These Telemedicine Platform Services Terms and Conditions (“Terms”) together with the online order form (“Order Form”) submitted in connection herewith and the documents referenced herein create a legally binding agreement (the “Agreement”) between Chiron Health, Inc., a Delaware corporation (“Chiron Health”) and the entity or (if applicable) individual (“Provider”) that submitted the Order Form. By signing up with Chiron you are entering into the Agreement and you agree to be bound by its terms and conditions. Please read the Agreement carefully and do not sign the Agreement or access the Chiron Platform or use the Telemedicine Platform Services if you are unwilling or unable to be bound by the terms of the Agreement. The parties agree as follows:
If any Reimbursable Claim is denied by the applicable insurance carrier on the basis that such Reimbursable Claim is not eligible for telemedicine benefits (“Denied Claim”), Provider shall provide Chiron Health with the Required Documentation within the Request Window. If Chiron Health, in its reasonable discretion, determines a Denied Claim, through any number of resubmissions to the applicable insurance company, may be resolved or otherwise accepted, in whole or in part, Provider shall cooperate with Chiron Health (including, by promptly responding to inquiries; providing all information, documentation and assistance reasonably requested; and resubmitting such Denied Claim) to resolve such Denied Claim. If a Denied Claim is not able to be resolved through resubmission, Chiron Health shall pay Provider the lesser of (a) the allowable amount of the claim as contracted with the insurance carrier, or (b) fifty dollars ($50), less any payment collected from the patient for the telemedicine visit.
In any given month, Chiron shall not be obligated to reimburse any amounts under this guarantee related to Telemedicine Medical Services performed in that month exceeding the fees paid by Provider to Chiron Health for Telemedicine Support Services in that same month (exclusive of credit card processing fees and taxes paid, if any).