Your healthcare and history can be tricky stuff, but it’s almost always personal. That’s why we’re doing our best to make sure we keep your privacy safe. We keep your information protected so that you can focus on more important things, like getting the most out of your health insurance.
These Terms of Service (these “Terms of Service”) sets forth between you and TLC Patients Advocate. These Terms of Service include the terms and conditions set forth below, and any policies, guidelines, and amendments that may be incorporated by reference into these Terms of Service from time to time (collectively with these Terms of Service, the “Agreement”).
2. Acceptance of Terms.
By accessing or using any Services or this website, you agree that the Agreement, without modification, governs the Services (as defined below) and your use of this website. Continuing to use the TLC Patients Advocate website following the posting of any changes to these Terms of Service will also indicate that you accept those changes.
TLC Patients Advocate was created as a resource to help healthcare consumers understand their medical bills and save money on them.
All information is offered for general informational purposes only. WE DO NOT OFFER FINANCIAL ASSISTANCE OF ANY KIND TO PATIENTS WHO HAVE INCURRED MEDICAL DEBT OR FOR ANY OTHER PURPOSE.
You should always use caution when giving out personally identifying information (“PHI”) about yourself or your family members in any communication to us or through our website. If you post information on our blogs or through emails by using our Service, that information may be viewed by other users of our website. TLC Patients Advocate does not control or endorse the content, messages or information found in any communications from other users on our website and, therefore, TLC Patients Advocate specifically disclaims any liability with regard to such communications and any actions resulting from your participation in those communications.
When you sign up for an account with TLC Patients Advocate and upload your documents (such as provider bill, explanation of benefits or insurance card), you will be asked to sign a release of information form for yourself or on behalf of your dependents that allows us to view your personal health information. If you create an account for someone else who is over the age of 18 (such as your partner, spouse, college age children or parent) then we will request authorization from that person to view their personal health information. We will only view the personal health information that you upload, and we will only act on those documents you upload and which of our Service you opt into or elect to receive. You can further limit which providers or health plans we can interact with on the authorization form. The authorization to view your personal health information (limited by the contents of the documents you share with us and the provider and health plans represented on these documents) will remain in effect for one year from the date of signature.
5. Your Obligations.
(a) Applicable laws.
You are solely responsible for complying with all applicable international, national, state, regional and local laws and regulations applicable to you.
In connection with the Services or the use of this website, you agree that you will not: (i) upload, post or otherwise transmit through or to this website any content that is (a) unlawful, abusive, threatening, harmful, obscene, lewd, offensive, defamatory or otherwise objectionable, (b) might infringe the intellectual property rights, privacy rights, rights of publicity, or other proprietary rights of others, (c) contains any viruses, trojan horses, time bombs, or any other harmful programs or elements; (ii) disrupt, place unreasonable burdens or excessive loads on, interfere with or attempt to gain unauthorized access to any portion of our website, its computer systems, servers or networks; (iii) provide false information about you to TLC Patients Advocate; (iv) impersonate any other person, or otherwise attempt to mislead others about your identity or the origin of any content, message or other communication; (v) transmit junk mail, chain letters, or other unsolicited bulk e-mail or duplicative messages; (vi) collect information about other visitors to TLC Patients Advocate website without TLC Patients Advocate consent or otherwise systematically extract data or data fields, including without limitation any financial data or e-mail addresses; (vii) sell access to or the use of this website, including any content contained on, downloaded or accessed from this website; or (viii) redistribute any content, including financial, legal or other data, provided by TLC Patients Advocate in any manner whatsoever, including by means of printed publication, fax broadcast, Web pages, e-mail, Web newsgroups or forums, or any other electronic or paper-based service or method. You will not provide any content that attempts to solicit or other users for commercial purposes. You grant us the right to screen and/or remove any content that is submitted to our website.
TLC Patients Advocate reserves the right, in its sole discretion, to terminate the Services or your access to TLC Patients Advocate website, or any portion thereof, at any time and for any reason without notice.
7. Account Access Password.
(a) If you receive a user identification name or password from TLC Patients Advocate to access TLC Patients Advocate database or use Services, you will: (i) keep the user identification name and password confidential; (ii) not allow any other entity or person to use the user identification name or password or gain access to TLC Patients Advocate database or services; (iii) be liable for all action taken by any user of the user identification name or password; and (iv) promptly notify TLC Patients Advocate if you believe the user identification name or password have been used inappropriately or the confidentiality of the information made available through such use has been compromised.
(b) You agree that any loss incurred by you or TLC Patients Advocate as a result of any party gaining access to your account orTLC Patients Advocate website using information which that party was not authorized to obtain or using such information in a manner not permitted by this Agreement (including but not limited to improper or unauthorized use of your user ID and password) shall be your responsibility.
8. Disclaimers and Limitation of Liability.
(a) You understand and acknowledge that TLC Patients Advocate only provides informational and administrative services related to issues about health insurance coverage. We do not provide medical or diagnostic services, nor do we recommend treatment or healthcare advice, nor does TLC Patients Advocate provide legal services or advice. Information provided by TLC Patients Advocate is not intended, nor implied to substitute for professional medical advice. You should always seek the advice of your physician or other qualified healthcare professional prior to making any treatment decisions. You should always seek the advice of your attorney or other qualified legal advisor prior to making legal decisions.
(b) Our services are designed to help make you more knowledgeable and pro-active with respect to your health insurance. We want to help you understand your health insurance so that you can minimize unforeseen expenses and maximize insurance benefits to which you are entitled. However, we do not provide health insurance coverage. Most health insurance policies require financial responsibility on the part of the policy holder beyond the policy premiums, e.g. co-pays, co-insurance, deductibles and non-covered services. Generally, health insurance companies will not confirm coverage or payment on any services until they have fully processed the claim. For this reason, we cannot guarantee coverage or your financial exposure for any health care or health care related services.
(c) WE MAKE NO REPRESENTATIONS ABOUT THE SUITABILITY, RELIABILITY, AVAILABILITY, TIMELINESS, AND ACCURACY OF THE INFORMATION, SOFTWARE, SERVICES AND RELATED GRAPHICS CONTAINED ON THE COPATIENT WEBSITE FOR ANY PURPOSE. TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, THE SERVICES ARE PROVIDED ON AN ‘AS IS’ BASIS WITHOUT ANY WARRANTY WHATSOEVER. TLC PATIENTS ADVOCATE DISCLAIMS ALL WARRANTIES, EXPRESS, IMPLIED, OR STATUTORY, TO YOU AS TO ANY MATTER WHATSOEVER, INCLUDING ALL IMPLIED WARRANTIES OF PRACTICEABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NON-INFRINGEMENT OF THIRD PARTY RIGHTS. TLC PATIENTS ADVOCATE FURTHER DISCLAIMS ANY WARRANTY INSURING THAT THE SERVICES WILL (I) BE SECURE, UNINTERRUPTED, TIMELY, OR FREE FROM DEFECTS, ERRORS, OMISSIONS, INTERRUPTIONS, DELAYS OR OTHER LOSSES, (II) BE COMPATIBLE OR OPERATE IN COMBINATION WITH ANY OF YOUR SPECIFIC HARDWARE, SOFTWARE SYSTEMS, OR DATA, AND (III) FREE OF VIRUSES AND OTHER HARMFUL COMPONENTS. NO ORAL OR WRITTEN INFORMATION OR ADVICE GIVEN BY TLC PATIENTS ADVOCATE OR ITS EMPLOYEES OR REPRESENTATIVES SHALL CREATE A WARRANTY OR IN ANY WAY INCREASE THE SCOPE OF TLC PATIENTS ADVOCATE OBLIGATIONS.
(d) TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT SHALL TLC PATIENTS ADVOCATE AND/OR ITS OWNERS, OFFICERS, DIRECTORS, EMPLOYEES, OR OTHER REPRESENTATIVES BE LIABLE FOR ANY CONSEQUENTIAL, INDIRECT, SPECIAL, INCIDENTAL, RELIANCE, OR EXEMPLARY DAMAGES WHATSOEVER ARISING OUT OF OR RELATING TO THE AGREEMENT OR THE SERVICES OR THE USE OF THE COPATIENT WEBSITE, WHETHER FORESEEABLE OR UNFORESEEABLE, AND WHETHER BASED ON BREACH OF ANY EXPRESS OR IMPLIED WARRANTY, BREACH OF CONTRACT, MISREPRESENTATION, NEGLIGENCE, STRICT LIABILITY IN TORT, OR OTHER CAUSE OF ACTION, EVEN IF SUCH PARTY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. UNDER NO CIRCUMSTANCES SHALL TLC PATIENTS ADVOCATE TOTAL LIABILITY TO YOU OR ANY THIRD PARTY ARISING OUT OF OR RELATED TO THE AGREEMENT, SERVICES OR WEBSITE EXCEED ONE THOUSAND ($1,000.00) DOLLARS, REGARDLESS OF WHETHER ANY ACTION OR CLAIM IS BASED ON WARRANTY, CONTRACT, TORT OR OTHERWISE.
You agree to indemnify, defend, and hold harmless TLC Patients Advocate, its employees, officers, directors, managers, members, shareholders, and agents from and against any loss, liability, damage, penalty or expense (including attorneys’ fees, expert witness fees and cost of defense) that each may suffer or incur as a result of claims arising from any breach by you or any of your agents or affiliates of the terms of the Agreement, including, without limitation, any failure to comply with your obligations set forth in the Agreement, or any claims made by healthcare providers or health plans.
The Agreement is governed by the laws of the State of Tennessee. You hereby consent to the exclusive jurisdiction and venue of courts in Memphis, Tennessee, U.S.A. in all disputes arising out of or relating to the use of the TLC Patients Advocate website. Use of this website in any jurisdiction that does not give effect to all provisions of these Terms of Service, including without limitation, this paragraph, is unauthorized. You agree that no joint venture, partnership, employment, or agency relationship exists between you and TLC Patients Advocate as a result of the Agreement or the use of this website. TLC Patients Advocate performance of the Agreement is subject to existing laws and legal process, and nothing contained in the Agreement will prohibit TLC Patients Advocate right to comply with governmental, court and law enforcement requests or requirements relating to your use of the website or information provided to or gathered by TLC Patients Advocate with respect to such use. If any part of the Agreement is held invalid or unenforceable pursuant to applicable law, then the invalid or unenforceable provision will be deemed superseded by a valid, enforceable provision that most closely matches the intent of the original provision and the remainder of the Agreement shall continue in full force and effect.
11. Dispute Resolution.
TLC Patients Advocate and you each acknowledge and agree that any controversy, disagreement, dispute or claim arising out of or relating to the Services or the Agreement, or any breach in connection therewith or herewith (each, a “Dispute”), will be settled by following the procedures set forth below:
(a) TLC Patients Advocate, on the one hand, and you, on the other hand, agree first to contact the other to advise of any such Dispute. The party alleging, asserting and/or initiating the Dispute shall contact the other party or parties who is or are alleged to be liable or responsible for such Dispute, and provide a written description of the Dispute, all relevant documents/information and the proposed resolution (the “Claim Notice”). You agree to contact TLC PATIENTS ADVOCATE as contemplated above by calling or writing to: TLC Patients Advocate, Memphis, Tennessee, Tel. No. 901-444-1598.
(b) You and the Claims Administrator for TLC Patients Advocate shall then seek in good faith to resolve the Dispute. As part of this process, each party to the Dispute shall provide a monetary amount that, if paid to the party alleging, asserting and/or initiating the Dispute, would settle the Dispute (the “Settlement Amount”). If the parties do not agree to a Settlement Amount, or the parties are otherwise unable to settle the Dispute within thirty (30) days of the date of delivery of the Claim Notice, then the parties shall proceed to arbitration, as set forth below.
(c) IN THE ABSENCE OF RESOLVING THE DISPUTE, AND INSTEAD OF SUING IN COURT, TLC PATIENTS ADVOCATE AND YOU EACH AGREE TO SETTLE AND RESOLVE FULLY AND FINALLY ALL DISPUTES EXCLUSIVELY BY ARBITRATION, EXCEPT IN THE FOLLOWING LIMITED CIRCUMSTANCES: (I) TLC PATIENT ADVOCATE OR YOU MAY COMMENCE AN INDIVIDUAL ACTION IN SMALL CLAIMS COURT WHERE THE AMOUNT OF THE DISPUTE DOES NOT EXCEED THE JURISDICTIONAL LIMIT OF SUCH COURT; AND (II) YOU MAY FILE A DISPUTE WITH ANY FEDERAL, STATE OR LOCAL GOVERNMENTAL AGENCY THAT CAN, IF THE LAW SO AUTHORIZES, SEEK RELIEF AGAINST TLC PATIENTS ADVOCATE ON BEHALF OF YOU. THIS AGREEMENT TO HAVE DISPUTES RESOLVED BY ARBITRATION IS MADE WITH THE UNDERSTANDING THAT EACH PARTY IS IRREVOCABLY, KNOWINGLY AND INTELLIGENTLY WAIVING AND RELEASING ITS RIGHT TO LITIGATE DISPUTES THROUGH A COURT AND TO HAVE A JUDGE OR JURY DECIDE DISPUTES. Without limitation, TLC Patients Advocate and you agree that Disputes, as defined above, shall include the following matters: (a) any Dispute by any party against any agent, employee, successor, or assign of the other party or parties, including to the full extent permitted by applicable law, third parties who are not parties to the Agreement, whether related to the Services or otherwise; (b) any past, present, and future Dispute; and (c) any Dispute as to the scope, validity or applicability of this Dispute Resolution provision, and/or the arbitrability of any Dispute; and (d) any Dispute against TLC Patients Advocate, or any other party as stated above, related in any way to the Services, including, but not limited to, the characterization of the transactions referenced in the Agreement, privacy, solicitation, or advertising, even if it arises after the Services have terminated.
(d) The foregoing arbitration shall be administered by the American Arbitration Association (the “AAA”) in accordance with its Commercial Arbitration Rules in effect when a Claim Notice is duly provided. If any AAA procedure or rule conflicts with the terms of the Agreement, the the Agreement will apply.
(e) The arbitration shall be governed by the Federal Arbitration Act (the “FAA”), 9 U.S.C. Sections 1-16. Any award by the arbitrator may be entered as a judgment in any court having jurisdiction. Any arbitrator’s decision and award is final and binding, subject only to those exceptions under the FAA. TLC Patients Advocate and you agree the FAA’s provisions, not state law, govern all questions of whether a Dispute is subject to arbitration.
(f) Unless TLC Patients Advocate and you agree otherwise, the foregoing arbitration will be conducted by a single neutral arbitrator selected by utilizing the process provided in the AAA’s Commercial Arbitration Rules in effect when Claim Notice is duly filed. The arbitrator shall be a licensed attorney and/or retired judge. Except as otherwise provided below, the arbitration shall be conducted in the county where the principal address of the party against whom the Dispute is initially commenced is located – and for any claim against TLC Patients Advocate, that address shall beTLC Patients Advocate, Memphis, Tennessee Tel. No. 901-444-1598. The arbitrator shall have no authority to award punitive, consequential or other monetary damages not measured by the prevailing party’s actual damages, except as may be required by statute or as otherwise provided below.
(g) For Disputes of $10,000.00 or less that are initiated by you (“Small Disputes”), the following rules shall apply notwithstanding anything to the contrary in the procedures or rules of the AAA:
(1) The arbitration shall be conducted in accordance with the AAA’s Expedited Procedures.
(2) The arbitrator shall include a finding as to whether the initiation of such Dispute was frivolous. If it is determined by the arbitrator not to be frivolous, then TLC Patients Advocate shall pay the fees and costs assessed by the AAA in administering the arbitration.
(3) If the arbitrator finds that TLC Patients Advocate is liable to you for an amount greater than the Settlement Amount presented by TLC Patients Advocate prior to the commencement of arbitration (after all offsets and counterclaims are applied), then TLC Patients Advocate shall be required to pay in addition to any award of the arbitrator an amount equal to the greater of (x) $500.00, or (y) the amount of your reasonable attorneys’ fees.
(4) You may choose to conduct the arbitration in the state of its principal address.
(i) TLC PATIENTS ADVOCATE AND YOU EACH AGREE NOT TO PURSUE ARBITRATION ON A CLASS-WIDE BASIS. ARBITRATION WILL BE CONDUCTED SOLELY IN AN INDIVIDUAL CAPACITY, AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING.
Notwithstanding anything to the contrary in the Agreement, all sections of the Agreement that by their nature should survive termination or expiration will survive, including, without limitation, accrued rights to payment, indemnification obligations, warranty disclaimers, and limitations of liability.
13. Notices; Consent to Electronic Communications.
By applying for the Services and confirming that you have read this Agreement, you are confirming to TLC Patients Advocate that you have the means to access the Internet through its own service provider and download or print electronic communications. You agree to the receipt of electronic communications by email or by the posting of such information by TLC Patients Advocate at one or more of TLC Patients Advocate sponsored websites, such as www.tlcadvocate.com. Such communications may pertain to the services delivered by TLC Patients Advocate, the use of information you may submit to TLC Patients Advocate, changes in laws impacting the Services or other reasons, such as amendment of this Agreement. In addition, all notices and other communications required or permitted under this Agreement by TLC Patients Advocate to you may also be delivered by TLC Patients Advocate to you either by FAX, overnight carrier or first class mail, postage or other charges prepaid, addressed and transmitted as set forth below. All notices and other communications required or permitted under this Agreement by you to TLC Patients Advocate shall be delivered by you to TLC Patients Advocate by overnight carrier or certified mail, postage or other charges prepaid, addressed and transmitted as set forth below. Notice by FAX or e-mail shall be deemed delivered when transmitted. Notice by mail or overnight carrier shall be deemed delivered on the first (1st) business day after mailing or delivery to the carrier. Following are the addresses for the purposes of notices and other communications hereunder, which may be changed by written notice in accordance with this section:
(a) If to TLC Patients Advocate, addressed and transmitted as follows:
TLC Patients Advocate Memphis, Tennessee
(b) If to you, at the address provided as the billing address, or the FAX number or e-mail address and to the contact listed on the Authorization.
14. Electronic Signature.
You may become a party to, and become bound by, the Agreement by completing the Authorization and accepting it electronically over the Internet. This is done by clicking or entering “I Agree”, by providing an electronic form of signature or otherwise by affirmatively indicating acceptance or consent where requested on an electronic version of the Authorization (any such method constituting an “Electronic Consent”). By providing such Electronic Consent, you acknowledge that you have received and reviewed all applicable pages, terms and conditions of the Agreement, and you represent, warrant, consent and agree as follows:
(a) The electronic agreement process allows you to sign and agree to legally binding agreements online by providing its Electronic Consent;
(b) You intend to use the electronic agreement process to provide your Electronic Consent;
(c) Your Electronic Consent is legally binding, and is governed by the Electronic Signatures in Global and National Commerce Act of 2000, and/or the Uniform Electronic Transactions Act governances (or an amended version thereof) in its state of residence, and you agree to be bound by these governances;
(d) The individual providing Electronic Consent on your behalf is authorized to do so and is at least 18 years old; and
(e) The Electronic Consent will be binding upon you, and will not be construed by a court of law to have any less effect than a standard ink or paper signature.
Terms & Conditions Updated: 04/05/2020