Terms of Service

1. Agreement

• By engaging our services, you agree to these terms
• "Client" means the ambulatory surgery center or operating entity
• "Services" means implant carveout recovery auditing and dispute escalation
• "Recovery" means funds collected from a workers' compensation carrier on a previously denied or underpaid implant claim

2. Services

• Addback Recovery Partners audits Workers' Compensation implant carveout claims against applicable state fee schedules and statutory dispute resolution procedures
• Services currently cover Texas Department of Workers' Compensation (DWC) claims only
• We do not provide general medical billing, coding, or revenue cycle management services

3. Fees

• Our fee is 33% of Recovery collected on Client's behalf
• No fee is charged unless Recovery is collected
• For an initial five-case audit: if no Recovery is found, we will remit $500 to Client within 30 days of delivering the audit report
• Fees are invoiced upon collection and payable within 15 days

4. Client Obligations

• Client will provide denial EOBs, CMS-1500 submissions, and manufacturer invoices for requested claims
• Client will execute a Business Associate Agreement (BAA) prior to sharing protected health information
• Client represents that it has authority to authorize recovery efforts on the submitted claims

5. No Outcome Guarantee

• We make no guarantee of recovery on any specific claim
• Recovery depends on factors outside our control, including carrier behavior, claim age, and documentation availability
• The $500 audit guarantee applies to the initial five-case audit only

6. Confidentiality

• All Client information and claim documentation is treated as confidential
• We will not disclose Client information to third parties except as required to perform the Services or as required by law
• Protected health information is handled pursuant to the executed BAA

7. Term and Termination

• Either party may terminate the engagement at any time with written notice
• Fees owed on Recovery collected prior to termination remain payable
• Sections 3, 5, 6, and 8 survive termination

8. Limitation of Liability

• Our total liability shall not exceed fees paid in the 90 days preceding the claim
• We shall not be liable for indirect, consequential, or incidental damages

9. Governing Law

• State of New Mexico
• Disputes resolved in Bernalillo County, New Mexico