Terms of service

The short version

Patient Bill is a done-for-you medical-bill negotiation service. You retain us as your authorized representative and sign a HIPAA authorization that lets us request records, talk to the provider and insurer, and negotiate on your behalf. We charge a contingency fee on the documented savings. The exact percentage depends on the bill amount and is set out in the Service Agreement you sign during intake — that signed agreement locks in your rate for this case. If we don't reduce your bill, you owe nothing.

1. Acceptance of these terms

By creating an account, clicking a button labeled "I agree," "Sign," "Continue," "Start Free Audit," or any similar control, or by otherwise using Patient Bill (the "Service"), you acknowledge that you have read, understood, and agreed to be bound by these Terms of Service (the "Terms") and our Privacy Policy. These Terms form a binding contract between you and Patient Bill, Inc. ("Patient Bill," "we," "us," or "our"). If you do not agree, do not use the Service.

2. Who can use Patient Bill

You must be at least 18 years old and able to form a binding contract. If the bill is for someone else (a spouse, parent, or adult child), you must confirm during intake that you have authority — typically because the patient will electronically sign the HIPAA authorization, or because you hold a power of attorney or are the legal guardian. Bills for minor children may be authorized by a parent or guardian.

You agree to provide accurate registration information, keep your password confidential, and notify us immediately of any unauthorized use. You are responsible for all activity on your account. You may maintain only one account per person; we may suspend duplicate accounts.

3. What we do — and what we are not

• Review the bill and any supporting documents you provide.
• Request itemized statements, medical records, and Explanation-of-Benefits documents from the provider and insurer under your HIPAA authorization.
• Negotiate reductions, payment plans, and charity-care applications directly with the provider, insurer, and any collection agency.
• Keep you informed and seek your approval before accepting any settlement.

Patient Bill is not a law firm, an insurance broker or producer, a tax or financial advisor, a debt collector under the Fair Debt Collection Practices Act, or a "credit-repair organization" under the federal Credit Repair Organizations Act (CROA). We do not give legal, medical, insurance, tax, or financial advice. We do not represent you in court, in arbitration, in bankruptcy, or before any administrative agency. If your situation appears to require any of those services, we will tell you and recommend you consult an appropriate professional.

4. Your responsibilities and accuracy warranty

• Forward written correspondence from the provider, insurer, or collector to us promptly.
• Do not pay or settle the bill directly without first consulting us.
• Sign the HIPAA authorization required to release records. If the patient is not you, ask the patient to sign the link we email them.
• Tell us if any facts on your intake change.

You represent and warrant that (a) every fact you submit is true and complete, (b) you have the legal right and authority to submit the bill, the patient's information, and the documents you upload, and (c) you have obtained any consent needed from the patient if the patient is not you. You agree to indemnify Patient Bill in full for any claim arising from false information you provided, from your unauthorized use of another person's protected health information (PHI), or from signing the HIPAA authorization or Service Agreement on behalf of someone you were not authorized to bind.

5. AI and automated output disclaimer

Audit results, suggested reductions, and recommended dispute letters are generated in whole or in part by artificial-intelligence systems and automated tooling. These outputs may be inaccurate, incomplete, or out of date. You are required to review, edit, and approve every audit and every letter before it is mailed or sent on your behalf. By approving a letter or settlement, you confirm you have reviewed it and accept it as your own communication. Patient Bill is not liable for errors, omissions, or hallucinations in AI-generated content, for any reliance you place on it, or for any outcome that results from sending it.

6. Mailed letters and third-party delivery

When you ask us to mail a dispute letter, we hand the letter to a third-party mail vendor (currently Lob) which prints and posts it through the United States Postal Service or a comparable carrier. We do not control delivery, transit time, recipient processing, or whether the recipient acts on the letter. We are not liable for lost, delayed, damaged, misrouted, undeliverable, or returned mail, for carrier outages, or for any consequence of late or non-delivery.

7. Communications consent

By providing your email address you consent to receive transactional and service-related emails from us, including account notices, audit results, signature reminders, case updates, mailing confirmations, invoices, and security alerts. If you sign up and provide a mobile number, you consent to receive autodialed or pre-recorded SMS and voice messages from Patient Bill at that number for account, case, and transactional purposes, even if the number is on a do-not-call list. Message and data rates may apply. Message frequency varies. Reply STOP to opt out of SMS; reply HELP for help. Consent to marketing texts is not a condition of purchase.

You may opt out of non-essential email via the unsubscribe link or by emailing hello@patientbill.org. You cannot opt out of essential transactional messages while your account or case is active.

8. Our fee — contingency

Current published fee schedule (the rate that applies to your case is locked in by the Service Agreement you sign):

• You owe Patient Bill a contingency percentage of the Verified Savingson your bill. The percentage is set by our published fee schedule at the time you sign the Service Agreement, based on the bill amount, and is locked in for this case in the Service Agreement itself. Verified Savings means the difference between the amount the bill demanded when you retained us and the final amount you are obligated to pay, documented by a final statement, zero-balance letter, or comparable writing.
• No upfront fee. No monthly fee. No fee if we achieve no savings.
• We invoice only after Verified Savings are documented.
• If you terminate the engagement after we have secured a settlement offer you decline, and you then accept an equal or better outcome within 90 days, the contingency fee remains due on those savings.

9. Intellectual property

The Service, including all software, text, graphics, logos, audit logic, letter templates, and the "Patient Bill" name, is owned by Patient Bill or its licensors and is protected by copyright, trademark, and other laws. We grant you a limited, revocable, non-exclusive, non-transferable license to access and use the Service for your personal, non-commercial use of disputing your own (or an authorized person's) medical bill. All other rights are reserved.

You retain ownership of the documents and information you upload ("Your Content"). You grant Patient Bill a worldwide, royalty-free license to host, copy, transmit, display, process, and create derivative works of Your Content solely to provide, secure, and improve the Service for you and to comply with law. This license ends when Your Content is deleted, except for backups kept for a commercially reasonable retention period and content we are required to retain.

10. Acceptable use

You agree not to:

• Upload content you do not own or are not authorized to submit, or submit a bill for a person without that person's authority.
• Reverse engineer, decompile, scrape, or attempt to extract source code or non-public data from the Service.
• Use the Service to harass, defraud, impersonate, or harm anyone, or to violate any law (including HIPAA, the FDCPA, the TCPA, or state consumer- protection laws).
• Interfere with the Service, probe it for vulnerabilities without our written permission, or use it to send unsolicited messages.
• Resell, sublicense, or build a competing product from the Service.

11. Third-party services

The Service relies on third-party vendors including (without limitation) payment processors (Stripe), mail vendors (Lob), AI providers, hosting and database providers, transactional-email providers, and error-monitoring providers. We are not responsible or liable for outages, errors, security incidents, billing, or acts or omissions of any third party, and your use of their services may be governed by their own terms.

12. DMCA / copyright complaints

We respect intellectual-property rights. If you believe content on the Service infringes your copyright, send a notice that complies with 17 U.S.C. § 512(c)(3) to our designated agent at hello@patientbill.orgwith the subject "DMCA Notice." We may remove or disable allegedly infringing content and terminate repeat infringers.

13. Disclaimer of warranties

THE SERVICE AND ALL CONTENT, AUDIT RESULTS, AND LETTERS ARE PROVIDED "AS IS" AND "AS AVAILABLE," WITHOUT WARRANTY OF ANY KIND, EXPRESS OR IMPLIED. TO THE FULLEST EXTENT PERMITTED BY LAW, PATIENT BILL DISCLAIMS ALL WARRANTIES, INCLUDING THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, TITLE, ACCURACY, COMPLETENESS, AND QUIET ENJOYMENT, AND ANY WARRANTIES ARISING FROM COURSE OF DEALING OR USAGE OF TRADE. WE DO NOT WARRANT THAT THE SERVICE WILL BE UNINTERRUPTED, SECURE, OR ERROR-FREE; THAT DEFECTS WILL BE CORRECTED; THAT AUDIT RESULTS OR LETTERS WILL BE ACCURATE; OR THAT ANY SPECIFIC REDUCTION, SETTLEMENT, OR OUTCOME WILL BE ACHIEVED. INSURANCE AND PROVIDER DECISIONS ARE NOT WITHIN OUR CONTROL. SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF CERTAIN WARRANTIES; THOSE EXCLUSIONS MAY NOT APPLY TO YOU.

14. Limitation of liability

TO THE FULLEST EXTENT PERMITTED BY LAW, IN NO EVENT WILL PATIENT BILL, ITS OFFICERS, DIRECTORS, EMPLOYEES, AFFILIATES, OR LICENSORS BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES, OR FOR ANY LOSS OF PROFITS, REVENUE, GOODWILL, DATA, OR BUSINESS, ARISING OUT OF OR RELATED TO THE SERVICE OR THESE TERMS, EVEN IF WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

OUR AGGREGATE LIABILITY FOR ALL CLAIMS RELATED TO THE SERVICE OR THESE TERMS WILL NOT EXCEED THE GREATER OF (A) THE TOTAL FEES YOU ACTUALLY PAID PATIENT BILL IN THE TWELVE (12) MONTHS BEFORE THE EVENT GIVING RISE TO THE CLAIM, OR (B) ONE HUNDRED U.S. DOLLARS ($100). The foregoing limitations do not apply to liability that cannot be excluded or limited under applicable law (for example, certain consumer-protection rights, or our gross negligence or willful misconduct where such carve-outs are required).

15. Indemnification

You agree to defend, indemnify, and hold harmless Patient Bill and its officers, directors, employees, and agents from and against any and all claims, damages, liabilities, losses, costs, and expenses (including reasonable attorneys' fees) arising out of or related to: (a) your use or misuse of the Service; (b) Your Content, including any infringement, defamation, or privacy claim; (c) false, inaccurate, or unauthorized information you submitted, including submitting another person's PHI without authority; (d) your breach of these Terms or applicable law; or (e) any communication sent or settlement entered on your behalf based on instructions you approved.

16. Binding arbitration and class-action waiver

Please read this section carefully — it affects your legal rights.

You and Patient Bill agree that any dispute, claim, or controversy arising out of or relating to these Terms or the Service (a "Dispute") will be resolved by binding individual arbitration administered by the American Arbitration Association (AAA) under its Consumer Arbitration Rules, and not in court. The arbitration will be held in the State of Delaware, or remotely at the arbitrator's discretion. The arbitrator's award is final and may be entered in any court of competent jurisdiction.

You and Patient Bill waive any right to a jury trial and to participate in a class action, consolidated action, or representative action. Disputes must be brought in your individual capacity only; the arbitrator may not consolidate claims or preside over any class or representative proceeding.

30-day opt-out. You may opt out of this arbitration agreement by sending an email to hello@patientbill.orgwith the subject "Arbitration Opt-Out" within 30 days of first accepting these Terms, including your full name, address, and email on file. Opting out will not affect any other part of these Terms.

Small claims and injunctive carve-outs. Either party may bring an individual claim in small-claims court if it qualifies, and either party may seek injunctive or equitable relief in court to protect its intellectual property or confidential information. If the class-action waiver is found unenforceable as to a particular claim, that claim will be severed and litigated in court; the remainder of this section remains in force.

17. Governing law and venue

These Terms are governed by the laws of the State of Delaware, without regard to its conflict-of-laws principles. For any Dispute not subject to arbitration, the parties consent to the exclusive jurisdiction and venue of the state and federal courts located in New Castle County, Delaware, and waive any objection based on forum non conveniens.

18. Termination

You may terminate this agreement at any time by emailing hello@patientbill.org. We may suspend or terminate your access at any time, with or without notice, if we reasonably believe you have violated these Terms or that continued access poses a legal or security risk. Termination does not relieve you of fees on Verified Savings already documented or on settlement offers covered by the 90-day clause.

19. Modifications

We may modify the Service, including adding, changing, or removing features, at any time. We may also modify these Terms; if a change is material, we will provide notice by email, in-product banner, or by updating the "Last updated" date and posting the revised Terms here at least 14 days before they take effect (or immediately for changes required by law or security). Continued use after the effective date constitutes acceptance.

20. Force majeure

We are not liable for any failure or delay caused by events beyond our reasonable control, including acts of God, natural disasters, war, terrorism, civil unrest, labor actions, government action, pandemics, internet or utility failures, cyberattacks, or third-party vendor outages.

21. Assignment

You may not assign or transfer these Terms or your account, by operation of law or otherwise, without our prior written consent; any attempted assignment is void. We may freely assign these Terms and our rights and obligations to an affiliate, successor, or acquirer (including in connection with a merger, sale, reorganization, or bankruptcy).

22. Survival

Sections covering fees owed, intellectual property, disclaimers, limitation of liability, indemnification, arbitration and class-action waiver, governing law, and any provisions that by their nature should survive will survive termination of these Terms.

23. Electronic signatures and records

Typing your full legal name and clicking the signature button creates an electronic signature with the same legal effect as a handwritten one under the federal E-SIGN Act and the Uniform Electronic Transactions Act (UETA). You consent to receive these Terms, the Service Agreement, the HIPAA authorization, invoices, and all related disclosures and notices in electronic form. You may withdraw this consent by closing your account, but doing so will end your ability to use the Service. We capture the timestamp, IP address, and user-agent at the moment of signing.

24. Miscellaneous

These Terms, together with the Service Agreement and Privacy Policy, are the entire agreement between you and Patient Bill regarding the Service and supersede any prior agreements on that subject. If any provision is held unenforceable, it will be enforced to the maximum extent permissible and the remaining provisions will remain in full force. Our failure to enforce any right is not a waiver of that right. Headings are for convenience only and do not affect interpretation. The Service Agreement controls if anything here conflicts with it on the subject of the engagement.

25. Contact for legal notices

Legal notices to Patient Bill must be sent to:

Patient Bill, Inc. — Legal
2261 Market St #4501
San Francisco, CA 94114
Email: hello@patientbill.org

This page summarizes the Service Agreement you sign during intake. The signed Service Agreement controls if anything here conflicts with it. This page is provided for transparency, is a plain-language draft, has not been reviewed by counsel, and is not a substitute for legal advice. You are encouraged to consult an attorney before relying on it.