Terms of Service

Effective Date: March 1, 2026  •  Last Updated: April 9, 2026
Operator: BillerBrain™ at billerbrain.com

Section 1Agreement to Terms

By accessing or using BillerBrain™ ("the Service," "the Application," "the Tool"), operated through the web application at app.billerbrain.com and the website at billerbrain.com (collectively, "the Sites"), you agree to be bound by these Terms of Service ("Terms"). If you do not agree to these Terms in their entirety, you may not access or use the Service.

The Service is owned and operated by Conduit Catalyst LLC, a limited liability company registered in the State of Mississippi, United States ("the Company," "we," "us," "our"). These Terms constitute a legally binding agreement between you ("User," "you," "your") and the Company.

If you are using the Service on behalf of an organization, you represent and warrant that you have the authority to bind that organization to these Terms, and that your agreement constitutes the organization's agreement.

By creating an account or using any feature of the Service, you confirm that you are at least 18 years of age, that you have read and understood these Terms, and that you agree to be bound by them.

Section 2Nature of the Service — Administrative Reference Only

The Service comprises two distinct products: (1) the BillerBrain™ denial code lookup tool, which provides structured informational lookups of denial reason codes (CARC, RARC, and Group Codes) based on the official CMS X12 master code database and publicly available Medicare and Medicaid claims processing documentation; and (2) BillerBrain Agency Shield™ ("Shield"), a batch denial intelligence engine that accepts ERA/EOB document uploads, extracts and clusters denial patterns, runs analysis across multiple AI models simultaneously, and produces Recovery Status verdicts, appeal guidance, root cause synthesis, and downloadable PDF reports. Shield is stateless — no uploaded document data is retained after the session ends.

The outputs of both products are:

• Not legal advice. No output should be interpreted as legal guidance. No attorney-client relationship is created by your use of the Service.
• Not compliance advice. The Service does not evaluate your organization's compliance posture, audit readiness, or regulatory obligations under any federal or state law.
• Not medical or clinical advice. The Service does not make clinical determinations, assess medical necessity, establish or refute a standard of care, or render any opinion with clinical implications.
• Not a claim submission, modification, or transmission tool. The Service does not submit, modify, transmit, amend, adjudicate, or interact with any claim in any payer's system, clearinghouse, or electronic health record. It has no connection to any payer infrastructure whatsoever.

2.1 — Agency Shield Specific Disclaimers

With respect to BillerBrain Agency Shield™ specifically, you acknowledge and agree to all of the following:

• AI outputs may contain errors or hallucinations. Shield's Recovery Status verdicts, appeal guidance, and root cause synthesis are generated by large language models and may be incomplete, incorrect, outdated, or inconsistent with current payer policy. No AI-generated output is guaranteed to be accurate.
• Recovery Status verdicts are reference intelligence only — not coverage determinations. A verdict of RECOVERABLE, CONDITIONAL, or NOT RECOVERABLE reflects AI model analysis of the submitted denial pattern data. It does not constitute a legal, medical, or contractual determination of coverage, benefits, or payment obligation under any payer contract, insurance policy, or applicable law.
• NOT RECOVERABLE classifications require independent payer verification before any write-off action. Under no circumstances should a NOT RECOVERABLE verdict be used as the sole or primary basis for writing off any claim, AR balance, or receivable. You must verify the classification directly with the specific payer — via provider manual review, payer portal inquiry, or direct payer contact — before taking any write-off action.
• Appeal success rate estimates are not guarantees of outcomes. Any appeal success rate percentages cited in Shield outputs are industry-cited estimates derived from AI model training data. They are provided for informational context only and do not represent a prediction, warranty, or guarantee of the outcome of any specific appeal you may file.

All billing, coding, appeal, write-off, and compliance decisions made in connection with or informed by the Service's output remain solely your responsibility as the licensed professional or the employing organization. You must exercise independent professional judgment before acting on any information provided by the Service.

The Company's liability posture is functionally equivalent to that of published reference manuals such as the Optum360 coding manual, the AMA CPT codebook, or CMS published MLN guidance documents. These resources provide informational guidance. Professionals apply judgment. The Service is no different.

Section 2AAI Model Disclosure — Agency Shield

2A.1 — Third-Party AI Models Used

Shield's analysis engine routes denial pattern data through large language model APIs operated by three third-party providers: Google LLC, OpenAI, LLC, and Anthropic, PBC. These providers are accessed via a proprietary orchestration layer. All three models process the same query dimensions simultaneously, and their outputs are synthesized into a consensus Recovery Status verdict and supporting guidance. Your use of Shield constitutes acknowledgment that your de-identified denial data is processed by these third-party AI providers pursuant to their respective API terms of service and data processing agreements.

2A.2 — Inherent Limitations of AI-Generated Outputs

You acknowledge that AI-generated outputs carry inherent limitations that affect their reliability for consequential professional decisions, including:

• Large language models are trained on data with a fixed knowledge cutoff and may not reflect current payer reimbursement policies, LCD/NCD updates, CMS transmittals, or payer-specific contract amendments issued after that cutoff date
• AI models may generate outputs that are confidently stated but factually incorrect, a phenomenon commonly referred to as "hallucination"
• Consensus verdicts across multiple models reduce but do not eliminate the risk of error; all three models may produce the same incorrect output if their training data reflects the same inaccuracy
• Shield's analysis reflects the denial pattern data you submit and the models' interpretation of that data — it does not access live payer adjudication systems, real-time claims status, or current provider contract terms

2A.3 — Your Verification Obligation

Before acting on any AI-generated guidance produced by Shield — including but not limited to filing an appeal, writing off a claim, adjusting a billing practice, or advising a client — you must independently verify all AI-generated guidance against the specific payer's current provider manual, applicable LCD/NCD, and any payer-specific claims processing instructions in effect at the time of the denial. The Company expressly disclaims all liability for any action taken in reliance on Shield output without such independent verification.

2A.4 — No Endorsement of Third-Party AI Providers

The Company's use of Google, OpenAI, and Anthropic APIs does not constitute an endorsement of those providers' products, policies, or data practices. Each provider operates independently and is subject to change. The Company does not warrant the continued availability of any specific AI model or the consistency of outputs across model versions or updates.

Section 3No Protected Health Information Policy

The Service is designed to process only administrative billing data: denial reason codes, procedure codes (CPT/HCPCS), adjustment codes, group codes, billed amounts, allowed amounts, drug names, and AR balance data. This data is not patient-identifiable information and is not Protected Health Information (PHI) as defined under HIPAA (45 CFR §160.103).

3.1 — Your Obligation to De-Identify Before Upload

Before submitting any image (photograph or digital export of an ERA, EOB, or remittance advice) to the Service — including uploads to BillerBrain Agency Shield™ for batch denial analysis — you must crop or otherwise permanently redact all patient-identifiable information, including without limitation:

• Patient name, date of birth, Social Security number, or equivalent government identifier
• Medical record number, health plan beneficiary number, or member ID
• Patient address, phone number, or email address
• Any other identifier defined as PHI under 45 CFR §160.103

If you submit PHI to the Service, you do so at your own risk and in material violation of these Terms. The Company bears no liability for PHI you transmit through the Application, and you agree to indemnify the Company for any claims, losses, or regulatory actions arising from such transmission.

3.2 — Agency Shield Acknowledgment Checkbox

Prior to initiating any ERA/EOB batch processing through BillerBrain Agency Shield™, the Service requires you to affirmatively check an acknowledgment checkbox confirming that you have removed all PHI from the documents you are uploading. This checkbox is a required condition of processing and cannot be bypassed. However, your completion of the acknowledgment checkbox does not transfer liability for PHI submissions to the Company. The checkbox is a compliance reminder only. Responsibility for ensuring that uploaded documents are fully de-identified remains solely with you. The Company has no technical means to detect or prevent the submission of PHI and does not assume any obligation to do so by virtue of providing the acknowledgment step.

3.3 — HIPAA Business Associate Status

BillerBrain™ is not a HIPAA Covered Entity and is not a Business Associate as defined under the Health Insurance Portability and Accountability Act (45 CFR Part 160). The Service does not process, store, or transmit Protected Health Information on behalf of any covered entity. No Business Associate Agreement (BAA) is required, available, or offered.

If your compliance framework requires a BAA with every external vendor or tool, this Service may not be appropriate for your workflow until you confirm with your compliance officer that the de-identified administrative data you submit does not constitute PHI in your organization's assessment.

Section 4Account Registration and Access

4.1 — Registration

Access to the Service requires registration with a valid work email address. You agree to provide accurate, current, and complete information during registration and to keep that information up to date. You are responsible for maintaining the security of your account session and for all activity that occurs under your account.

4.2 — Authentication

The Service uses magic-link email authentication. Access is granted through a one-time link sent to your registered email address. You are responsible for maintaining the security and confidentiality of your email account, which functions as your authentication credential for this Service.

4.3 — Account Responsibility

You agree to: (a) notify us promptly of any unauthorized access to or use of your account; (b) not share your authentication session with others unless explicitly permitted under your plan tier; (c) not create multiple accounts to circumvent usage limits; and (d) not use the account of any other user.

4.4 — Eligibility

The Service is intended for adult professionals in the medical billing, healthcare administration, coding, and revenue cycle management industry. By registering, you represent that you are at least 18 years of age and are using the Service for professional or organizational purposes.

Section 5Subscriptions, Billing, and Payment

5.1 — Plan Tiers

The Service is offered across two products under the following plan tiers, subject to change in accordance with Section 9:

BillerBrain™ App

• Free — Lifetime access to 10 text lookups and 5 ERA/EOB photo scans. No payment required.
• Starter ($29/month) — 200 text lookups and 50 photo scans per billing cycle.
• Pro ($79/month) — 1,000 text lookups and 250 photo scans per billing cycle.
• Agency ($199/month) — 5,000 text lookups and 1,000 photo scans per billing cycle.

BillerBrain Agency Shield™

• Shield Free ($0) — 2 lifetime batch analyses. No payment required.
• Shield Starter ($49 one-time) — 3 batch analyses, no expiration.
• Shield Pro ($189/month) — Unlimited batch analyses per billing cycle.
• Shield Scale ($499/month) — High-volume processing with priority queue access.
• Shield Beta ($0) — Manual activation only; available exclusively to authorized beta testers approved by the Company. Beta access may be revoked at any time without notice.

Usage limits for subscription plans reset on the first day of each billing cycle. Unused batch analyses or lookups do not accumulate or roll over unless explicitly stated in your plan description.

5.2 — Billing and Payment Processing

All subscription payments are processed by Stripe, Inc., a PCI-DSS Level 1 certified payment processor. By subscribing to a paid plan, you authorize Stripe to charge your designated payment method on a recurring monthly basis (or as a one-time charge, where applicable) until your subscription is cancelled. The Company does not store, process, or have access to your raw payment card information. All payment data is governed by Stripe's Privacy Policy.

5.3 — Taxes

Subscription fees are exclusive of applicable taxes. Where required by law, taxes will be added to your invoice. You are responsible for any applicable sales, use, VAT, GST, or equivalent taxes in your jurisdiction.

5.4 — Cancellation

You may cancel your subscription at any time through your account settings or by contacting us. Cancellation takes effect at the end of your current billing cycle. You retain full access to your subscribed plan until the end of the period for which you have paid. One-time purchase plans (Shield Starter) are not subject to cancellation or recurring billing.

5.5 — Refunds

Subscription fees are non-refundable except where required by applicable law. If you believe you were charged in error, contact us within seven (7) days of the charge and we will investigate and respond within two (2) business days. If an error is confirmed, we will issue a full refund of the erroneous charge.

5.6 — Plan Changes

You may upgrade or downgrade your plan at any time. Upgrades take effect immediately. Downgrades take effect at the start of your next billing cycle. The Company reserves the right to modify plan pricing, usage limits, or feature availability with 14 days' advance notice to active subscribers for changes materially affecting their current plan.

Section 6Acceptable Use

You agree that you will not use the Service to:

• Submit, upload, or transmit Protected Health Information or any patient-identifiable data
• Submit fraudulent, fabricated, or intentionally misleading billing codes for any purpose
• Reverse-engineer, decompile, disassemble, scrape, or systematically extract the Service's code database, response logic, or any underlying proprietary methodology
• Resell, sublicense, redistribute, or commercialize the Service's outputs as a standalone product or as part of a competing service without prior written authorization from the Company
• Automate queries through scripting, bots, or programmatic means beyond the documented API, if any, in a way that circumvents usage limits or degrades service availability for other users
• Attempt to gain unauthorized access to any part of the Service, its infrastructure, or any other user's account
• Use the Service in any manner that violates applicable federal, state, or local law, regulation, or professional licensing requirement
• Facilitate, enable, or assist any third party in doing any of the above

6.1 — Agency Shield Specific Use Restrictions

With respect to BillerBrain Agency Shield™ specifically, you further agree that you will not:

• Use Shield output as a standalone basis for writing off claims without independent verification. No claim, AR balance, or receivable may be written off, adjusted, or contractually adjusted solely on the basis of a Shield Recovery Status verdict. Independent payer verification is required before any write-off action is taken.
• Represent Shield reports as coverage determinations to clients, payers, or auditors. Shield outputs are AI-generated reference intelligence. You may not present, characterize, or submit a Shield report or verdict to any patient, payer, insurance company, government agency, auditor, or court as a coverage determination, benefits verification, medical necessity opinion, or regulatory compliance finding.
• Use Shield output as a substitute for qualified billing compliance review. Shield analysis does not replace the review and judgment of a licensed billing professional, certified coder, compliance officer, or qualified healthcare attorney. You may not use Shield output to satisfy any compliance review, audit response, or regulatory reporting obligation that requires qualified professional judgment.

The Company reserves the right to suspend or terminate your access immediately and without refund for any material violation of this section.

Section 7Intellectual Property

All content, software, design, trademarks, service marks, trade dress, proprietary methodology, and underlying technology of the Service are the exclusive intellectual property of BillerBrain™ or its licensors, protected under applicable United States and international intellectual property laws.

The CARC/RARC code definitions referenced by the Service are published government data (CMS X12 database) and are not claimed as proprietary by the Company. The Company's proprietary interest lies in the architecture, response structure, user interface, AI orchestration methodology, denial clustering logic, and processing methodology of the Service, not in the government code definitions themselves.

Subject to your compliance with these Terms, the Company grants you a limited, non-exclusive, non-transferable, non-sublicensable, revocable license to access and use the Service solely for your internal professional purposes during the term of your subscription. No other license is granted.

You may not reproduce, distribute, modify, create derivative works from, publicly display, publicly perform, republish, download, store, or transmit any material from the Service, except as explicitly permitted by these Terms or with prior written consent from the Company.

Section 8Third-Party Services and Integrations

The Service relies on third-party providers to function, including payment processors, cloud infrastructure providers, analytics platforms, and AI inference APIs. Your use of the Service constitutes acknowledgment of the following:

• Third-party providers operate under their own terms of service and privacy policies, which govern their relationship with the data they process
• The Company is not responsible for the acts, omissions, policies, or data practices of any third-party provider
• The Company will make reasonable efforts to select providers with strong security and data minimization practices, but cannot guarantee their performance or continued compliance
• The Sites may contain links to external websites or resources. The Company does not endorse, control, or assume responsibility for any third-party content or sites

Section 9Service Availability and Modifications

The Company strives to maintain high availability of the Service but does not warrant uninterrupted, error-free operation. The Service may be temporarily unavailable due to scheduled maintenance, unplanned outages, infrastructure failures, or events beyond our reasonable control.

The Company reserves the right to modify, update, discontinue, or restrict any feature or aspect of the Service at any time. For modifications that materially affect paid subscribers, we will provide reasonable advance notice. For the discontinuation of the Service entirely, we will provide at least 30 days' notice and offer prorated refunds for prepaid unused subscription periods.

Section 10Disclaimer of Warranties

TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, THE SERVICE IS PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS WITHOUT WARRANTIES OF ANY KIND, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHERWISE. THE COMPANY EXPRESSLY DISCLAIMS ALL WARRANTIES, INCLUDING BUT NOT LIMITED TO:

• Implied warranties of merchantability, fitness for a particular purpose, and non-infringement
• Warranties that the Service will meet your specific professional requirements or produce a particular billing or revenue outcome
• Warranties that outputs will be error-free, complete, current, or suitable for any specific billing, coding, appeal, or compliance action
• Warranties that the Service will be available at any particular time, uninterrupted, or secure from all possible threats
• Warranties that AI-generated outputs produced by Agency Shield™ will be accurate, current, consistent, or free from hallucination or material error

CMS CARC/RARC codes are updated periodically. While the Company makes reasonable efforts to maintain currency with CMS publications, the Company does not warrant real-time synchronization with every CMS update. You are responsible for verifying critical information against current CMS source documentation before relying on it for consequential decisions.

Section 11Limitation of Liability

TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW:

• THE COMPANY SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO: LOST REVENUE, LOST PROFITS, LOST OR DENIED CLAIMS, AUDIT PENALTIES, REGULATORY FINES, COMPLIANCE VIOLATIONS, OVERPAYMENTS, UNDERPAYMENTS, LEGAL FEES, OR LOSS OF BUSINESS OPPORTUNITIES, ARISING FROM YOUR USE OF OR RELIANCE ON THE SERVICE, REGARDLESS OF THE THEORY OF LIABILITY (CONTRACT, TORT, NEGLIGENCE, STRICT LIABILITY, OR OTHERWISE) AND EVEN IF THE COMPANY WAS ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
• IN NO EVENT SHALL THE COMPANY'S TOTAL AGGREGATE LIABILITY TO YOU FOR ALL CLAIMS ARISING FROM OR RELATED TO YOUR USE OF THE SERVICE EXCEED THE GREATER OF: (A) THE TOTAL SUBSCRIPTION FEES YOU PAID TO THE COMPANY IN THE THREE (3) CALENDAR MONTHS IMMEDIATELY PRECEDING THE EVENT GIVING RISE TO THE CLAIM, OR (B) ONE HUNDRED U.S. DOLLARS ($100.00).

11.1 — Agency Shield Specific Liability Carve-Out

Without limiting the foregoing, and for the explicit avoidance of doubt, the Company is not liable under any theory of liability — including contract, tort, negligence, strict liability, or otherwise — for any of the following arising from your use of BillerBrain Agency Shield™:

• Any claim write-off, accounts receivable adjustment, or revenue loss resulting from reliance on a Shield Recovery Status verdict (RECOVERABLE, CONDITIONAL, or NOT RECOVERABLE) without independent verification with the specific payer
• Any lost revenue, underpayment, or denial outcome resulting from an appeal filed or not filed based on Shield's appeal guidance or root cause synthesis
• Any audit finding, RAC audit result, payer recoupment demand, or overpayment allegation arising from a billing practice informed by Shield output
• Any regulatory action, compliance violation, or civil or administrative penalty arising from reliance on Shield's AI-generated analysis without qualified professional review
• Any damages arising from the inaccuracy, incompleteness, or hallucination of outputs produced by the Google, OpenAI, or Anthropic model APIs used by Shield
• Any damages arising from reliance on appeal success rate estimates cited in Shield outputs, which are industry-cited reference figures only and not predictions or guarantees of any specific outcome

This carve-out applies regardless of whether the Company was advised of the possibility of such damages and regardless of whether a Shield Recovery Status verdict, appeal success rate estimate, or root cause synthesis was the primary, contributing, or sole factor in the decision giving rise to the claimed loss.

Some jurisdictions do not allow the exclusion or limitation of certain damages. If you are located in such a jurisdiction, the above limitations apply to the fullest extent permitted by applicable law in that jurisdiction.

Section 12Indemnification

You agree to indemnify, defend, and hold harmless BillerBrain™ and its members, officers, employees, agents, successors, and assigns from and against any and all third-party claims, actions, demands, losses, liabilities, damages, costs, and expenses (including reasonable attorneys' fees) arising out of or related to:

• Your access to or use of the Service, or your violation of these Terms
• Any billing, coding, appeal, write-off, or compliance decision you make based in whole or in part on the Service's output
• Your submission of Protected Health Information or patient-identifiable data to the Service
• Your violation of any applicable law, rule, or regulation in connection with your use of the Service
• Any claim by a third party — including patients, payers, government agencies, regulators, or auditors — arising from your use of the Service
• Any content or data you submit to the Service

This indemnification obligation survives the termination or expiration of your account and these Terms.

Section 13Termination

13.1 — Termination by the Company

The Company may suspend or terminate your access to the Service at any time, with or without notice, for any of the following reasons, among others: material violation of these Terms; submission of PHI or patient-identifiable data; suspected fraud or abuse; systematic circumvention of usage limits; non-payment of subscription fees; or the Company's decision to discontinue the Service. Upon termination for cause, no refund will be issued for prepaid subscription periods.

13.2 — Termination by You

You may terminate your account at any time by cancelling your subscription through your account settings or by contacting us. Your account will remain active through the end of your current paid period following cancellation.

13.3 — Effect of Termination

Upon any termination of your account, your right to access and use the Service ceases immediately. Sections 2, 2A, 3, 7, 10, 11, 12, 14, and 15 of these Terms survive termination and remain in full force and effect.

Section 14Governing Law and Dispute Resolution

These Terms shall be governed by and construed in accordance with the laws of the State of Mississippi, United States, without regard to its conflict-of-law provisions.

Any dispute, claim, or controversy arising out of or relating to these Terms or the Service — including questions of formation, interpretation, breach, or termination — shall be resolved exclusively in the state or federal courts of competent jurisdiction located in Madison County, Mississippi. You irrevocably consent to the personal jurisdiction of such courts and waive any objection to venue in such courts.

Before initiating any formal legal proceeding, you agree to first contact the Company in writing at the address in Section 16 and make a good-faith effort to resolve the dispute informally for a period of at least thirty (30) calendar days from the date of written notice. This informal dispute resolution period is a condition precedent to initiating litigation.

Section 15General Provisions

15.1 — Entire Agreement

These Terms, together with the Privacy Policy, constitute the entire agreement between you and BillerBrain™ regarding your use of the Service and supersede all prior and contemporaneous agreements, representations, warranties, and understandings, whether written or oral.

15.2 — Severability

If any provision of these Terms is held unenforceable or invalid by a court of competent jurisdiction, that provision shall be enforced to the maximum extent permissible to effect the intent of the parties, and the remaining provisions shall remain in full force and effect.

15.3 — Waiver

The Company's failure to enforce any right or provision of these Terms shall not constitute a waiver of that right or provision. No waiver of any term shall be effective unless made in writing and signed by an authorized representative of the Company.

15.4 — Assignment

You may not assign or transfer any of your rights or obligations under these Terms without the prior written consent of the Company. The Company may assign its rights and obligations under these Terms without restriction, including in connection with a merger, acquisition, or sale of substantially all assets. These Terms inure to the benefit of and are binding upon the parties and their respective permitted successors and assigns.

15.5 — Changes to These Terms

The Company reserves the right to modify these Terms at any time. Updated Terms will be posted at billerbrain.com/terms with a new Last Updated date. For material changes significantly affecting your rights or obligations, the Company will provide at least 14 days' advance notice via email to your registered account address. Your continued use of the Service after the effective date of any modification constitutes your acceptance of the updated Terms.

15.6 — Force Majeure

The Company shall not be liable for any delay or failure to perform its obligations under these Terms resulting from causes beyond its reasonable control, including without limitation: acts of God, natural disasters, pandemic, governmental actions, civil unrest, terrorism, labor disputes, internet service provider failures, third-party infrastructure outages, or other events outside the Company's reasonable ability to prevent or mitigate.

15.7 — Notices

All legal notices from you to the Company must be in writing and delivered to the address in Section 16. The Company may provide notices to you via email to the address registered to your account. Email notices are deemed delivered when sent, absent a delivery failure notification.

Section 16Contact

For questions about these Terms, to report a violation, or to initiate the informal dispute resolution process required under Section 14, contact us:

We respond to all written inquiries within one (1) business day. We are real people and we take our obligations under these Terms seriously.