Terms of Service Effective Date: April 30, 2026 Company Name: Precision Clinical Appeals (“Company”, “we”, “us”, or “our”) Website: https://PrecisionClinicalAppeals.com
1. Acceptance of Terms By accessing our website or utilizing the clinical appeal consulting services offered by Precision Clinical Appeals, you (“the Client,” “Practice,” or “User”) agree to be bound by these Terms of Service. If you are entering into this agreement on behalf of a medical practice or healthcare entity, you represent that you have the legal authority to bind that entity to these terms.
2. Description of Services Precision Clinical Appeals provides specialized clinical consulting services designed to assist healthcare providers in appealing denied medical insurance claims. Our services include, but are not limited to:
Analyzing insurance payer policies.
Utilizing proprietary AI-driven analysis to cross-reference EMR documentation with coverage criteria.
Drafting clinical appeal letters with physician oversight.
Note: We are a consulting firm, not a law firm or a licensed medical billing entity. We do not guarantee the recovery of funds, as final adjudication lies solely with the insurance payer.
3. Professional Relationship & No Medical Advice Precision Clinical Appeals provides administrative and clinical consulting to healthcare providers.
No Physician-Patient Relationship: Our review of clinical documentation does not establish a physician-patient relationship between Precision Clinical Appeals and the Client’s patients.
No Legal Advice: Our consultants do not provide legal advice. All appeal letters drafted should be reviewed by the Client’s billing or legal department before submission.
4. HIPAA Compliance & Data Security As a service provider for a “Covered Entity” under the Health Insurance Portability and Accountability Act (HIPAA), we are committed to the highest standards of data security.
Business Associate Agreement (BAA): Our relationship is governed by a formal BAA, which must be executed before the transfer of any Protected Health Information (PHI).
Secure Intake: Clients agree to submit PHI only through our designated, end-to-end encrypted secure vaults. Precision Clinical Appeals is not liable for PHI sent via unencrypted channels (such as standard email) by the Client.
5. Fees and Payment (The “Risk-Free” Trial) Performance-Based Fees: Unless otherwise agreed in a separate written contract, our initial “Risk-Free” offering is based on a contingency or “found money” model. Fees are earned only upon the successful overturning of a denial.
Reporting: Client agrees to notify Precision Clinical Appeals within 15 days of receiving a re-adjudication or payment for an appeal drafted by the Company.
6. Client Responsibilities The Client is responsible for:
Providing accurate and complete clinical documentation and EMR notes.
Ensuring that all procedures appealed were performed with the intent of medical necessity.
Final submission of the appeal letters to the respective insurance payers.
7. Limitation of Liability To the maximum extent permitted by law, Precision Clinical Appeals shall not be liable for any indirect, incidental, or consequential damages resulting from the use of our services or the failure of an insurance payer to overturn a denial. Our total liability for any claim arising out of these terms shall not exceed the total fees paid by the Client to the Company during the three months preceding the claim.
8. Intellectual Property All proprietary AI workflows, templates, and strategies utilized by Precision Clinical Appeals remain the exclusive intellectual property of the Company. Clients are granted a limited license to use the drafted appeal letters solely for the specific patient cases for which they were generated.
9. Termination Either party may terminate the professional relationship at any time with written notice. Upon termination, Precision Clinical Appeals will fulfill its data destruction obligations as outlined in our Privacy Policy and BAA.
10. Governing Law These Terms of Service shall be governed by and construed in accordance with the laws of the State of Florida, without regard to its conflict of law provisions.
11. Contact Information For questions regarding these Terms of Service, please contact:
Precision Clinical Appeals Email: drtdshelton@proton.me Address: Zephyrhills, Florida