Service Terms & Conditions
Please read these terms carefully before using our claim recovery services
Last updated: December 2024
Key Terms Overview
Important highlights from our service agreement
Clear terms for our claim recovery services and partnership
Transparent and ethical business practices
Comprehensive protection of your sensitive information
Clear definition of mutual responsibilities
By accessing or using AdviClaim Solutions' services, you agree to be bound by these Terms and Conditions ("Terms"). These Terms constitute a legally binding agreement between you (the "Client" or "Hospital") and AdviClaim Solutions ("Company," "we," "us," or "our").
If you do not agree to these Terms, you may not access or use our services. These Terms apply to all users of our services, including hospitals, healthcare providers, and their authorized representatives.
Our Services Include:
- Health insurance claim processing and recovery services
- Rejected, delayed, and stuck claim resolution
- 24x7 dedicated claim team support
- Transparent and compliant claim handling processes
- Consultation and optimization services
- Reporting and analytics on claim recovery performance
Service Limitations:
Our services are limited to legitimate insurance claims processing and recovery. We do not engage in fraudulent activities, misrepresentation, or any practices that violate insurance regulations or healthcare laws.
Documentation and Information:
- Provide accurate, complete, and timely documentation for all claims
- Ensure all medical records and supporting documents are authentic
- Maintain proper authorization for claim submission and recovery
- Notify us promptly of any changes in claim status or relevant information
Compliance and Legal Requirements:
- Comply with all applicable healthcare and insurance regulations
- Maintain proper licensing and accreditation for healthcare services
- Ensure patient consent and privacy protection as required by law
- Cooperate with any regulatory inquiries or audits
Success-Based Model:
- No setup fees, upfront costs, or monthly charges
- Fees are charged only upon successful claim recovery
- Fee structure will be clearly defined in the service agreement
- Payment is due within 30 days of successful claim settlement
Fee Calculation:
Our fees are calculated as a percentage of the successfully recovered claim amount. The specific percentage will be agreed upon in writing before services commence and may vary based on claim complexity and recovery difficulty.
Confidentiality Commitment:
We maintain strict confidentiality of all client information, patient data, and business information. All employees and contractors are bound by comprehensive confidentiality agreements.
Data Security:
- Implementation of industry-standard security measures
- Compliance with HIPAA and other applicable data protection regulations
- Regular security audits and vulnerability assessments
- Secure data transmission and storage protocols
Performance Standards:
- 24x7 availability for urgent claim matters
- Initial response within 24 hours for all inquiries
- Regular progress updates on claim status
- Transparent reporting on recovery activities
Quality Assurance:
We maintain rigorous quality control processes to ensure accuracy and compliance in all claim processing activities. Our team undergoes regular training and certification updates.
Service Limitations:
While we strive for maximum claim recovery success, we cannot guarantee specific outcomes for individual claims. Insurance claim decisions ultimately rest with the insurance providers, and various factors beyond our control may affect claim outcomes.
Liability Cap:
Our total liability for any claims arising from our services shall not exceed the total fees paid by the client for the specific services in question. We are not liable for indirect, consequential, or punitive damages.
Termination Rights:
- Either party may terminate the agreement with 30 days written notice
- Immediate termination for material breach of terms
- Termination for insolvency or bankruptcy of either party
- Completion of all active claims before final termination
Post-Termination:
Upon termination, we will complete processing of any claims in progress and return all client materials. Confidentiality obligations and payment terms for completed work remain in effect.
All proprietary methods, processes, software, and materials developed or used by AdviClaim Solutions remain our intellectual property. Clients retain ownership of their data and documentation provided to us for claim processing purposes.
Resolution Process:
- Initial attempt at good faith negotiation
- Mediation through mutually agreed mediator
- Binding arbitration if mediation fails
- Jurisdiction: Courts of India for any legal proceedings
These Terms are governed by the laws of India. Any disputes arising from these Terms or our services will be subject to the exclusive jurisdiction of the courts in India.
We reserve the right to modify these Terms at any time. Significant changes will be communicated to clients with at least 30 days notice. Continued use of our services after changes constitutes acceptance of the modified Terms.
For questions about these Terms or our services, please contact us:
Email: support@adviclaimsolutions.com
Phone: +91 97123 46969
Address: AdviClaim Solutions Legal Department
We are committed to addressing any concerns or questions you may have about our Terms and services.
These Terms and Conditions are effective as of the date listed above. By using our services, you acknowledge that you have read, understood, and agree to be bound by these Terms. If you have any questions or concerns, please contact us before using our services.