Terms of Service
Draft. Have a Nevada-licensed attorney review these Terms before launch. Bracketed items are details or decisions still to be filled in.
Effective date: [DATE]
These Terms are an agreement between you and [LEGAL NAME], LLC, a Nevada limited liability company ("we," "us"), for use of Medical Bill Buster (the "Service") by patients. Employer and health plan services are governed by a separate written agreement and Business Associate Agreement.
1. What we are, and what we are not
We are not a law firm. We provide medical billing advocacy only. We are not attorneys, and nothing we provide is legal, medical, or tax advice. No attorney-client relationship is created. We are not a collection agency, debt-management or debt-settlement service, or insurer. You decide whether to send any letter we prepare.
2. The Service
(a) Free audit. Upload a bill to see how many possible errors we found and an estimate of how much your balance could drop, at no cost. The audit is automated. It can miss errors and can flag charges that turn out to be correct.
(b) Unlocking. To see each issue and get your letters, you give us your email and save a payment method. Saving a payment method does not charge it.
(c) Your letters. You are responsible for reviewing letters for accuracy before sending them.
3. Fee: 25% of verified savings
3.1 No savings, no fee. You pay nothing upfront. Our only fee is 25% of Verified Savings on the bill you uploaded.
3.2 Definitions.
- Baseline Balance: the amount you owed ("patient responsibility") on the bill you uploaded, recorded when you uploaded it.
- Final Balance: what you owe for the same services on your final Explanation of Benefits (EOB) or the provider's final statement.
- Verified Savings: Baseline Balance minus Final Balance, excluding (i) payments you made, (ii) insurance payments on claims still pending when you uploaded the bill, and (iii) [DECIDE: reductions from financial assistance or charity care — included or excluded].
3.3 Final document. No fee is calculated until you upload your final EOB or statement, and we check that it matches your original bill (account number, claim ID, date of service, provider NPI, and facility). If we don't receive it within [90] days after you unlock your audit, your case closes and no fee is owed.
3.4 Notice before any charge. Before charging, we email you the Baseline Balance, Final Balance, and the calculation, and wait at least [10] days. If you dispute the calculation in writing during that time, we won't charge until the dispute is resolved.
3.5 Payment authorization. By saving a payment method, you authorize us to charge it once per bill for the fee calculated under this Section 3, without you being present, after the notice in Section 3.4. The amount varies with your savings. If a charge fails, we'll send an invoice payable within 30 days.
3.6 Cancelling. You may cancel and remove your payment method at any time by emailing [EMAIL]. Cancelling doesn't affect a fee for savings already verified.
4. Your responsibilities
Provide accurate, complete documents, and tell us about payments, settlements, or insurance decisions that affect the bill. A dispute does not by itself stop collection activity, credit reporting, or deadlines, and you remain responsible for any amount you legitimately owe.
5. No guarantee
We do not guarantee any savings or any response from a provider, insurer, or collector. Savings figures shown by the Service are upper-bound estimates, not promises.
6. Privacy
Our Privacy Policy explains what we collect and your rights.
7. Arbitration, class action waiver, and jury waiver
Please read this section carefully. You agreed to it by typing your initials when you unlocked your audit.
7.1 Informal resolution. Before filing a claim, email [EMAIL] and give us 30 days to try to resolve it.
7.2 Binding arbitration. Any dispute arising from these Terms or the Service will be resolved by binding individual arbitration administered by the American Arbitration Association under its Consumer Arbitration Rules. The seat of arbitration is Clark County, Nevada. [ATTORNEY: consider allowing hearings by video, on documents only, or in the consumer's home county.] The Federal Arbitration Act governs this Section 7. Your initials are your specific authorization of this provision (NRS 597.995).
7.3 Small claims. Either party may bring an individual claim in small claims court instead, if it qualifies.
7.4 Class action waiver. Claims may be brought only individually, not as a plaintiff or class member in any class or representative proceeding.
7.5 Jury waiver. To the extent a dispute is decided in court rather than arbitration, you and we waive any right to a jury trial.
7.6 Opt-out. You may opt out of Section 7 by emailing [EMAIL] within 30 days after you first accept these Terms.
8. Limitation of liability
To the fullest extent the law allows, our total liability for any claim relating to the Service is limited to the fees you paid us for the bill at issue.
9. Governing law and venue
These Terms are governed by the laws of the State of Nevada, except that Section 7 is governed by the Federal Arbitration Act. Any matter not subject to arbitration will be brought in the state or federal courts located in Clark County, Nevada. If you live outside the United States, this does not take away mandatory consumer protections of the country where you live.
10. Changes
We may update these Terms. Changes won't affect the fee terms for a bill you have already uploaded unless you agree in writing.
11. Contact
[LEGAL NAME], LLC. [ADDRESS]. [EMAIL]