1. DESCRIPTION OF SERVICES. Grin Status LLC will provide the Recipient the following services (collectively, the “services”):
   • Requested Dental Insurance Eligibility and Benefits.
     All Eligibility and Benefits will be based on insurance customer service availability from the time request is submitted.
     All Eligibility and Benefits will be based on information provided by insurance company.
   • Requested Dental Insurance Billing Services.
     Claims Submission, Follow-ups, Appeals, Payment Posting
2. PAYMENT. The Recipient agrees to pay Grin Status, LLC for services rendered as per agreement. Unless in duration of a free trial.
3. CONFIDENTIALITY and HIPAA COMPLIANCE. All parties and its employees, agents, or representatives will not at any time or in any manner, either directly or indirectly, use for the personal benefit, or divulge, disclose, or communicate in any manner, any information that is proprietary to the Provider and Recipient. All parties and its employees, agents, and representatives will protect such information and treat it as strictly confidential. The parties acknowledge that patient information may include Protected Health Information (“PHI”) as defined under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). The Provider agrees to comply with all applicable federal and state privacy and security laws, including HIPAA and its implementing regulations, in the handling, transmission, storage, and safeguarding of PHI. The Recipient agrees to provide the Provider only with the minimum necessary information required to perform the requested services. This provision will continue to be effective after the termination of this Contract. All parties agree that patient information provided will be strictly confidential and communicated and stored securely between the two parties and its employees, agents, or representatives via website(s), app(s), and/or web services.
4. Permitted Uses and Disclosures / Authorization. Recipient agrees to give all rights and authorization to the provider for all dental insurance eligibility and benefit check purposes only. Provider will have all rights to create and access any portals on behalf of the recipient for insurance eligibility and benefit check purposes only.
5. ASSIGNMENT. Neither party may assign or transfer this Contract without the prior written consent of the non-assigning party, which approval shall not be unreasonably withheld.
6. DEFAULT. This contract will continue for indefinite time for all services requested unless occurrence of any of the following:
   • Failure to make a required payment when due
   • Insolvency or bankruptcy of either party
   • By written request by either party to terminate contract
7. LIABILITY. Provider’s services include obtaining and retrieving patients’ dental insurance eligibility and benefit information, as well as submitting dental insurance claims on behalf of the Recipient as per request on contract.

   The Recipient acknowledges and agrees that the Provider is not responsible or liable for any clinical services rendered, treatment decisions, insurance claim determinations, reimbursements, denials, delays, or payments related to patient care.

   The Recipient further understands and acknowledges that all eligibility and benefit information provided is based on information obtained from the patient’s insurance carrier and is not a guarantee of coverage, eligibility, payment, reimbursement, or benefits. Final payment and coverage are determined solely by the insurance carrier according to the terms of the patient’s policy at the time services are rendered.

   The Recipient also acknowledges that the Provider’s submission of dental insurance claims is performed solely as an administrative service and does not guarantee claim approval, payment, reimbursement, processing time, or insurance coverage. The Recipient agrees that the Provider shall not be held liable for any denied, delayed, reduced, rejected, or unpaid claims, or for any payment determinations made by the insurance carrier.

   The Recipient releases, indemnifies, and holds the Provider harmless from any and all claims, liabilities, losses, damages, costs, or disputes arising out of or relating to insurance eligibility information, benefit verification, claim submissions, claim adjudication, reimbursement decisions, or payment determinations made by any insurance carrier.

Any requests submitted and ongoing billing services means that you have read, understand, and agree to all terms/conditions in full.