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Terms & Conditions

These Terms and Conditions (“Terms”) govern the use of the Advanta Partners website (the “Site”) and the contractual relationship for the provision of Chronic Care Management (“CCM”) services (collectively, the “Services”) between Advanta Partners (“Advanta Partners,” “we,” “us,” or “our”) and the client healthcare entity (the “Client” or “you”).

 

1. Acceptance of Terms

 

By accessing the Site or executing a Service Agreement with Advanta Partners, you agree to be bound by these Terms and all incorporated documents. If you are using the Services on behalf of a healthcare entity, you represent and warrant that you have the authority to bind that entity to these Terms.

 

2. Scope of Services

 

 

A. Service Definition

 

Advanta Partners provides fully managed CCM solutions to facilitate the coordination of care for the Client’s eligible patient population, including non-face-to-face clinical staff time, secure patient engagement tools, and administrative support.

 

B. Client Responsibilities

 

The Client remains the Covered Entity responsible for:

  • Obtaining valid, documented patient consent for CCM services, as required by CMS.

  • Retaining ultimate clinical responsibility for all patient care, diagnoses, and treatment decisions.

  • Reviewing and acting upon critical alerts and patient data provided by Advanta Partners in a timely manner.

  • Ensuring compliance with its own Notice of Privacy Practices and state licensing requirements.

 

3. Data Handling and HIPAA Compliance

 

 

A. Business Associate Status

 

Advanta Partners acts as a Business Associate (BA) to the Client (a Covered Entity). The use, disclosure, and safeguarding of Protected Health Information (PHI) will be governed by a separate, executed Business Associate Agreement (BAA), which is incorporated into these Terms by reference.

 

B. Security and PHI

 

We will implement and maintain reasonable and appropriate security safeguards to protect ePHI, in accordance with the HIPAA Security Rule. The Client acknowledges that no electronic transmission is 100% secure.

 

4. Financial and Billing Terms

 

 

A. Fees and Payment

 

The Client agrees to pay Advanta Partners the fees specified in the executed Service Agreement or Statement of Work. Fees are typically based on factors such as the number of enrolled patients, the complexity of services provided, and the specific program options selected.

 

B. Reimbursement and Coding

 

Advanta Partners provides administrative and documentation support to facilitate CCM CPT code billing (e.g., CPT 99490, 99487, 99453, 99457). The Client is solely responsible for the final submission of claims to Medicare, Medicaid, or any third-party payer, and for ensuring the medical necessity and accuracy of the claim. Advanta Partners makes no guarantee regarding claim approval or final reimbursement amounts.

 

C. Term and Termination

 

The initial term of the Services will be defined in the Service Agreement. Either party may terminate the agreement:

  • For cause, upon written notice, if the other party materially breaches these Terms or the BAA and fails to cure the breach within thirty (30) days.

  • As otherwise defined in the Service Agreement (e.g., termination for convenience).

 

5. Intellectual Property

 

The Client acknowledges that all software, technology, care protocols, documentation, and underlying methodology used to provide the Services are the sole and exclusive property of Advanta Partners. The Client is granted a limited, non-exclusive, non-transferable license to use the Advanta Partners Platform only as necessary to receive the Services.

 

6. Warranties and Limitation of Liability

 

 

A. Service Warranty

 

Advanta Partners warrants that the Services will be performed in a professional manner and in compliance with the executed BAA.

 

B. Limitation of Liability

 

Advanta Partners shall not be liable for any indirect, incidental, special, consequential, or punitive damages, including, but not limited to, loss of profits, loss of data, or interruption of business, arising out of or related to these Terms, even if Advanta Partners has been advised of the possibility of such damages. Our total liability to the Client shall not exceed the total fees paid by the Client to Advanta Partners in the twelve (12) months preceding the claim.

 

C. Disclaimer of Medical Liability

 

ADVANTA PARTNERS IS NOT A HEALTHCARE PROVIDER. We disclaim all liability for any clinical outcome, diagnosis, or decision made by the Client's medical staff using the data or support provided by the Services.

 

7. Governing Law

 

These Terms shall be governed by and construed in accordance with the laws of the State of Michigan, without regard to its conflict of laws principles.

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