Terms of Service & SLA Agreements

1. Acceptance of Terms & HIPAA BAA Requirement

By contracting or engaging with Syllavera Medical Billing ("Syllavera", "we," or "us"), the medical provider practice, group clinic, or healthcare organization ("Provider" or "Client") agrees to these Terms of Service. Under federal law, no services involving Protected Health Information (PHI) will commence until a mutually executed Business Associate Agreement (BAA) is active.

2. Scope of Billing Services & SLA

Syllavera performs back-office billing administrative operations including ICD-10 modifier checking, clearinghouse claim formatting (ANSI 837P), electronic remittance posting (ANSI 835), prior authorizations, and denial appeals management. We commit to:

• Reviewing and submitting clean claims within forty-eight (48) business hours of receiving electronic encounter records.
• Appealing documented denials or requests for information (RFI) from insurance payers within seven (7) business days.

3. Provider Responsibilities & Coding Accuracy

The Provider is solely responsible for clinical chart documentation, patient consent, and checking diagnosis/procedure code selection.

• Clinical Accuracy: We do not alter or create clinical records. Coding audits are completed based on documentation entered by the Client's clinicians.
• Credentialing Integrity: Client must maintain active credentialing and contracting status with insurance networks. We are not liable for claims rejected due to lapsed provider credentials.

4. Fees, Invoicing & Collections Lift Percentages

Fees are billed monthly as a percentage of collected revenue or flat fee matching the Client's active subscription tier.

• Invoices are generated on the 5th of each month reflecting collections posted in the previous calendar month.
• Undisputed payments are due within fifteen (15) calendar days. Overdue balances may lead to a temporary pause in active claim scrubbing and follow-up services.

5. Termination & Data Portability

Either party may terminate the billing services contract with sixty (60) days written notice. Upon termination, Syllavera will securely transmit all final ERA/collections records to the Client and purge Client PHI from active billing networks in compliance with federal guidelines.