Terms and Conditions
Welcome to Physician Care Billing (physicianmedicalbillingservices.us). These Terms and Conditions govern the professional relationship between Physician Care Billing (the “Service Provider”) and the healthcare provider or medical practice (the “Client”). By engaging our services, you agree to comply with the following terms, which are designed to ensure transparency, security, and financial optimization within the US Healthcare System.
1. Professional Services Agreement
Physician Care Billing provides comprehensive Revenue Cycle Management (RCM) services, including but not limited to medical coding, claim submission, and denial management.
- Exclusive Provider : During the term of the agreement, Physician Care Billing typically serves as the exclusive provider of billing services for the Client.
- Service Standards: We agree to perform all duties in a professional manner in accordance with all applicable federal, state, and local laws.
- Performance Targets: We strive for a high first-pass claim acceptance rate, with many clients achieving up to a 98% collection rate.
2. Client Responsibilities
The Client is responsible for providing the necessary data to perform accurate physician medical billing.
- Data Accuracy: The Client must provide accurate and complete patient demographic, procedure, and insurance information.
- Clinical Documentation: The Client retains ultimate responsibility for ensuring that services billed were actually rendered, medically necessary, and properly documented.
- Authorization & Consents: The Client must obtain all necessary patient consents and authorizations required for billing, such as Assignment of Benefits.
3. Fees and Payment Terms
Our fee structure is designed to align our success with your practice’s revenue growth.
- Service Fees : Fees are typically calculated as a percentage of net collections, often ranging between 3.99% and 5.99% per month.
- Invoicing : Physician Care Billing will invoice the Client at the start of each month for services rendered in the previous month.
- Payment Due Date: Payments are generally due within 30 days of receipt of the invoice.
4. Term and Termination
Compliance is mandatory in every workflow we manage.
- Agreement Duration : Standard agreements often include an initial term (e.g., 1 to 3 years) with automatic renewal for successive periods.
- Termination for Cause : Either party may terminate the agreement immediately upon written notice for a material breach that remains uncorrected.
- Termination for Convenience : Many contracts allow for termination with a prior written notice period, typically 30 to 90 days.
5. HIPAA Compliance and Confidentiality
Compliance is mandatory in every workflow we manage.
- Data Protection : We maintain a fully HIPAA-compliant infrastructure, utilizing encryption, secure storage, and strict access controls to protect Protected Health Information (PHI).
- Business Associate Agreement (BAA) : We execute a formal BAA to legally bind our team to federal privacy standards.
- Confidential Information : Both parties agree not to disclose proprietary business information, such as fee structures or contracting strategies, to third parties.
6. Limitation of Liability and Indemnification
Under HIPAA and other applicable privacy laws, individuals have the right to:
- Accuracy of Information : Physician Care Billing is not liable for damages resulting from incorrect billing information provided by the Client.
- Indemnification : The Client agrees to hold Physician Care Billing harmless from liability arising from the performance of the contract, except in cases of gross negligence by the Service Provider.
