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Terms And Conditions

1. Acceptance of Terms

ClaimMax RCM, LLC ("ClaimMax," "we," "us," or "our") provides medical billing, coding, credentialing, contracting, eligibility verification, denial management, accounts receivable, payment posting, virtual assistant, and revenue cycle management services to healthcare practices across the United States.

By accessing or using claimmaxrcm.com or engaging our services, you ("Client," "you," or "your") agree to be bound by these Terms and Conditions, our Privacy Policy, and any executed service agreement or Business Associate Agreement. If you do not agree, do not use this website or our services.


2. Company Information

ClaimMax RCM is a United States-based company headquartered in California and registered with the Internal Revenue Service as a U.S. taxpayer entity, organized as an LLC under the laws of California.

Subcontractors and Service Providers

ClaimMax RCM may, at its sole discretion, use qualified employees, affiliates, contractors, or subcontractors located within or outside the United States to perform or support the services we provide. These personnel may assist with administrative, billing, coding, credentialing, eligibility verification, claims, revenue cycle, technology, customer support, and other operational functions as we consider appropriate.

ClaimMax RCM remains fully responsible for the services delivered in connection with our engagements, including work performed by our personnel and subcontractors. We take reasonable steps to ensure that all personnel and subcontractors are bound by appropriate confidentiality, data security, and privacy obligations, and by applicable HIPAA requirements, including the execution of written agreements where required by law.

Where a subcontractor handles Protected Health Information (PHI), that subcontractor is required to comply with its obligations under HIPAA and with the terms of the applicable Business Associate Agreement.


3. Eligibility

You must be at least 18 years of age and legally authorized to enter into binding agreements on behalf of yourself or the healthcare entity you represent. By using our services, you represent that you meet these requirements and that all information provided is accurate, current, and complete.


4. Description of Services

ClaimMax provides outsourced medical billing and revenue cycle management services to physician practices, group practices, multi-specialty clinics, hospitals, and ancillary healthcare providers.

  • Medical billing and claim submission
  • Specialty-matched coding (CPT, ICD-10-CM, HCPCS)
  • Provider credentialing and payer enrollment
  • Insurance eligibility verification and prior authorization
  • Denial management and appeals
  • Accounts receivable follow-up
  • Payment posting (ERA 835 and manual EOB)
  • Medical billing virtual assistants
  • End-to-end revenue cycle management

The exact scope of services for each engagement is defined in a separate executed service agreement between ClaimMax and the Client.


5. Service Agreement and Business Associate Agreement

All ClaimMax engagements require an executed service agreement specifying scope, deliverables, performance standards, and operational terms. ClaimMax also requires a signed Business Associate Agreement (BAA) before any access to protected health information (PHI) is granted, in accordance with HIPAA and the HITECH Act.

The terms of the executed service agreement and BAA control in the event of any conflict with these general Terms and Conditions.


6. Client Responsibilities

To enable ClaimMax to perform services effectively, the Client agrees to provide the following without delay:

  • Timely access to EHR, practice management, and clearinghouse systems
  • Accurate provider, payer, and practice information
  • Timely responses to coding queries and documentation requests
  • Compliance with all applicable healthcare laws and regulations
  • Accurate clinical documentation supporting submitted claims
  • Cooperation during onboarding, audits, and reporting cycles

The Client retains ultimate responsibility for the accuracy of clinical documentation, medical necessity determinations, and compliance with provider-side regulatory obligations.


7. Fees and Payment Terms

Service fees, billing frequency, payment methods, and any applicable taxes are defined in the executed service agreement between ClaimMax and the Client.

Late payments may incur interest charges and may result in service suspension after appropriate written notice.


8. Confidentiality

Both parties agree to maintain strict confidentiality regarding all non-public business, financial, operational, and clinical information exchanged during the engagement.

PHI is handled exclusively under the terms of the executed BAA and applicable HIPAA Privacy Rule and Security Rule requirements.


9. Intellectual Property

All content on claimmaxrcm.com, including text, graphics, logos, frameworks, methodologies, workflows, training materials, and software, is the property of ClaimMax RCM, LLC or its licensors and is protected under United States and international laws.


10. Permitted Use of Website

You agree to use claimmaxrcm.com only for lawful purposes and in a manner that does not infringe the rights of any third party.

  • Unauthorized scraping or automated access
  • Reverse engineering website functionality
  • Submitting misleading or fraudulent information
  • Uploading malware or harmful code
  • Unauthorized access attempts
  • Impersonating any person or entity

11. Third-Party Links and Services

Our website may contain links to third-party websites or references to third-party software platforms. These references are provided for convenience only.

ClaimMax does not endorse or assume responsibility for third-party websites or services.


12. Disclaimer of Warranties

The claimmaxrcm.com website and all content are provided on an "as is" and "as available" basis without warranties of any kind.


13. Limitation of Liability

To the fullest extent permitted by applicable law, ClaimMax shall not be liable for indirect, incidental, consequential, special, punitive, or exemplary damages.


14. Indemnification

You agree to indemnify, defend, and hold harmless ClaimMax RCM, LLC and its affiliates from claims or damages arising from your breach of these Terms or misuse of services.


15. Termination

Either party may terminate the service engagement under the terms outlined in the executed service agreement.


16. HIPAA, HITECH, and Regulatory Compliance

ClaimMax operates under HIPAA Privacy Rule, HIPAA Security Rule, HITECH Act, and SOC 2 Type II audited controls.


17. Force Majeure

Neither party shall be liable for delays caused by events beyond reasonable control including disasters, internet outages, or government actions.


18. Governing Law and Jurisdiction

These Terms and Conditions are governed by the laws of the State of California.


19. Dispute Resolution

Disputes shall first be resolved through good-faith negotiation, followed by binding arbitration if necessary.


20. Severability

If any provision is found unenforceable, the remaining provisions shall remain in full force and effect.


21. Entire Agreement

These Terms and Conditions, together with executed agreements and policies, constitute the entire agreement between ClaimMax and the Client.


22. Changes to Terms and Conditions

ClaimMax reserves the right to modify these Terms at any time. Changes become effective immediately upon posting.


23. Contact Information

For questions or concerns regarding these Terms and Conditions, please contact us using the details below.

ClaimMax RCM, LLC
[Headquarters Address Placeholder]
California, USA

Email: info@claimmaxrcm.com

Phone: +1 (916) 299-5335