Partner Terms of Service

The following terms of service agreement (these “Terms” or “Agreement”) set out the terms and conditions which apply to the provision of certain services provided by Claimable, a company incorporated in the State of Delaware ("Claimable", “we”, “us” or “our”).​

Claimable provides a software-based service (“Platform”) that enables healthcare providers, patient advocates, and other authorized entities (collectively, “Partners”, “you”, or “your”) to create, manage, and collaborate on healthcare appeals on behalf of or in coordination with their patients or clients (“Patients” or “End Users”). The Platform facilitates the generation, submission and tracking of appeals, integrates supporting documentation, and enables communication between Partners and End Users to streamline the appeals process. Claimable acts as a technology provider and does not offer legal, medical, or insurance advisory services.​

If you are eligible to be a Claimable Partner and wish to obtain a license to access and use our Platform and related services—whether through our website, in-person, via video, audio, text messaging, or through a third-party platform (collectively, our “Service”)­—you agree to be bound by these terms. This includes access to all content and functionality offered as part of our Service, whether as a guest or as a registered user of an affiliated, managed, or member account (“Member Entity”).

1. Acceptance of the Partner Terms of Service

• You agree to accept these legally binding Terms by a) opening an account as a Member Entity, or b) registering as a user of a Member Entity account, or c) using our Partner Platform, or d) purchasing Appeal Credits via our Order Form. BEFORE YOU DO ANY OF THOSE, PLEASE READ THESE TERMS CAREFULLY.  If you do not want to agree to these Terms, you must not use our Service or set up an account.  
  
  
• You also agree to abide by other Claimable rules and policies, including our:
  • Business Associates Agreement (BAA), which establishes the responsibilities and safeguards a business associate must follow when handling protected health information (PHI) on behalf of a covered entity, ensuring HIPAA compliance. (See https://www.getclaimable.com/business-associates-agreement.)
  • Privacy Policy, which explains what information we collect from you and how we protect it) that are expressly incorporated into and are a part of these Terms. Please read them carefully. (See https://www.getclaimable.com/privacy-policy.)
    
• Once these Terms begin to apply to you, you are bound by them until they no longer apply. (See Section 9 (Termination and Cancellation).)
  

2. Service

• Appeal Sponsorship. Pursuant to the payment of applicable Fees (see Section 4), you may purchase Appeal Credits in bundles (e.g., 10-pack, 30-pack, or 100-pack of appeals) via our Order Form. Each Appeal Credit represents one appeal submission.
• Creating Appeals. The Claimable platform enables partners and patients to generate appeal letters based on case details, supporting documents, and relevant clinical evidence. The appeal creation process includes: a) uploading supporting documents, b) answering guided questions, and c) generating an appeal letter that is automatically structured for submission. Once as appeal is created, the user may review and edit before submission.
• Referring Patients. Partners may refer patients to Claimable by submitting their information via the platform. By submitting a referral, the Partner warrants that they have obtained necessary patient consent to share information with Claimable. Claimable is granted a non-exclusive, sublicensable, non-transferable, and revocable license to use patient information solely for appeal processing, in accordance with the Business Associate Agreement (BAA) and applicable laws. A referred patient is notified and prompted to log in, review their case, and submit an appeal.
• Managing Appeals. Partners can track the status of appeals in real time through the Platform. The system provides visibility into each appeal's progress, including submission status (such as draft, pending, submitted, or completed), insurer updates (such as requests for additional documentation), and final outcomes (approved, denied, or under review). Automated notifications keep partners informed of key appeal events, ensuring they can take timely action when necessary.
• Collaborating on Appeals. Claimable enables partners to collaborate with patients throughout the appeals process. Partners may review patient-submitted appeals, suggest edits, and upload additional supporting documentation to strengthen the case. The platform also provides a secure messaging system (if applicable) for direct communication between partners and patients. Additionally, partners can delegate tasks to team members, facilitating a streamlined workflow for managing multiple appeals efficiently.
• No Guarantee of Continuous Service Availability. Claimable strives to maintain uptime for the platform but does not guarantee uninterrupted access. Claimable shall not be liable for service interruptions, delays, or outages due to maintenance, system failures, or other circumstances beyond its control.
  

3. Company Obligations. We shall:

• Upon your referral of a patient to us, ensure we alert patients in a timely manner and begin to onboard them to our platform for provision of appeal services; and
• Provide a secure and HIPAA-compliant platform for managing patient appeals, ensuring appropriate safeguards are in place to protect Protected Health Information (PHI).
• Maintain the functionality and availability of the Claimable platform, ensuring reasonable uptime and access, except during scheduled maintenance or circumstances beyond our control.
• Facilitate appeal submission and tracking, ensuring that referred patients have the tools and resources necessary to complete their appeals, including guided steps and document uploads.
• Notify Partners of important updates or changes to the platform that may impact their ability to refer patients, purchase Appeal Credits, or collaborate on appeals.
• Retain appeal-related records for a reasonable period in accordance with applicable legal and regulatory requirements, unless otherwise requested by the Partner or required by law.
• Provide customer support to assist Partners with technical issues, platform navigation, and inquiries related to the appeal submission process.
  

4. Partner Obligations. Partner shall:

• Partners must obtain explicit consent from each patient before referring them to Claimable and sharing personal information, ensuring compliance with applicable privacy laws, including HIPAA and any state-specific regulations.
• Partners agree to cooperate reasonably with Claimable by providing accurate, complete, and timely information necessary for the submission and processing of patient appeals, including letters of medical necessity and supporting documents.
• Partners must use Appeal Credits appropriately, ensuring that sponsored appeals are for patients who meet Claimable’s eligibility criteria and who have authorized appeal initiation.
• Partners are responsible for ensuring the accuracy of patient information they provide to Claimable and must notify Claimable promptly of any errors, updates, or corrections.
• Partners shall not use Claimable’s platform or services for any unlawful, fraudulent, or deceptive purposes, including but not limited to misrepresenting patient information or submitting appeals without patient knowledge or consent.
• Partners must maintain compliance with all applicable laws, regulations, and industry standards when using Claimable’s services.
• Partners shall not engage in any activities that disrupt, abuse, or interfere with Claimable’s platform, including attempting to bypass system limitations, reverse-engineering the software, or engaging in unauthorized data scraping
• Partners must ensure that any team members or employees using Claimable’s platform do so in accordance with these terms and maintain confidentiality of any protected or sensitive information accessed through the platform.
• Partners acknowledge that Claimable may suspend or terminate access to the platform if a Partner fails to comply with these obligations or engages in conduct that compromises compliance, security, or the integrity of Claimable’s services.

5. Fees and Payment

• No Cost to Open an Account & Promotional Waivers. Fees for patient appeal submissions may be waived at Claimable’s discretion during promotional offers (e.g., a 30-day free trial) or when Claimable provides evaluative access to partners or end-users. Promotional offers are subject to change and may be revoked at any time.
• Referral Model – Patients Pay Upon Submission. Partners may refer patients for free using the Claimable platform. The referred patient is responsible for the payment of any applicable fees upon submitting an appeal.
• Sponsorship Model – Partners Purchase Appeal Credits. You may purchase Appeal Credits at the rates set out on our rate sheet as provided by us from time to time. All fee amounts (“Fees”) are due at the time of checkout upon submission of an Order Form.  Payments must be completed through our designated payment processor before appeal credits are issued. Each credit represents one appeal submission.
  • Purchasing Credits. We offer you the right and opportunity to purchase in advance the use of our insurance claim appeal service on behalf of your patients (“Appeal Credits”). Such Appeal Credits permit you to sponsor claim appeals for patients, making the appeals a cost-free proposition for the patient. You enable that process when you refer a patient to us to start an appeal – the purchased Appeal Credit is then provisionally transferred to the patient’s account. In the event the patient does not utilize the Appeal Credit and takes no action for 30 days, the transfer is voided, and we return the credit to your account. There is no expiry of Appeal Credits purchased from us.
  • Credits purchased are non-refundable. Except as required by law, in instances where you have made a payment to us to purchase Appeal Credits, we do not provide refunds if an appeal is submitted or if your Appeal is not successful. Claimable makes no representations, warranties, or guarantees regarding the likelihood that a referred patient will use an Appeal Credit or that any appeal submitted through the platform will result in a favorable outcome.
  • Payments for Appeal Credits are processed securely via Stripe or other third-party payment providers. Applicable sales, use, or excise taxes may be collected at checkout based on the billing address and tax laws in the applicable jurisdiction. Claimable is not responsible for any additional taxes, fees, or charges imposed by a federal, state, or local government beyond the amount collected at the time of purchase.
    

6. Mobile Messaging

• By using Claimable's mobile (SMS/text) message services, you agree to these terms and conditions. We may modify or cancel mobile messaging or any of its features without notice. To the extent permitted by applicable law, we may also modify these terms at any time, and your continued use of mobile messaging following the effective date of any such changes constitutes your acceptance of those changes.
• Consent and Authorization. By consenting to Claimable’s mobile messaging service, you agree to receive recurring SMS/text messages from and on behalf of Claimable through your wireless provider to the mobile number you provided, even if your mobile number is registered on any state or federal Do Not Call list. Text messages may be sent using an automatic telephone dialing system or other technology.
  • Partners: By using Claimable’s platform, you consent to receive service-related text messages, including but not limited to account alerts, updates on patient appeals, and platform notifications.
  • Partner-Authorized Customer Messaging: If you request that Claimable send SMS/text messages to your customers (e.g., patients or clients), you represent and warrant that you have obtained the necessary prior express consent from those individuals to receive such messages on their behalf, in compliance with all applicable laws, including but not limited to the Telephone Consumer Protection Act (TCPA) and CAN-SPAM.
• Types of Messages.
  • Service-related messages may include updates, alerts, and information (e.g., appeal updates, account alerts, status notifications).
  • Promotional messages (if applicable) may include special offers, marketing promotions, and other relevant business communications.

• No Purchase Requirement & Opt-Out Rights. You understand that participation in this program is not required to use Claimable’s services and is not a condition of any purchase. Your participation in this program is voluntary. You or your customers may opt out of mobile messaging at any time by texting STOP to +1.888.894.8916 or by clicking the unsubscribe link (where available) in any text message. You will receive a one-time opt-out confirmation message, and no further messages will be sent unless initiated by you.
• Partner Responsibilities for Customer Messaging.
  • Partners must obtain valid, prior express consent from customers before requesting Claimable to send SMS/text messages to them.
  • Partners shall not use Claimable’s SMS services to send unsolicited messages or messages that violate applicable law.
  • Claimable is not liable for any messages sent by Partners in violation of these terms.

• Fees & Carrier Responsibilities. Claimable does not charge for mobile messaging; however, message and data rates may apply. You and your customers are responsible for all charges associated with text messaging imposed by your wireless provider. Wireless carriers are not liable for delayed or undelivered messages. Claimable is not responsible for any failed, delayed, or misdirected delivery of information sent through mobile messaging.

• Privacy & Data Use. Claimable respects your right to privacy. To see how we collect and use personal information, please see our Privacy Policy at www.getclaimable.com/privacy-policy.
  
  

7. Intellectual Property Rights.

• Claimable acknowledges that, as between Claimable and Partner, Partner does not grant Claimable any rights in any patient data or any other intellectual property of Partner other than as agreed upon under the Agreement.
• Claimable and its licensors retain all rights, titles, and interests, including intellectual property right, in our and their intellectual property respectively. These Terms and any related Order Form do not in any way grant you any rights into any product, service and any intellectual property rights associated with Claimable products and services.
• You hereby grant us a royalty-free, worldwide, transferable, sub-licensable, irrevocable, and perpetual:
  • license and right to use Resultant Data to tailor or improve our services. “Resultant Data" means data and information related to Partner's use of the Services that is aggregated and anonymized, including to compile statistical and performance information related to the provision and operation of the Services; and
  • license and right to any feedback, comments, ideas, and suggestions for improvement as provided by you and any of your Representatives (collectively, "Feedback"). To the extent that such Feedback relates in any way to Claimable’s Confidential Information (as defined), such Feedback is exclusive to Claimable and shall be Claimable Confidential Information. Claimable may, without any obligation, incorporate, use, commercialize and distribute in any manner, including, without limitation, as part of the Services such Feedback without any attribution, payment or other obligation to Partner or its Affiliates.
• Claimable may collect, analyze, and use anonymized and aggregated data derived from appeals submitted through the platform. Such data may be used for research, analytics, service improvements, and industry insights, provided that it does not include any personally identifiable information.
  

8. Confidentiality

• (a) Ownership of Confidential Information. The Parties acknowledge that during the performance of the Agreement, each Party will have access to certain of the other Party’s Confidential Information or Confidential Information of third parties that the disclosing Party is required to maintain as confidential. Both Parties agree that all items of Confidential Information are proprietary to the disclosing Party or such third party, as applicable, and shall remain the sole property of the disclosing Party or such third party.
• (b) Mutual Confidentiality Obligations. Each Party agrees: (i) to use the Confidential Information only for the purposes described herein; (ii) that such Party will hold in confidence and not disclose the Confidential Information from dissemination to any third party without the other’s consent, except as permitted by the Agreement; (iii) to restrict access to the Confidential Information to such of its personnel, agents, and/or consultants, if any, who have a need to have access, provided such Party remains responsible for their compliance with this Section 6 and they are bound by confidentiality obligations no less protective than this Section 8; and (iv) to return or destroy all Confidential Information of the other Party in its possession that is not required to be retained by Law upon termination or expiration of the Agreement.
• (c) Confidentiality Exceptions. Notwithstanding the foregoing, the provisions of subsections (a) and (b) shall not apply to Confidential Information that (i) is publicly available or in the public domain at the time disclosed; (ii) is or becomes publicly available or enters the public domain through no fault of the recipient; (iii) is rightfully communicated to the recipient by persons not bound by confidentiality obligations with respect thereto; (iv) is already in the recipient’s possession free of any confidentiality obligations with respect thereto at the time of disclosure; (v) is independently developed by the recipient; or (vi) is approved for release or disclosure by the disclosing Party without restriction. Notwithstanding the foregoing, each Party may disclose Confidential Information to the limited extent required in order to comply with the order of a court or other governmental body, or as otherwise necessary to comply with applicable law, provided that the Party making the disclosure pursuant to the order shall first have given written notice to the other Party of the disclosure requirement if permitted by Law and reasonably cooperated with the other Party’s efforts to obtain a protective treatment of the information subject to the requirement.
  

9. Termination and Cancellation

• This Agreement shall commence as of the Effective Date and shall continue until either Party provides the other Party with at least 30 days’ written notice that it wishes this the Agreement to terminate. 
• Either party may terminate this Agreement, effective upon written notice to the other party (the “Defaulting Party”), if the Defaulting Party: (a) materially breaches this Agreement, and such breach is incapable of cure, or the Defaulting Party does not cure such breach within 30 days after receipt of written notice of such breach; (b) becomes insolvent or is subject to similar proceedings. 
• Independent Contractor. Claimable is an independent contractor and in no event will Claimable be considered an agent or employee of Partner or any of its subsidiaries or affiliates for any purpose.
  

10. Limited Warranty; Disclaimers

• Representations and Warranties. Each Party represents and warrants that:
  • it is duly organized, validly existing, and in good standing as a corporation or other entity under the Laws of the jurisdiction of its incorporation or other organization;
  • it has the full right, power, and authority to enter into and perform its obligations and grant the rights, licenses, consents, and authorizations it grants or is required to grant under these Terms, including in respect of its Affiliates as contemplated hereunder;
  • the execution of the Order Form, by its representative whose signature is set forth at the end of such documents has been duly authorized by all necessary corporate or organizational action of such party; and
  • when executed and delivered by both Parties, the foregoing documents under subsection (c), as well these Terms, will constitute the legal, valid, and binding obligation of such Party, enforceable against such Party in accordance with its terms.
    

11. No Other Warranties

• THE SERVICES ARE PROVIDED “AS IS” AND CLAIMABLE SPECIFICALLY DISCLAIMS ALL WARRANTIES, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHERWISE. CLAIMABLE SPECIFICALLY DISCLAIMS ALL IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, AND NON-INFRINGEMENT, AND ALL WARRANTIES ARISING FROM COURSE OF DEALING, USAGE, OR TRADE PRACTICE. CLAIMABLE MAKES NO WARRANTY OF ANY KIND THAT THE SERVICES OR ANY PRODUCTS OR RESULTS OF THE USE THEREOF, WILL MEET PARTNER'S OR A PATIENT’S REQUIREMENTS, OR ACHIEVE ANY INTENDED RESULT, OR IN THE EVENT OF ACCESS TO A SOFTWARE SOLUTION PROVIDED AS PART OF THE SERVICES, BE COMPATIBLE OR WORK WITH ANY OF PARTNER'S OR ANY THIRD PARTY'S SOFTWARE, SYSTEM, OR OTHER SERVICES, OR BE SECURE, ACCURATE, COMPLETE, FREE OF HARMFUL CODE, OR ERROR-FREE, OR THAT ANY ERRORS OR DEFECTS CAN OR WILL BE CORRECTED.
• CLAIMABLE DOES NOT MAKE ANY PROMISES THAT A PATIENT WILL UTILIZE THE APPEAL CREDIT OR THAT ANY APPEAL FILED ON A PATIENT’S BEHALF WILL RESULT IN ANY POSITIVE OUTCOME FOR THE PATIENT.
  

12. Limitations of Liability

• Exclusion of Damages. IN NO EVENT WILL CLAIMABLE BE LIABLE UNDER OR IN CONNECTION WITH THE AGREEMENT OR ITS SUBJECT MATTER UNDER ANY LEGAL OR EQUITABLE THEORY, INCLUDING BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT LIABILITY, AND OTHERWISE, FOR ANY: (a) LOSS OF PRODUCTION, USE, BUSINESS, REVENUE, OR PROFIT OR DIMINUTION IN VALUE; (b) IMPAIRMENT, INABILITY TO USE OR LOSS, INTERRUPTION, OR DELAY OF THE SERVICES; (c) LOSS, DAMAGE, CORRUPTION, OR RECOVERY OF DATA, OR BREACH OF DATA OR SYSTEM SECURITY; (d) COST OF REPLACEMENT GOODS OR SERVICES; (e) LOSS OF GOODWILL OR REPUTATION; OR (f) CONSEQUENTIAL, INCIDENTAL, INDIRECT, EXEMPLARY, SPECIAL, ENHANCED, OR PUNITIVE DAMAGES, REGARDLESS OF WHETHER SUCH PERSONS WERE ADVISED OF THE POSSIBILITY OF SUCH LOSSES OR DAMAGES OR SUCH LOSSES OR DAMAGES WERE OTHERWISE FORESEEABLE, AND NOTWITHSTANDING THE FAILURE OF ANY AGREED OR OTHER REMEDY OF ITS ESSENTIAL PURPOSE.
• Cap On Monetary Liability. IN NO EVENT WILL CLAIMABLE’S AGGREGATE LIABILITY OF ARISING OUT OF OR RELATED TO THIS AGREEMENT, WHETHER ARISING UNDER OR RELATED TO BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT LIABILITY, OR ANY OTHER LEGAL OR EQUITABLE THEORY, EXCEED THE TOTAL AMOUNTS PAID TO CLAIMABLE UNDER THIS AGREEMENT IN THE 12 MONTH PERIOD PRECEDING THE EVENT GIVING RISE TO THE CLAIM. THE FOREGOING LIMITATIONS APPLY EVEN IF ANY REMEDY FAILS OF ITS ESSENTIAL PURPOSE.
  

13. Governing Law and Dispute Resolution

• These Terms shall be governed by and construed in accordance with the laws of the State of California, without giving effect to any choice of law or conflict of law provisions. Any disputes arising under these Terms shall be resolved exclusively in the state or federal courts located in San Francisco, California.
• Except for claims for injunctive or equitable relief or claims regarding Intellectual Property Rights which may be brought in any court of competent jurisdiction, the Agreement and all related documents including all exhibits attached hereto, and all matters arising out of or relating to the Agreement, whether sounding in contract, tort, or statute are governed by, and construed in accordance with the laws of the State of California without giving effect to its conflicts of law principles. The Parties hereto agree that any dispute, claim or controversy arising out of or relating to the Agreement, including the determination of the scope or applicability of the Agreement to arbitrate, shall be determined by final and binding arbitration (except for an action for interim equitable relief that may be sought in any court of competent jurisdiction), before a sole arbitrator. The arbitration shall be administered by JAMS (or its successor) pursuant to its Streamlined Arbitration Rules and Procedures. All decisions of the arbitrator shall be final and binding. The Parties will pay their own costs (including, without limitation, attorneys’ fees) and expenses in connection with such arbitration.
  

14. Miscellaneous

• Severability. If any term or provision of the Agreement is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect the validity or enforceability of any other provision of this Agreement, which shall remain in full force and effect.
• Assignment. Neither Party may transfer or assign this agreement without the written consent of the other Party provided however a party may, transfer or assign its rights and obligations under this Agreement to an affiliate or in connection with a merger, acquisition, corporate reorganization, or sale of all or substantially all of its assets to which this Agreement relates.
• Entire Agreement. These Terms, together with any Order Form and the BAA, collectively govern your relationship with us and no other agreement shall supersede these items; to the extent of any inconsistencies between these items, the BAA shall govern. 
• Modification. We may modify these Terms but they will not become effective unless you approve them in writing.
• Notice. The Parties will provide all notices to the other in writing at the email address used conventionally between the Parties for the lead representative of the receiving Party.
• Force Majeure. If either Party experiences a delay or failure in performance that is beyond their reasonable control, including but not limited to acts of God, power outages, governmental actions and requirements, pandemics, it will not be considered a breach of this Agreement.
• No Third-Party Beneficiaries. The Agreement benefits solely the Parties to the Agreement and their respective permitted successors and assigns and nothing in the Agreement, express or implied, confers on any other person or entity any legal or equitable right, benefit, or remedy of any nature whatsoever under or by reason of the Agreement.
• Publicity. Neither Party will use the other’s logo or other information in any announcement, a public facing website, or news/press release without obtaining the other party’s permission.
• Counterpart. When purchasing Appeal Credits, the Order Form may be executed in counterparts, each of which is deemed an original, but all of which together are deemed to be one and the same. 

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