIPAA.

Data Security

We will implement and maintain reasonable and appropriate security measures to protect your data and PHI from unauthorized access, use, or disclosure.

These measures may include encryption, firewalls, access controls, and regular security audits.

In the event of a data breach, we will notify you in accordance with applicable laws and regulations.

Term and Termination

The term of our agreement will be specified in the Service Agreement.

Either party may terminate the agreement under the conditions outlined in the Service Agreement, which may include:

Material breach of the agreement

Failure to pay fees

Change in laws or regulations that make performance impossible

Mutual agreement