1. Acceptance of Terms

By accessing our website or engaging our billing and revenue cycle management services, you (“Client” or “you”) agree to be bound by these Terms of Service (“Terms”). If you are acting on behalf of a dental practice or organization, you represent that you have authority to bind that entity. If you do not agree to these Terms, please discontinue use of our website and services.

2. Description of Services

Specialty Dental Billing Solutions provides outsourced billing and revenue cycle management services for specialty dental practices, including but not limited to oral and maxillofacial surgery, dentoalveolar procedures, orthognathics, pathology, implants and grafting, head and neck oncology, TMJ, trauma, infections, and coordination of benefits.

Our services include:

  • Dental and medical insurance claim submission (primary and secondary)
  • Claim scrubbing, follow-up, and outstanding claim inquiry and correction
  • Appeals of denied claims
  • Retrieval and processing of EOBs and ERAs
  • Insurance payment posting and contractual adjustment posting
  • Reconciliation of daily posting activity
  • Response to insurance-related patient account questions
  • A dedicated account manager for each client practice

The specific scope of services for your practice is defined in a separate Service Agreement.

3. Service Agreement and Business Associate Agreement

Formal engagement of our services requires execution of:

  • A Service Agreement outlining the scope of work, responsibilities, and fees
  • A Business Associate Agreement (BAA) as required under HIPAA, governing our handling of Protected Health Information on your behalf

These Terms govern your general use of our website and services. The Service Agreement and BAA govern delivery of contracted billing services and supersede these Terms in the event of any conflict relating to service delivery.

4. Client Responsibilities

By engaging our services, you agree to:

  • Provide at least two dedicated remote connections (via our secure LogMeIn license or a server connection) for our team to access your practice management system
  • Complete and return the onboarding questionnaire with accurate practice information (NPI, TIN, and related details)
  • Create and maintain appropriate usernames for our team in your practice management software
  • Grant access to necessary reports, attachments, X-rays, and documentation within your system
  • Provide insurance portal login credentials required for claim submission and follow-up
  • Submit EOBs to eBridge a minimum of twice per week
  • Agree to the use of the designated Account/Billing Category (patient or insurance) as established during onboarding
  • Designate an authorized point of contact for communication and approvals
  • Notify us promptly of changes to providers, insurance contracts, or practice information that may affect billing

5. Fees and Payment

  • Service fees are outlined in your Service Agreement
  • Invoices are issued on a monthly basis in accordance with the agreed fee structure
  • Payment is due within the timeframe specified in your Service Agreement
  • Late or missed payments may result in service suspension
  • Fee adjustments will be communicated with reasonable advance notice as specified in your Service Agreement

6. Confidentiality

Both parties agree to keep confidential all non-public information shared in the course of the engagement, including practice financials, patient data, system credentials, insurance portal logins, and business strategies. Confidentiality obligations survive the termination of the service relationship.

All PHI is handled pursuant to the BAA and in compliance with HIPAA regulations.

7. HIPAA Compliance

Specialty Dental Billing Solutions operates as a HIPAA Business Associate. Both parties acknowledge their respective obligations under HIPAA and agree to fulfill those obligations throughout the engagement. In the event of a security incident or breach of unsecured PHI, we will notify your practice in accordance with applicable breach notification requirements under HIPAA and the HITECH Act.

8. Cybersecurity Obligations

We maintain a cybersecurity program that includes HIPAA-compliant secure remote connections, regular security scans, proactive risk mitigation, and ongoing compliance training. You agree to cooperate with reasonable security requirements, including maintaining appropriate access controls and notifying us promptly if you suspect unauthorized access to shared credentials or systems.

9. Intellectual Property

All methodologies, processes, templates, reporting systems, and operational tools developed and used by Specialty Dental Billing Solutions remain our exclusive property. Client data, patient records, and practice information remain the property of the client.

10. Disclaimers

Our services are designed to maximize insurance collections and reduce administrative burden. However, we do not guarantee specific collection amounts, reimbursement rates, or claim approval outcomes, as these are determined by payers and subject to factors beyond our control.

Our website is provided “as is” without warranties of any kind, express or implied.

11. Limitation of Liability

To the maximum extent permitted by applicable law, Specialty Dental Billing Solutions shall not be liable for indirect, incidental, special, consequential, or punitive damages, including lost revenue or collections, arising from your use of our services or website. Our total liability for any claim under these Terms or the Service Agreement shall not exceed the total fees paid by you in the three (3) months preceding the claim.

Nothing in these Terms limits liability for damages arising from gross negligence, willful misconduct, or a breach of HIPAA obligations.

12. Indemnification

You agree to indemnify, defend, and hold harmless Specialty Dental Billing Solutions and its employees, officers, and agents from any claims, liabilities, or damages arising from your breach of these Terms, your provision of inaccurate or incomplete information, or your violation of any applicable law or regulation.

13. Term and Termination

The engagement begins upon execution of the Service Agreement and continues until terminated by either party in accordance with its terms. Upon termination:

  • All remote access to your practice systems will be revoked
  • Outstanding invoices become immediately due
  • PHI will be returned or securely destroyed in accordance with the BAA
  • Confidentiality obligations survive termination

14. Independent Contractor

Specialty Dental Billing Solutions operates as an independent contractor. Nothing in these Terms creates an employment, partnership, agency, or joint venture relationship between the parties.

15. Governing Law

These Terms are governed by the laws of the Commonwealth of Massachusetts, without regard to conflict of law provisions. Disputes shall be resolved in the courts of Massachusetts, and both parties consent to jurisdiction therein.

16. Changes to Terms

We may update these Terms from time to time. Continued use of our website or services following notice of any changes constitutes your acceptance of the updated Terms.

17. Contact Us

For questions about these Terms:

Specialty Dental Billing Solutions