# CREDIMED SERVICE AGREEMENT (v1.2)

**Effective Date:** [AUTO-GENERATED UPON ACCEPTANCE]

This version (v1.2) supersedes prior versions for all claims initiated on or after the Effective Date. Claims initiated under prior versions of this Agreement continue to be governed by the version in effect at the time of acceptance.

## 1. Scope of Service

Credimed Inc. ("Credimed", "we", "us") provides a document preparation and submission support service for out-of-network dental insurance reimbursement claims. We agree to prepare, translate, itemize, and assist in the electronic submission of one (1) claim on behalf of the undersigned ("you", "Member") based solely on the documents and information you provide.

Credimed acts solely as an administrative support service. We are not a healthcare provider, insurance company, third-party administrator (TPA), licensed insurance adjuster, or billing company. We do not make coverage determinations, modify clinical information, or independently verify the accuracy of submitted materials.

All claims are prepared using standard CDT codes and submitted to your insurer's claims portal typically within twenty-four (24) hours of receiving complete documentation and your signed authorization.

## 2. Pricing, Resubmissions, and Money-Back Guarantee

### 2.1 Pricing (System-Determined by Claim Complexity)

Credimed uses an automated pricing engine to analyze the Member's uploaded documentation and determine the complexity of the claim. Based on this analysis, the system assigns one of three pricing tiers:

- Standard Plan — $49 USD. Typically applies to claims with a single procedure.
- Plus Plan — $79 USD. Typically applies to claims with two (2) to three (3) procedures.
- Premium Plan — $99 USD. Applies to claims with four (4) or more procedures, or where the system detects coding ambiguity that requires human specialist review prior to submission.

The assigned price is presented to the Member before payment. The Member must explicitly authorize the final price before any charge is made. The Member does not select a tier; pricing is determined solely based on claim characteristics.

If additional procedures are added or complexity changes, pricing may be recalculated and must be re-authorized by the Member prior to processing.

Credimed does not charge any commission, percentage, or fee tied to the reimbursement amount. The plan fee paid at checkout, plus any additional resubmission fees expressly authorized by the Member under Section 2.2, represents the full extent of the Member's mandatory financial obligation to Credimed.

### 2.2 Resubmissions

If a claim is denied or requires correction, Credimed may perform resubmissions on the Member's behalf:

- Standard Plan ($49): includes one (1) resubmission. Additional resubmissions are available at a fee of $19 USD per attempt and require the Member's express authorization.
- Plus Plan ($79): includes one (1) resubmission. Additional resubmissions are available at a fee of $19 USD per attempt and require the Member's express authorization.
- Premium Plan ($99): includes unlimited resubmissions for the same claim within a twelve (12) month period from the original submission date, at no additional cost.

All resubmissions must relate to the same claim and are subject to insurer appeal deadlines, documentation requirements, and insurer-specific limitations.

Additional resubmission fees ($19 USD per attempt) are non-refundable, as they correspond to services already rendered.

Resubmissions are performed only when Credimed determines, in its reasonable judgment, that a viable correction or additional submission strategy exists.

### 2.3 Money-Back Guarantee (100% Conditional Refund)

Credimed offers a conditional refund guarantee across all pricing tiers. If a claim is eligible for reimbursement under the Member's insurance policy but is not paid after all Credimed-supported resubmissions, Credimed will refund 100% of the plan fee paid.

This guarantee applies only to the original plan fee (Standard $49 USD / Plus $79 USD / Premium $99 USD) and does not include additional resubmission fees.

#### Eligibility Conditions

The refund applies only if all of the following conditions are met:

(a) the service is covered under the Member's insurance policy;
(b) the service is not subject to an explicit plan exclusion;
(c) documentation is complete, valid, and accurately reflects services rendered;
(d) the claim was coded using standard CDT codes based on the information provided and accepted coding practices.

Eligibility is determined based on the insurer's policy terms, claim documentation, and standard coding practices. Eligibility does not guarantee payment and remains subject to the insurer's final determination.

#### Exclusions

The refund guarantee does not apply if the denial is due to any of the following:

- plan exclusions or non-covered services;
- out-of-network limitations or reduced coverage;
- deductible not met;
- frequency or annual maximum limitations;
- missing or incomplete documentation provided by the Member;
- inaccurate, unverifiable, or fraudulent information provided by the Member;
- the Member's failure to authorize required resubmissions within insurer deadlines.

#### Final Denial

A claim is considered finally denied when both of the following are true:

(a) all resubmissions included in the Member's plan have been completed; and
(b) either (i) Credimed determines, acting reasonably and in good faith, that no further viable resubmission strategy exists, or (ii) the Member declines additional resubmissions that are reasonably required.

If the Member declines further necessary resubmissions, the claim is considered voluntarily closed and is not eligible for refund.

#### Partial Payment Rule

Any reimbursement issued by the insurer, regardless of amount, is considered a successful outcome and voids eligibility for refund. Once the insurer issues any payment relative to the submitted services, the plan fee is fully earned and non-refundable.

#### Refund Process

Refunds are issued to the original payment method within fourteen (14) business days after the final denial determination.

Refund requests must be submitted within sixty (60) days of the final denial determination. Requests submitted after this window will not be honored.

#### Dispute Process

A Member who disagrees with Credimed's eligibility determination may request an internal review by emailing disputes@credimed.us within thirty (30) days of the determination.

Credimed will respond in writing within fourteen (14) business days with a final decision. Credimed's decision following the internal review shall be final and binding.

The internal review process does not extend the sixty (60) day window for submitting refund requests.

## 3. Reimbursement Flow

Any reimbursement approved by your insurance carrier will be issued directly to you by your insurer, typically in the form of a paper check or electronic payment according to your plan terms.

At no point does Credimed receive, control, hold, or have access to your reimbursement funds. Credimed is not a payee, intermediary, financial agent, or custodian of funds.

## 4. HIPAA & Data Handling

Credimed processes Protected Health Information ("PHI") solely for the purpose of preparing, submitting, and supporting your insurance claim.

We implement administrative, technical, and physical safeguards consistent with the HIPAA Security Rule, including encryption at rest (AES-256) and in transit (TLS 1.3), access controls, and audit logging. Access to PHI is restricted to authorized personnel involved in your case under a minimum necessary standard.

Where applicable, Credimed may act as a Business Associate in connection with PHI processing and will execute a Business Associate Agreement (BAA) where required by law.

In the event of a data breach involving your PHI, Credimed will provide notification in accordance with applicable federal and state laws. You may request deletion of your PHI after your claim reaches a final determination, subject to legal retention requirements.

## 5. Electronic Submission Authorization

You authorize Credimed to:

(a) prepare and submit your claim using the information and documentation you provide;
(b) assist in communicating with your insurer's claims department regarding that submission;
(c) use the electronic signature captured on this platform as your legally binding signature in accordance with the E-SIGN Act (15 U.S.C. §§ 7001 et seq.).

If applicable, you acknowledge that any credentials or access information you provide are shared voluntarily and solely for the limited purpose of facilitating claim submission. Credimed will not use such access for any unrelated purpose.

Credimed does not assume control over your insurance account and does not act as your legal representative beyond the limited administrative purposes described herein.

## 6. Your Representations and Indemnification

You represent and warrant that:

(a) all documents and receipts submitted are authentic, accurate, and belong to you;
(b) the services reflected were actually received and paid for by you;
(c) you have not previously received reimbursement for the same services;
(d) your insurance information is current and valid as of the date of treatment.

You agree to indemnify, defend, and hold harmless Credimed from any claims, damages, liabilities, or expenses arising from inaccurate, incomplete, or fraudulent information you provide.

You represent that you are either (i) the patient who received the services described, or (ii) a legally authorized representative of the patient with authority to act on their behalf, including authorization to access, use, and submit Protected Health Information related to the claim.

## 7. Communications Consent

By providing your contact information, you consent to receive communications from Credimed via email, SMS, or messaging platforms (including WhatsApp) related to your claim, account activity, and service updates. Message and data rates may apply.

You acknowledge that providing your phone number constitutes consent to receive automated or manual communications related to your claim, subject to applicable laws.

You may opt out of SMS communications at any time by replying STOP. Opt-out instructions for other communication channels will be provided where applicable.

## 8. Limitation of Liability

Credimed does not guarantee any reimbursement outcome. All coverage and payment determinations are made solely by your insurance carrier based on your individual plan.

To the maximum extent permitted by law, Credimed's total liability shall not exceed the total fees paid by you to Credimed in the preceding twelve (12) months.

Credimed shall not be liable for any indirect, incidental, consequential, special, or punitive damages, including but not limited to loss of benefits, delays in payment, claim denials, or delays caused by insurers, third-party systems, or incomplete documentation.

Some jurisdictions do not allow the exclusion or limitation of certain damages, so the above limitations may not fully apply to you.

## 9. Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of Delaware, without regard to conflict of law principles.

To the extent required by applicable consumer protection laws, you may also have rights under the laws of your state of residence.

## 10. Contact

For legal or general inquiries: legal@credimed.us
For refund eligibility disputes: disputes@credimed.us
For claim support: contact your assigned claims specialist through your dashboard