Terms of Service

Effective Date: February 22, 2025  |  Last Updated: February 22, 2025
Operator: Conduit Catalyst LLC  |  Gulfport, Mississippi

SECTION 1
Agreement to Terms

By accessing or using Denial Decoder ("the Tool"), operated via the Telegram bot @MDCDenialBot and the website denialdecoder.xyz ("the Site"), you agree to be bound by these Terms of Service ("Terms"). If you do not agree to these Terms, do not use the Tool.

The Tool is owned and operated by Conduit Catalyst LLC, a limited liability company registered in the State of Mississippi, United States ("the Company," "we," "us," or "our").

These Terms constitute a legally binding agreement between you ("User," "you," or "your") and the Company. By sending any message to the Telegram bot or using any feature of the Tool, you confirm that you have read, understood, and agreed to these Terms in their entirety.

SECTION 2
Nature of the Tool — Administrative Reference Only

The Tool provides informational lookups of denial reason codes (CARC, RARC, and Group Codes) based on the official CMS/X12 master code database and publicly available Medicare claims processing documentation. The outputs of the Tool are:

• Not legal advice. No output should be interpreted as legal guidance, and no attorney-client relationship is created by your use of the Tool.
• Not compliance advice. The Tool does not evaluate your organization's compliance posture, audit readiness, or regulatory obligations.
• Not medical advice. The Tool does not make clinical determinations, assess medical necessity, or render diagnostic opinions.
• Not a claim submission or modification tool. The Tool does not submit, modify, transmit, amend, or interact with any claim in any payer's system. It never touches your claims.

All billing, coding, appeal, and compliance decisions made using the Tool's output remain solely your responsibility. You must exercise independent professional judgment before acting on any information provided by the Tool. Every response from the Tool includes a verification notice reminding you of this obligation.

The Company's liability model is functionally identical to that of published reference manuals (such as the Optum360 coding manual, the AMA CPT codebook, or UpToDate clinical references). These resources provide guidance. You apply professional judgment. The Tool is no different.

SECTION 3
No Protected Health Information (PHI) Policy

The Tool is designed to process only administrative billing data — denial reason codes, procedure codes (CPT/HCPCS), billed and allowed amounts, adjustment codes, and group codes. This is not patient-identifiable information.

3.1 — Your Responsibility to Redact

Before sending any image (photo of an ERA, EOB, or remittance advice) to the bot, you must crop or redact all patient-identifiable information, including but not limited to:

• Patient name
• Date of birth
• Social Security number
• Medical record number
• Health plan beneficiary number
• Address, phone number, or email of the patient
• Any other identifier defined as PHI under HIPAA (45 CFR §160.103)

If you send PHI to the Tool, you do so at your own risk and in violation of these Terms. The Company is not responsible for any PHI you transmit through the Telegram platform.

3.2 — We Are NOT a HIPAA Business Associate

Conduit Catalyst LLC is not a HIPAA Covered Entity and is not a Business Associate as defined under the Health Insurance Portability and Accountability Act. The Tool does not store, process, or maintain Protected Health Information on behalf of any covered entity.

No Business Associate Agreement (BAA) is required, offered, or available. If your compliance framework requires a BAA with every vendor you use, this Tool may not be appropriate for your workflow until you confirm with your compliance officer that the redacted data you send does not constitute PHI.

SECTION 4
Telegram Platform Disclaimer

The Tool is delivered via Telegram Messenger ("Telegram"), a third-party messaging platform operated by Telegram FZ-LLC. By using the Tool, you acknowledge and agree:

• The Company is not affiliated with, endorsed by, or partnered with Telegram in any way.
• The Company is not responsible for Telegram's platform availability, uptime, outages, or service interruptions. If Telegram goes down, the Tool goes down. We cannot control this.
• The Company is not responsible for Telegram's data handling, encryption, privacy practices, or security. Telegram's own Privacy Policy and Terms of Service govern your use of the Telegram platform.
• Messages you send to the bot are transmitted through Telegram's infrastructure before reaching the Tool's API. The Company does not control what Telegram logs, stores, or retains on its servers.
• You are responsible for securing your own Telegram account (password, two-factor authentication, device security).

SECTION 5
Accounts, Subscriptions, and Payment

5.1 — Plan Tiers

The Tool offers the following plan tiers, which may be updated at any time:

• Free — Limited lifetime usage (10 text lookups, 5 photo scans). No payment required.
• Starter ($29/month) — 200 text lookups, 50 photo scans per month.
• Pro ($79/month) — 1,000 text lookups, 250 photo scans per month.
• Agency ($199/month) — 5,000 text lookups, 1,000 photo scans per month.

Usage limits reset on the first day of each billing cycle. Unused lookups or scans do not roll over.

5.2 — Payment Processing

All payments are processed securely by Stripe, Inc. The Company does not see, store, or have access to your raw credit card number. All payment data is governed by Stripe's Privacy Policy and PCI-DSS compliance standards.

5.3 — Cancellation and Refunds

You may cancel your subscription at any time. Cancellation takes effect at the end of your current billing cycle. No partial-month refunds are issued. If you believe you were charged in error, contact support@denialdecoder.xyz within 7 days of the charge.

5.4 — Right to Modify Plans

The Company reserves the right to change, modify, add, or discontinue any plan tier, pricing, usage limit, or feature at any time, with or without prior notice. If a change materially affects your current paid subscription, we will make reasonable efforts to notify you at least 14 days before the change takes effect. Continued use of the Tool after any such change constitutes acceptance of the modified terms.

SECTION 6
Acceptable Use

You agree NOT to use the Tool to:

• Transmit Protected Health Information or any patient-identifiable data
• Submit fraudulent, fabricated, or intentionally misleading billing codes
• Reverse-engineer, scrape, copy, or systematically extract the Tool's code database
• Resell, sublicense, or redistribute the Tool's outputs commercially without written permission
• Overwhelm the bot with automated queries, scripted attacks, or denial-of-service attempts
• Use the Tool in any manner that violates federal or state law

We reserve the right to suspend or terminate your access immediately for any violation of this section, without refund.

SECTION 7
Limitation of Liability

TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW:

• The Tool is provided "AS IS" and "AS AVAILABLE" without warranties of any kind, whether express, implied, statutory, or otherwise, including but not limited to implied warranties of merchantability, fitness for a particular purpose, accuracy, or non-infringement.
• The Company does not warrant that the Tool's outputs are error-free, complete, current, or suitable for any specific billing, compliance, or appeal action. CMS codes are updated periodically, and while we make reasonable efforts to maintain accuracy, we do not guarantee real-time synchronization with every CMS update.
• The Company shall not be liable for any direct, indirect, incidental, special, consequential, or punitive damages, including but not limited to: lost revenue, denied claims, audit penalties, compliance violations, overpayments, underpayments, regulatory fines, legal fees, or lost business opportunities — arising from your use of or reliance on the Tool's output.
• In no event shall the Company's total aggregate liability exceed the amount you have paid to the Company in the three (3) months immediately preceding the event giving rise to the claim.

SECTION 8
Indemnification

You agree to indemnify, defend, and hold harmless Conduit Catalyst LLC, its members, officers, employees, agents, and affiliates from and against any and all claims, damages, losses, liabilities, costs, and expenses (including reasonable attorneys' fees) arising out of or related to:

• Your use or misuse of the Tool or its outputs
• Any billing, coding, appeal, or compliance decision you make based in whole or in part on the Tool's output
• Your transmission of Protected Health Information or any patient-identifiable data to the Tool
• Your violation of these Terms
• Any claim by a third party (including patients, payers, government agencies, or auditors) arising from your use of the Tool

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

SECTION 9
Intellectual Property

All content, code, design, branding, and proprietary methodology of the Tool is the intellectual property of Conduit Catalyst LLC. The CMS/X12 CARC/RARC code definitions referenced by the Tool are published government data and are not claimed as proprietary by the Company.

You may not reproduce, distribute, modify, or create derivative works from the Tool, its interface, or its output structure without prior written consent.

SECTION 10
Termination

We may suspend or terminate your access to the Tool at any time, for any reason, with or without notice. Reasons may include, but are not limited to: violation of these Terms, suspected fraud, abuse of usage limits, or discontinuation of the service.

Upon termination, your right to use the Tool ceases immediately. Sections 2, 3, 7, 8, 9, 11, and 12 survive termination.

SECTION 11
Governing 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 Tool shall be resolved exclusively in the state or federal courts located in Harrison County, Mississippi. You consent to the personal jurisdiction of such courts and waive any objection to venue.

Before initiating any legal proceeding, you agree to first contact the Company at support@denialdecoder.xyz and attempt to resolve the dispute informally for a period of at least thirty (30) days.

SECTION 12
Changes to These Terms

The Company reserves the right to modify these Terms at any time. Updated Terms will be posted at denialdecoder.xyz/terms with a new "Last Updated" date. Your continued use of the Tool after any modification constitutes acceptance of the updated Terms.

For material changes that significantly affect your rights or obligations, we will make reasonable efforts to provide notice (via email, Telegram message, or website banner) at least 14 days before the change takes effect.

SECTION 13
Severability

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

SECTION 14
Entire Agreement

These Terms, together with the Privacy Policy, constitute the entire agreement between you and Conduit Catalyst LLC regarding your use of the Tool and supersede all prior agreements, representations, and understandings.

SECTION 15
Contact

If you have questions about these Terms, contact us:

Conduit Catalyst LLC
Gulfport, Mississippi
support@denialdecoder.xyz
denialdecoder.xyz