1. Introduction

Welcome to Primeish Billing (“Primeish Billing,” “we,” “us,” or “our”).

These Terms of Service (“Terms”) govern your access to and use of the Primeish Billing website and the medical billing, revenue cycle management, credentialing, claims management, eligibility verification, benefits verification, accounts receivable, denial management, and related administrative services we provide.

By accessing our website, requesting our services, or entering into an agreement with Primeish Billing, you agree to these Terms.

If you do not agree with these Terms, please do not use our website or services.

2. Our Services

Primeish Billing provides administrative and revenue cycle management services to healthcare providers, medical practices, clinics, and other healthcare organizations.

Depending on the services selected by the client, our services may include:

Medical billing
Claims creation and submission
Electronic claims submission
Eligibility verification
Benefits verification
CPT and ICD-10 coding support
Claim status follow-up
Accounts receivable management
Denial management
Appeals and reconsiderations
Payment posting
ERA/EOB review
Patient balance review
Provider credentialing assistance
Payer enrollment assistance
Authorization and referral follow-up
Single case agreement assistance
Gap exception assistance
Insurance verification
Insurance payer research
Aging report review
Billing workflow assistance
Revenue cycle reporting
Other healthcare administrative services agreed upon with the client

Services provided to each client may vary depending on the agreement, scope of work, and services purchased.

3. Our Role

Primeish Billing acts as a medical billing and administrative service provider.

Unless expressly agreed otherwise in writing, Primeish Billing does not:

Provide medical treatment
Diagnose medical conditions
Make clinical decisions
Determine medical necessity
Act as a healthcare provider
Guarantee insurance coverage
Guarantee claim payment
Guarantee payer approval
Guarantee credentialing or enrollment approval
Guarantee authorization approval
Guarantee reimbursement rates
Guarantee a specific revenue amount
Guarantee that a claim will not be denied

Final decisions regarding medical treatment, documentation, coding supported by clinical documentation, medical necessity, and patient care remain the responsibility of the healthcare provider.

4. Insurance Verification Disclaimer

When Primeish Billing performs eligibility or benefits verification, information is obtained from available payer, clearinghouse, portal, telephone, or other sources.

Insurance verification is provided for informational and administrative purposes only.

Verification of benefits does not guarantee:

Eligibility on the date of service
Coverage of a specific service
Medical necessity
Authorization
Claim payment
Reimbursement
Final patient responsibility

Insurance benefits may change, and payers may process claims differently from information provided during an eligibility or benefits inquiry.

The insurance payer ultimately determines claim adjudication and payment according to the applicable plan, policy, provider participation status, documentation, coding, and other requirements.

5. Claims and Billing

Primeish Billing may prepare and submit claims using information provided by the client.

The client is responsible for providing accurate, complete, and timely information, including:

Patient demographics
Insurance information
Provider information
Dates of service
Clinical documentation
CPT and HCPCS codes
ICD-10 codes
Modifiers
Units
Place of service
Referrals
Authorizations
Other information necessary for accurate claim submission

Primeish Billing is not responsible for delays, denials, rejections, underpayments, or other issues caused by inaccurate, incomplete, outdated, or untimely information supplied by the client.

6. Claim Denials and Appeals

Primeish Billing may review denied, rejected, or underpaid claims and, when included in the client’s service package, may assist with:

Denial analysis
Corrected claims
Reconsiderations
Appeals
Payer follow-up
Documentation requests
Authorization follow-up
Medical records requests
Other claim resolution activities

However, Primeish Billing does not guarantee that a payer will overturn a denial or pay a claim.

The final decision regarding a claim remains with the applicable insurance payer.

7. Credentialing and Payer Enrollment

When credentialing or payer enrollment services are provided, Primeish Billing may assist with:

Application preparation
Provider enrollment
Group enrollment
Payer applications
CAQH-related assistance
Recredentialing assistance
Payer follow-up
Enrollment status tracking
Network participation inquiries
Contracting-related administrative support

Credentialing and enrollment decisions are made by the applicable payer or credentialing organization.

Primeish Billing does not guarantee approval, network participation, effective dates, reimbursement rates, or completion within a specific timeframe unless expressly agreed in writing.

8. Authorizations, Referrals, Gap Exceptions and Single Case Agreements

Where applicable, Primeish Billing may assist with administrative processes involving:

Prior authorizations
Referrals
Retroactive authorization requests
Gap exceptions
Single case agreements
Payer medical policy inquiries
Documentation submission
Authorization status follow-up

Approval of an authorization, gap exception, referral, or single case agreement is determined solely by the applicable payer.

Submitting a request does not guarantee approval or payment.

9. Client Responsibilities

Clients are responsible for providing Primeish Billing with accurate and complete information necessary to perform the agreed services.

Clients agree to:

Provide accurate patient and insurance information
Provide complete clinical and billing documentation when required
Provide current provider information
Notify Primeish Billing of changes affecting billing
Provide timely access to necessary billing systems and payer portals
Maintain appropriate licenses and provider credentials
Maintain appropriate professional liability and other required insurance
Make appropriate clinical and medical decisions
Review information supplied for billing when necessary
Respond to requests for documentation or clarification
Notify Primeish Billing of payer, practice, or provider changes
Comply with applicable laws and payer requirements

Delays caused by missing or incomplete information may affect claim submission and collection timelines.

10. Client Responsibility for Clinical Documentation

Healthcare providers remain responsible for ensuring that documentation accurately supports the services provided.

Primeish Billing does not create false documentation, fabricate medical records, alter clinical information, or knowingly submit claims containing inaccurate information.

Clients are responsible for ensuring that services billed were actually provided and appropriately documented.

11. Coding and Billing Compliance

Primeish Billing may provide coding and billing support based on information and documentation supplied by the client.

Coding recommendations or billing guidance are administrative in nature and do not replace the professional judgment of a qualified healthcare provider or certified coding professional.

Clients remain responsible for reviewing and approving billing information where appropriate and ensuring that claims comply with applicable payer rules and regulations.

12. No Guarantee of Payment

Primeish Billing makes no guarantee regarding:

Claim approval
Claim payment
Reimbursement amount
Patient payment
Payer processing time
Credentialing approval
Network participation
Authorization approval
Appeal outcome
Contract rates
Revenue increases

Insurance companies and other payers independently determine claim adjudication and reimbursement.

13. Fees and Payment

Clients agree to pay Primeish Billing according to the pricing, fee structure, or service agreement applicable to their account.

Depending on the agreement, fees may be structured as:

Monthly fees
Percentage-based billing fees
Per-claim fees
Per-provider fees
Per-service fees
Project-based fees
Credentialing fees
Other agreed-upon fees

Invoices are due according to the payment terms agreed upon between Primeish Billing and the client.

Failure to pay amounts when due may result in suspension or termination of services.

14. Third-Party Platforms and Payers

Primeish Billing may use or interact with third-party systems, including:

Insurance payer portals
Clearinghouses
Electronic health record systems
Practice management systems
Credentialing systems
Communication platforms
Payment platforms
Other technology platforms

Primeish Billing is not responsible for outages, errors, delays, policy changes, or technical problems originating from third-party systems.

15. Confidentiality and Healthcare Information

Primeish Billing may receive confidential business, patient, insurance, financial, and healthcare information while providing services.

We take reasonable measures to protect confidential information.

Where applicable, the handling of Protected Health Information (“PHI”) will be governed by applicable HIPAA requirements and the terms of an applicable Business Associate Agreement.

Clients should not provide information that is unnecessary for the services being requested.

16. Privacy

Our collection and use of personal information is governed by our Privacy Policy.

Please review our Privacy Policy for information regarding:

Personal information
Healthcare information
Cookies
SMS communications
Data security
Information sharing
Privacy rights

17. SMS Communications

If you separately opt in to receive SMS communications from Primeish Billing, you may receive messages relating to services, inquiries, account communications, reminders, updates, or other communications for which you have provided the appropriate consent.

Message frequency may vary.

Message and data rates may apply.

You may opt out at any time by replying:

STOP

For assistance, reply:

HELP

SMS consent is not required as a condition of purchasing services from Primeish Billing.

18. Website Use

You agree to use the Primeish Billing website only for lawful purposes.

You may not:

Attempt to gain unauthorized access to our systems
Interfere with website operations
Introduce malicious software
Use the website for fraudulent activities
Misrepresent your identity
Scrape or collect information through unauthorized means
Use the website in violation of applicable law

We reserve the right to restrict or terminate access to the website where necessary to protect our systems, users, or business.

19. Intellectual Property

Unless otherwise stated, the content available on the Primeish Billing website, including text, graphics, logos, designs, images, and other materials, is owned by or licensed to Primeish Billing.

You may not reproduce, distribute, modify, publish, sell, or commercially exploit website content without prior written permission.

20. Third-Party Links

Our website may contain links to third-party websites or services.

These links are provided for convenience and do not constitute an endorsement of those websites.

Primeish Billing is not responsible for the content, security, availability, or privacy practices of third-party websites.

21. Limitation of Liability

To the maximum extent permitted by applicable law, Primeish Billing shall not be liable for indirect, incidental, consequential, special, or punitive damages arising from the use of our website or services.

This may include losses resulting from:

Payer delays
Claim denials
Claim rejections
Insurance eligibility changes
Authorization issues
Credentialing delays
Payer policy changes
Clearinghouse errors
EHR or practice management system outages
Incorrect information supplied by a client
Patient nonpayment
Payer nonpayment
Third-party system failures

Nothing in these Terms is intended to exclude liability that cannot legally be excluded or limited under applicable law.

22. Indemnification

To the extent permitted by applicable law, clients agree to indemnify and hold Primeish Billing harmless from claims, losses, liabilities, damages, and expenses arising from:

Information supplied by the client that is inaccurate or incomplete
Client’s violation of applicable laws or regulations
Clinical decisions made by the client
Services provided by the client
Documentation created or maintained by the client
Client’s violation of these Terms
Client’s unauthorized use of Primeish Billing services

23. Termination

Either Primeish Billing or the client may terminate services according to the applicable service agreement.

Primeish Billing may suspend or terminate services where:

Invoices remain unpaid
The client violates these Terms
The client requests or requires unlawful activity
Continued access creates a security or compliance concern
Necessary information or system access is not provided
The relationship otherwise becomes impractical or inappropriate

Termination does not eliminate payment obligations for services already performed.

24. Changes to Services

Primeish Billing may modify, add, suspend, or discontinue portions of its website or services.

Where a change materially affects an existing client relationship, the applicable service agreement will control.

25. Changes to These Terms

We may update these Terms from time to time.

Updated Terms will be posted on this page with a revised effective date.

Your continued use of the website or services after an update constitutes acceptance of the revised Terms to the extent permitted by law.

26. Governing Law

These Terms shall be governed by applicable laws of the State of Texas, without regard to conflict-of-law principles, unless a separate written agreement between Primeish Billing and a client provides otherwise.

27. Entire Agreement

These Terms, together with any applicable service agreement, Business Associate Agreement, Privacy Policy, and other written agreements between Primeish Billing and a client, constitute the applicable understanding regarding the services.

If there is a conflict between these website Terms and a separately executed written service agreement, the written service agreement will control with respect to the specific client relationship.

28. Contact Information

For questions regarding these Terms or Primeish Billing services, please contact:

Primeish Billing

Email: sales@primeishbilling.com
Email: contact@primeishbilling.com

Phone: +1 (219) 202-6156

Address:
5900 Balcones Drive, STE 100
Austin, TX 78731
United States

Website: primeishbilling.com

Last Updated: September 3, 2026