1. pVerify Services

1. 1.1. Prompt provides Customer with the ability to access certain Third-Party Services from pVerify, Inc. (“pVerify”). In order for Prompt to provide Customer with access to certain patient benefits eligibility transaction services offered by pVerify (the “pVerify Services”), Customer agrees to comply with these pVerify Services Terms and Conditions. Customer acknowledges that Prompt is solely providing Customer access to the pVerify Services provided by pVerify, to make it more convenient and cost effective for Customer to access the pVerify Services. CUSTOMER ACKNOWLEDGES AND AGREES THAT PROMPT DOES NOT CONTROL THE PVERIFY SERVICES, AND OTHER THAN AS RELATED TO THE PROMPT OBLIGATIONS (AS DEFINED BELOW), PROMPT WILL HAVE NO OBLIGATIONS OR LIABILITY TO CUSTOMER AS RELATED TO THE PVERIFY SERVICES. Notwithstanding the foregoing, Customer acknowledges that pVerify is not a party to the Agreement and Prompt is passing certain terms pVerify requires of all users of the pVerify Services through to Customer to ensure Customer is aware of and understands what terms it must comply with, and what limitation or restrictions there are, in order to use the pVerify Services. 

2. 1.2. The pVerify Services will include the following:

   1. 1.2.1. Parsed benefits including Plan Info, Co-pays and Deductibles returned via JSON REST API or via the Premier Portal.

   2. 1.2.2. EDI ‘Par’ Payors and ‘Non-Par’ Payors supported by pVerify (over 900 Payors including Medicare, Commercial/BCBS and Medicaid). 

   3. 1.2.3. For Non-Par Poyers, the pass-thru fee is calculated based on number of STCs.

   4. 1.2.4. Unique feature for Skip Verification for the same patient during a calendar month.

   5. 1.2.5. Access to the full pVerify Portal.  

3. 1.3. Except as expressly provided herein, Customer may not modify, copy, distribute, broadcast, transmit, reproduce, publish, license, transfer, sell, mirror, frame, deep link, or otherwise use any information or material obtained from or through the pVerify Services, including through the pVerify site, without the prior written permission of the material's owner. As a condition of Customer’s use of the pVerify site, Customer warrants that Customer will not use pVerify Services for any purpose that is unlawful, unauthorized, or inconsistent with the Agreement (including any terms posted on the pVerify site), and Customer agrees that the license to use pVerify Services will terminate immediately upon any violation of this warranty.

4. 1.4. pVerify reserves the right to process test system inquiries on Customer’s behalf in order to monitor service performance and quality assurance.

2. Prompt Obligations. The pVerify Services will be provided to Customer directly from pVerify. In relation to the pVerify Services, Prompt’s sole obligation to Customer is to build out and maintain an API/integration in a commercially reasonable manner to allow Customer access to the pVerify Services through the Prompt Platform (collectively, the “Prompt Obligations”). 

3. System Requirements. Customer will use the pVerify Services according to these pVerify Services Terms and Conditions. Customer acknowledges and agrees that the pVerify Services require broadband internet connectivity, and Customer will provision any permissions as required. Any payor-required enrollments shall be Customer’s responsibility. Customer shall review, verify, and correct any prepopulated data fields prior to submitting any verification requests.

4. Customer Support. Customer shall direct any support questions, concerns, or issues related to the pVerify Services directly to pVerify. Customer shall direct any support questions, concerns, or issues related to the Prompt Obligations to Prompt. Notwithstanding any provision of the Agreement to the contrary, Section 2.2 (Implementation Services) of the General Terms and Conditions and Section 6 (Support and Maintenance) of the General Terms and Conditions shall not apply to the pVerify Services.

5. Fees. Prompt may provide Customer with a Prompt-determined number of credits to perform patient benefit eligibility transactions at no cost to Customer (the “pVerify Complimentary Credits”). Following Customer’s use, or expiration, of the pVerify Complimentary Credits (if any are provided), Customer will be unable to perform additional patient benefit eligibility transactions through the pVerify Services until Customer has purchased additional credits from Prompt and Prompt has received payment of the applicable pVerify Services Fees in full. Following Customer’s use, or expiration, of the pVerify Complimentary Credits (if any are provided), in exchange for Customer’s access to, or use of, the pVerify Services, Customer agrees to purchase credits from Prompt for the amount set forth in the Order Form or through the Platform (the “pVerify Services Fees”).   

6. Confidentiality. Customer acknowledges and agrees that certain payors, fiscal intermediaries, government entities, and other third-party information suppliers, may require compliance with obligations involving confidentiality, liability, and scope of use, as a condition of accessing their information. In the event such compliance obligations are directed to Customer, then Customer will convey such written obligations to pVerify as a requirement to access any such data. 

7. Disclaimer. THE STATE OR FEDERAL GOVERNMENT, OR COMMERCIAL PAYOR’S, RECORDS ARE THE FINAL AUTHORITY ON ELIGIBILITY, BENEFITS OR OTHER DATA. VERIFICATION BY PVERIFY OR OTHERWISE THROUGH THE PVERIFY SERVICES DOES NOT CONSTITUTE A GUARANTEE OF PAYMENT TO CUSTOMER BY SUCH THIRD-PARTY PAYOR. PVERIFY DOES NOT GUARANTEE THE ACCURACY OR COMPLETENESS OF THE INFORMATION RECEIVED; AND THE INFORMATION IS PROVIDED “AS IS” AND MAY HAVE BEEN COLLECTED FROM VARIOUS SOURCES, INCLUDING THIRD PARTIES.

8. Client Administrator Security Protocol. As part of the enrollment process, Customer agrees to designate one or more primary Client Security Administrator(s) to ensure that access to the pVerify Services and protected health information is limited to users that have been verified as legally and contractually bound affiliates of Customer. Such person or persons shall be referred to as the pVerify Client Administrator. Each such person shall comply with the implementation and administration of the foregoing, along with the following requirements: 

1. 8.1. Client Administrator, by adding a user, is verifying such user as a legally and properly bound affiliate with need to access protected health information prior to granting access and is warranting that HIPAA Security Standards governing access and use of PHI is maintained by all users. 

2. 8.2. Client Administrator will not utilize generic login names such as “front office” or “billing dept.” 

3. 8.3. Client Administrator will provide each individual authorized user with a specific and unique login name and password. 

4. 8.4. Client Administrator will transfer new login names and passwords to its employees in a secure manner that ensures that the login name and password remain restricted to the use of the intended specific and unique end user. 

5. 8.5. Client Administrator will advise and require all users to take precautionary measures to prevent their login names and passwords from being revealed to others. 

6. 8.6. Client Administrator will review its login name and password list on a monthly basis and immediately delete all employees listed who no longer require access to the pVerify Services.

9. Confirmation of the Rules of Behavior. By using the pVerify Services, Customer commits to abiding by the CMS Rules of Behavior while obtaining, disseminating, and using eligibility data for all transactions run within the pVerify Services. Use of the pVerify Services for marketing purposes is prohibited.