Legal
Terms and Conditions
Last updated October 2026
These Terms govern a healthcare provider’s use of the denial recovery and prior authorization services of Care Automation Solutions, LLC under a signed MSA. Where anything here conflicts with a signed MSA or Business Associate Agreement, that agreement controls.
1. The Services
Care Automation Solutions provides denial recovery and prior authorization services to specialty groups through two programs: Denial Recovery (a backlog sweep of unappealed denials within payer appeal deadlines; appeals, reopenings, and redeterminations; and ongoing denial recovery) and Authorization & Denial Management (prior authorization submission and follow-up, eligibility checks before treatment, front-desk error feedback, payer performance tracking, and everything in Denial Recovery). The program and scope you’ve selected are set out in your Master Services Agreement (“MSA”).
2. Your Responsibilities
You’re responsible for the accuracy and completeness of the information you provide, for having the authority to share it with us, for the clinical documentation behind your claims, and for compliance with payer rules and applicable law. We rely on the information you give us.
3. Fees
Fees are set out in your MSA. Denial Recovery is paid as a retainer plus a share of recovered dollars; Authorization & Denial Management is paid as a retainer plus a per-authorization fee. There are no upfront fees. Every program begins with a free denial backlog review.
4. Your Systems and Your Money
We work with your existing PM / EHR system and your clearinghouse stays in place. Payer payments stay in your bank account.
5. HIPAA and Protected Health Information
Our work involves Protected Health Information (PHI). A separate Business Associate Agreement (BAA) governs our handling of PHI and controls over this section in the event of any conflict. We use PHI only to provide the services in your MSA, and never for marketing, fundraising, or resale.
6. No Guarantee of Results
We don’t guarantee that any claim will be paid, that any appeal will succeed, or that any authorization will be approved, or that any particular amount will be recovered or collected. Any recoverable amount shown in a denial backlog review is an estimate, not a guarantee. Payment decisions rest with payers and are outside our control.
7. Liability
We aren’t liable for indirect or consequential damages, including lost revenue, arising from payer decisions, third-party system failures, or events beyond our reasonable control. Our total liability under these Terms is capped at the fees you paid us in the twelve months before the claim, as further detailed in your MSA.
8. Privacy
We don’t sell, rent, or share patient information with third parties for their own purposes. Our Privacy & Data Protection Statement explains how we handle information.
9. Termination and Data Retention
Your MSA governs termination. You remain responsible for fees accrued before termination. After termination we retain data only as long as required by law, by your BAA, or to resolve outstanding obligations.
10. Governing Law
These Terms are governed by the laws of the state specified in your MSA, and any dispute will be handled in the venue specified there.
11. Changes to These Terms
We may update these Terms to reflect changes in law or our services. We’ll post updates on this page and update the date at the top; continuing to use our services after a change takes effect means you accept it.
Contact
Questions about these Terms: hello@careautomation.io · (253) 444-7370
This page is provided for general informational purposes and isn’t legal advice. It’s subject to, and doesn’t override, any signed Master Services Agreement or Business Associate Agreement between Care Automation Solutions, LLC and a customer.