Terms of Service - Muni Health LLC

1. Agreement to Terms

By accessing or using Muni Health's services, website, and software (collectively, the "Services"), you agree to be bound by these Terms of Service ("Terms"). If you do not agree to these Terms, please do not use our Services.

2. Description of Services

Muni Health provides AI-powered insurance appeal generation tools designed to help medical practices overturn insurance denials and recover revenue.

Our Services include:

• Automated insurance appeal template generation
• Medical necessity justification documentation
• Denial letter analysis and appeal strategy recommendations
• Educational resources and compliance guidance

3. HIPAA and Business Associate Relationship

Business Associate Agreement Required: If you are a HIPAA-covered entity, you must execute a Business Associate Agreement (BAA) with us before using our Services. This BAA will be presented during account setup.

PHI Handling: We process Protected Health Information (PHI) temporarily as necessary to provide our Services. We implement appropriate safeguards including:

• Secure server-side processing of PHI to extract clinical context
• Immediate discarding of PHI after processing (no PHI storage)
• TLS 1.3 encryption for all data in transit
• PHI scrubbing before AI processing (no PHI sent to AI models)
• Comprehensive audit logging of all PHI processing activities

Your Responsibilities: You must ensure you have proper authorization to share PHI with us and comply with all applicable HIPAA requirements.

4. User Responsibilities

You agree to:

• Provide accurate, current, and complete information
• Maintain the security of your account credentials
• Comply with all applicable laws and regulations, including HIPAA
• Use the Services only for lawful purposes
• Review all generated content before submission to insurance companies
• Ensure you have proper patient authorizations before sharing PHI

5. Professional Disclaimer

Muni Health provides tools and templates to assist with healthcare appeals. However:

• We do not provide medical, legal, or financial advice
• All clinical decisions remain the sole responsibility of licensed healthcare providers
• Generated appeal templates should be reviewed and customized by qualified professionals
• Results may vary; we cannot guarantee specific outcomes or reimbursement rates
• We are not responsible for insurance company decisions or appeal outcomes

6. Data Privacy and Security

We maintain comprehensive privacy and security practices for handling your information. For details on how we collect, use, and protect your data, please review our Privacy Policy.

Data Retention: We do not store PHI - it is processed temporarily and immediately discarded. We retain only de-identified training data for service improvement. You may request deletion of your account data at any time by contacting legal@muni.health.

Breach Notification: We will notify you within 24 hours of discovering any potential breach of your PHI as required by HIPAA.

7. Payment Terms

Certain Services require payment. You agree to:

• Pay all fees associated with your selected service plan
• Provide accurate billing information
• Notify us of any billing discrepancies within 30 days

We reserve the right to modify pricing with 30 days' notice to existing customers.

8. Intellectual Property

All content, software, and materials provided through our Services are the intellectual property of Muni Health LLC or our licensors. You may not copy, modify, distribute, or reverse engineer any part of our Services without explicit written permission.

Your Content: You retain ownership of any PHI or other content you provide. You grant us a limited license to process this content solely to provide our Services.

9. Limitation of Liability

To the fullest extent permitted by law, Muni Health LLC shall not be liable for any indirect, incidental, special, consequential, or punitive damages resulting from your use of our Services, including but not limited to:

• Lost revenue or denied claims
• Data loss or corruption (beyond our backup obligations)
• Service interruptions
• Third-party actions or insurance company decisions

Maximum Liability: Our total liability to you for any claims related to our Services shall not exceed the amount you paid us in the 12 months preceding the claim.

10. Termination

Either party may terminate this agreement at any time with written notice. Upon termination:

• Your access to paid Services will cease
• Outstanding fees remain due
• We will provide final processing activity logs if requested (no PHI stored to delete/return)

Certain provisions (privacy, intellectual property, limitation of liability) survive termination.

11. Force Majeure

We are not liable for any failure to perform our obligations due to circumstances beyond our reasonable control, including but not limited to natural disasters, government actions, or third-party service outages.

12. Changes to Terms

We may update these Terms from time to time. Material changes will be communicated via email to your registered address with 30 days' notice. Continued use of our Services after changes constitutes acceptance of the modified Terms.

13. Dispute Resolution

Governing Law: These Terms are governed by the laws of Florida without regard to conflict of law principles.

Arbitration: Any disputes arising from these Terms or our Services shall be resolved through binding arbitration in Florida, except for claims related to intellectual property or HIPAA violations.

14. Severability

If any provision of these Terms is found to be unenforceable, the remaining provisions will continue in full force and effect.

15. Contact Information

For questions about these Terms or to exercise your rights under HIPAA, please contact us at:

Legal Department
Muni Health LLC
Email: legal@muni.health

16. Entire Agreement

These Terms, together with our Privacy Policy and any executed Business Associate Agreement, constitute the entire agreement between you and Muni Health LLC regarding our Services.