Terms and Conditions

1. Eligibility & Scope

1.1 Age

You must be at least 18 years old and capable of entering into a binding contract to use the Service. You may submit information on behalf of a dependent (e.g., your child) only if you have legal authority to do so.

1.2 Territory

The Service is designed for, and may only be used by, individuals located in the United States in connection with U.S.-based health care providers and insurers.

1.3 Agreement

By using the Service, you represent and warrant that:

• You meet the eligibility requirements above;
• All information you provide to us is true, accurate, and complete; and
• You will use the Service only in accordance with these Terms and applicable law.

2. Description of the Service

Bill Shield is a consumer-facing tool that helps you:

• Capture and upload images or files of medical bills, insurance cards, EOBs, and related documents;
• Use AI-powered analysis to extract, review, and identify potential billing or insurance errors;
• Receive non-binding estimates of potential savings based on detected issues;
• Generate appeal, grievance, or billing dispute documents (“Packets”); and
• With your authorization, have Y CORP submit those Packets on your behalf to health insurers, health care providers, or other payers via fax, mail, or other channels, and track status where possible.

The Service does not guarantee any particular result, payment, refund, or reduction in your bill.

3. No Legal, Medical, or Insurance Advice

3.1 Not a law firm or medical provider

Y CORP is not a law firm, medical provider, or insurance company. The Service and any content we provide (including templates, explanations, or suggested letters) are for informational and administrative purposes only.

3.2 No professional advice

Nothing in the Service constitutes:

• Legal advice;
• Medical advice or diagnosis;
• Insurance coverage advice; or
• Financial or tax advice.

You should consult a licensed attorney, medical professional, or other qualified advisor for specific advice regarding your situation.

3.3 No attorney-client relationship

Your use of the Service and communications with Y CORP do not create an attorney-client relationship.

4. Relationship to Insurers, Providers, and Regulators

4.1 No affiliation

Y CORP and Bill Shield are not affiliated with, endorsed by, or acting on behalf of any insurer, employer, government program, or healthcare provider.

4.2 No control over outcomes

We do not control:

• How an insurer or provider processes claims or appeals,
• Whether they accept or reject any appeal, or
• How quickly they respond.

Any “likely savings” or “estimated savings” shown in the app are non-binding estimates only and may differ from actual results.

5. Your Account & Security

5.1 Registration

To use the Service, you may need to create an account (e.g., via magic link or other login). You agree to keep your contact information up to date.

5.2 Confidentiality

You are responsible for maintaining the security of your device and login credentials and for all activities under your account.

5.3 Unauthorized use

You agree to notify us promptly at support@billshield.app if you suspect any unauthorized access to your account or PHI.

6. Your Responsibilities & User Content

6.1 Accurate information

You are responsible for providing accurate and complete information, including but not limited to:

• Medical bills, EOBs, and receipts;
• Insurance card images and plan details;
• Your contact information and mailing address;
• Answers to any intake questions about network status, visit type, or payments made.

6.2 User Content

“User Content” includes all information, text, images, documents, and other materials you submit or upload. You retain ownership of your User Content. You grant Y CORP a worldwide, non-exclusive, royalty-free license to use, reproduce, adapt, transmit, and create derivative works from User Content solely as needed to provide, operate, improve, and support the Service, and as otherwise described in our Privacy Policy.

6.3 HIPAA & PHI

Much of the User Content you provide will constitute Protected Health Information (“PHI”) under U.S. law. Y CORP will handle PHI in accordance with:

• The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its regulations, to the extent applicable; and
• Any Business Associate Agreements (BAAs) we enter into with covered entities and subcontractors.

6.4 Prohibited content

You agree not to upload or submit any content that is:

• False, fraudulent, or intentionally misleading;
• Harassing, threatening, or abusive;
• Malware or code designed to disrupt the Service.

7. Authorized Representative & Communications on Your Behalf

7.1 Authorization to act

When you agree to our in-app Authorized Representative (AOR) and HIPAA Authorization guidelines, you may appoint Y CORP (and its personnel and service providers) to act as your authorized representative for the limited purpose of:

• Communicating with your health insurer(s), health care provider(s), and billing companies;
• Requesting information, claim files, and explanations of benefits;
• Submitting appeals, grievances, complaints, or corrected claims regarding the bill(s) you provide; and
• Receiving responses and notices related to those appeals or complaints.

7.2 Scope and duration

The scope and duration of our authority will be defined by the text of the AOR/HIPAA forms you agree to in the app. You may revoke these authorizations in writing at any time, subject to our need to maintain records and comply with law.

7.3 Virtual mail / fax reception

You consent that:

• Insurers and providers may send written notices regarding your claims or appeals to Y CORP or our virtual mailbox/fax providers, and
• We may receive, open, scan, review, and store such correspondence on your behalf.

7.4 ESIGN consent

You agree that:

• Your electronic signature, typed name, or tap-to-sign in the app has the same legal effect as a handwritten signature; and
• Y CORP may affix your electronic signature (or a representation of it) to forms, letters, and other documents in order to submit appeals or complaints as you’ve authorized.

8. Use of AI, Automation, and Third-Party Services

8.1 AI processing

Bill Shield uses artificial intelligence (“AI”) and machine learning models (including hosted services such as Azure OpenAI) to:

• Perform OCR on bills and documents;
• Structure and analyze billing data;
• Identify potential billing or insurance errors; and
• Draft appeal letters and related documents.

8.2 Accuracy limitations

AI and automated systems may generate errors, omissions, or incomplete interpretations. We use reasonable efforts to design safeguards (including QA checks and reviews), but:

• We do not guarantee that all errors will be found;
• We do not guarantee that every flagged issue is correct; and
• You are encouraged to review any letters or submissions in the app and may choose not to proceed.

8.3 Third-party vendors

To provide the Service, we may use third-party vendors, including (as examples):

• Cloud hosting providers (e.g., Microsoft Azure);
• Fax and mail providers (e.g., Documo/mFax, Lob, or similar);
• Virtual mailbox providers for receipt and scanning of postal mail.

These vendors are required by contract (and BAA where applicable) to protect PHI and only use it for providing services to us.

9. Privacy & Data Security

9.1 Privacy Policy

Our Privacy Policy, incorporated by reference into these Terms, describes how we collect, use, disclose, and safeguard your information, including PHI and personal data.

9.2 Security safeguards

We implement reasonable administrative, technical, and physical safeguards designed to protect PHI and personal data, including:

• Encryption in transit;
• Access controls and role-based permissions;
• Audit logging for internal admin access.

However, no system is perfectly secure. We cannot guarantee that unauthorized access, hacking, data loss, or other breaches will never occur.

9.3 HIPAA Breach Notification

If we determine that a breach of unsecured PHI has occurred, we will comply with applicable HIPAA breach notification rules and any other required notifications.

10. Subscription Plans, Fees & Payments

10.1 Plans

Bill Shield may offer different subscription plans (e.g., “Basic,” “Unlimited Bills,” or similar) and promotional trials. Plan details, pricing, and limits are described in the app and may change from time to time.

10.2 Billing

If you purchase a plan:

• If purchased via Apple App Store or Google Play, billing is handled by those platforms under their own terms;
• If purchased directly via Y CORP, you authorize us and our payment processor to charge your selected payment method on a recurring basis until you cancel.

10.3 Renewals & Cancellations

Subscriptions automatically renew at the end of each billing period unless you cancel in accordance with the instructions in the app or applicable app store. Cancellations take effect at the next billing cycle; we generally do not prorate or refund partial periods.

10.4 Referral programs

If we offer referral or “refer a friend” rewards, they are subject to separate program terms and may be modified or discontinued at any time. We may withhold or cancel rewards if we suspect fraud or abuse.

11. Acceptable Use & Prohibited Conduct

You agree not to:

• Use the Service for any unlawful purpose or to violate any law or regulation;
• Provide false or fraudulent bills, identities, or information;
• Attempt to access or interfere with accounts, systems, or data that are not yours;
• Reverse engineer, decompile, or attempt to derive the source code of any part of the Service;
• Use automated means (bots, scrapers) to access the consumer-facing portions of the app, except for integrations expressly permitted by us;
• Bypass or attempt to bypass any security or rate-limiting features.

We may suspend or terminate your access if we believe you are violating these restrictions or abusing the Service.

12. Intellectual Property

12.1 Ownership

The Service, including all software, code, designs, logos, and content (excluding your User Content), is owned by Y CORP and its licensors and is protected by copyright, trademark, and other laws.

12.2 License to you

Subject to these Terms, we grant you a limited, non-exclusive, non-transferable, revocable license to use the Bill Shield app on devices that you own or control solely for your personal, non-commercial use.

12.3 Restrictions

You may not copy, modify, distribute, sell, lease, or create derivative works from the Service or any portion thereof, except as expressly allowed by these Terms.

13. Termination

13.1 By you

You may stop using the Service at any time and may request account deletion via the app or support@billshield.app.

13.2 By us

We may suspend or terminate your account or access to the Service at any time, with or without notice, if we believe:

• You have violated these Terms;
• Your use presents a security risk or legal risk; or
• We cease offering the Service.

13.3 Effect of termination

Upon termination:

• Your right to use the Service ends;
• We may retain certain information as required by law or as necessary for legitimate business purposes (e.g., records of appeals filed, audit logs, or compliance records).

14. Disclaimers

To the fullest extent permitted by law:

14.1 “As is”

The Service is provided on an “AS IS” and “AS AVAILABLE” basis, without warranties of any kind, whether express, implied, or statutory.

14.2 No warranties

We specifically disclaim all warranties, including but not limited to:

• Implied warranties of merchantability, fitness for a particular purpose, and non-infringement;
• Any warranty that the Service will detect all billing errors or always be accurate;
• Any warranty regarding the outcome of any appeal, dispute, or communication with an insurer or provider;
• Any warranty that the Service will be uninterrupted, secure, or error-free.

14.3 User responsibility

You remain solely responsible for:

• Reviewing any appeals or documents generated;
• Deciding whether to proceed with filing;
• Making payments to providers or insurers;
• Following up directly with insurers or providers as needed.

15. Limitation of Liability

To the fullest extent permitted by law:

15.1 No indirect damages

Y CORP and its officers, directors, employees, contractors, and agents will not be liable for any indirect, incidental, consequential, special, punitive, or exemplary damages arising out of or related to the Service or these Terms, including but not limited to:

• Loss of savings;
• Loss of use or data;
• Emotional distress;
• Claims by third parties.

15.2 Cap on direct damages

Our total aggregate liability to you for all claims arising out of or relating to the Service or these Terms will not exceed the greater of:

• The amount you paid to us for the Service in the twelve (12) months preceding the event giving rise to the claim; or
• One hundred U.S. dollars (US $100).

15.3 Basis of the bargain

You acknowledge that these limitations of liability are a fundamental part of the basis of the bargain between you and Y CORP.

Some jurisdictions do not allow certain limitations of liability, so some of the above may not apply to you; in that case, the limits will apply to the maximum extent permitted by law.

16. Indemnification

You agree to indemnify, defend, and hold harmless Y CORP and its officers, directors, employees, contractors, and agents from and against any claims, liabilities, damages, losses, and expenses (including reasonable attorneys’ fees) arising out of or related to:

• Your use of the Service;
• Your User Content;
• Your violation of these Terms or applicable law; or
• Any misrepresentation or error in the information you provide to us or to insurers/providers through the Service.

17. Dispute Resolution, Governing Law & Arbitration

17.1 Governing law

These Terms are governed by the laws of the State of Florida, without regard to its conflict of law principles, and applicable federal law.

17.2 Informal resolution

Before bringing any formal legal claim, you agree to first contact us at legal@billshield.app and attempt to resolve the dispute informally.

17.3 Arbitration

Except where prohibited by law, any dispute, claim, or controversy arising out of or relating to these Terms or the Service will be resolved by binding arbitration administered by a recognized arbitration provider, rather than in court. The arbitration will be conducted on an individual basis, in English, in [County, State] or via remote video proceedings.

17.4 Class action waiver

To the fullest extent permitted by law, you and Y CORP agree that each may bring claims against the other only in your or its individual capacity and not as a plaintiff or class member in any purported class or representative proceeding.

17.5 Exceptions

Either party may seek injunctive or equitable relief in a court of competent jurisdiction to protect its intellectual property or confidential information, without first resorting to arbitration.

18. Changes to the Service and These Terms

18.1 Service changes

We may modify, suspend, or discontinue all or part of the Service at any time, with or without notice.

18.2 Updates to Terms

We may update these Terms from time to time. When we do, we will revise the “Last updated” date above and, where required, notify you in the app or via email. Your continued use of the Service after the effective date of any changes constitutes your acceptance of the updated Terms.

19. Electronic Communications

By using the Service, you consent to receive electronic communications from us (e.g., emails, push notifications, in-app messages) regarding your account, appeals, RFIs, and the Service. You agree that such electronic communications satisfy any legal requirements that communications be in writing.

You may adjust notification preferences in the app, but certain transactional or legal notices may still be required.

20. Miscellaneous

• Entire Agreement: These Terms, along with our Privacy Policy and any AOR/HIPAA/ESIGN forms you approve, constitute the entire agreement between you and Y CORP regarding the Service.
• Severability: If any provision of these Terms is held invalid or unenforceable, the remaining provisions will remain in full force and effect.
• No waiver: Our failure to enforce any provision of these Terms will not be a waiver of that provision.
• Assignment: You may not assign or transfer your rights or obligations under these Terms. We may assign our rights and obligations freely in connection with a merger, acquisition, sale of assets, or by operation of law.

21. Contact Us

If you have questions about these Terms or the Service, you may contact us at:

support@billshield.app