Terms & Conditions

[Updated 01/26/2024]

Welcome to Suade, a trademark of Proper Dynamic Corporation, a California Corporation (referred to as "Suade," “we,” “us,” or “our”). These Terms and Conditions (the "Terms") govern your access to and use of our health insurance advocacy services, including appeals for denied claims, prior authorizations, and reimbursement maximization (“Services”). By engaging with Suade, you agree to abide by these Terms in their entirety.

Scope of Services

Suade provides specialized patient advocacy services to individuals and entities. Our primary focus includes:

Overturning denied medical claims and prior authorizations.
Maximizing reimbursements on approved claims and prior authorizations.
Assisting individuals in selecting the most suitable insurance plans during open enrollment periods.
Advocating on behalf of clients with insurers, state and federal agencies, and, when necessary, licensed attorneys.
Comprehensive management of medical health insurance-related issues, excluding dental, auto, disability, or other types of insurance.

Suade reserves the right to adjust the scope of services based on the individual circumstances of a client’s case.

Eligibility and Client Authorization

To use Suade’s Services, you must:

Be the primary insured party or legally authorized to act on behalf of the insured.
Authorize Suade to obtain and analyze necessary medical records and insurance data.
Provide accurate, truthful, and complete information.

By engaging our Services, you authorize Suade to:

Retrieve medical records and documentation from healthcare providers, including imaging records and clinical notes.
Communicate with insurers, state and federal regulators, and medical providers on your behalf.
Access and analyze your insurance policy details for the purpose of advocacy and reimbursement maximization.

Compensation and Payment Terms

Suade operates on a success-based model:

Clients compensate Suade with a percentage of any reimbursement or payout successfully obtained through our efforts. This percentage will be outlined in a separate agreement.
No fees are charged upfront, and clients owe nothing if Suade does not secure a successful outcome.
Payment is due within 15 days of the client’s receipt of reimbursement.

Refunds are not applicable since compensation is contingent upon success.

Confidentiality and Data Use

Suade adheres to strict confidentiality and compliance standards:

All client information is stored securely and managed in compliance with HIPAA and the California Medical Information Act (CMIA).
Data provided by clients may be anonymized and aggregated to improve Suade’s advocacy services. Any identifiable information shared for advocacy purposes will be limited to first name, last initial, and partial insurance member ID, ensuring privacy.
Suade may utilize third-party HIPAA-compliant services (e.g., fax, email, secure storage systems) to facilitate our Services.

Clients may revoke consent for data use at any time by providing written notice to Suade. Such revocation will not apply retroactively to ongoing or completed advocacy efforts.

Disclaimer of Guarantees

While Suade advertises an 87% success rate, we do not guarantee any specific outcome for your case. Outcomes vary based on individual circumstances, insurer policies, and regulatory frameworks.

Our Services are provided on a best-effort basis and "as is." Suade makes no warranties, express or implied, regarding the likelihood of success or any financial recovery.

Intellectual Property and Proprietary Rights

Suade’s advocacy processes, tools, and methodologies are proprietary and protected under intellectual property laws. By engaging with Suade, you agree not to copy, replicate, reverse-engineer, or misuse any aspect of our proprietary technologies or processes.

Any feedback or suggestions provided to Suade may be used by us without restriction to improve our Services.

Termination of Services

Either party may terminate the engagement at any time by providing written notice. Upon termination:

Suade will cease all advocacy efforts related to your case.
Any obligations related to confidentiality and indemnification will remain in effect.

Suade reserves the right to discontinue Services if:

The client provides inaccurate or incomplete information.
The client’s behavior undermines the advocacy process.
There are unforeseen circumstances that make continuation impractical or impossible.

Dispute Resolution

Any disputes arising from these Terms or Suade’s Services shall be resolved through mediation or binding arbitration, as mutually agreed by both parties. Arbitration shall be conducted under the rules of the American Arbitration Association and governed by the laws of the State of California. Class actions are expressly waived.

Affiliate Program

Suade may offer an affiliate program to incentivize referrals. Details regarding affiliate eligibility, compensation, and terms will be outlined in a separate agreement. Affiliates must adhere to Suade’s guidelines and ensure compliance with all applicable laws.

Limitation of Liability

Suade’s liability is limited to the fees paid by the client within the 12 months preceding the claim. Suade shall not be liable for indirect, incidental, or consequential damages, including lost profits.

Governing Law and Jurisdiction

These Terms are governed by the laws of the State of California. Any disputes not subject to arbitration will be resolved in the courts of California.

Contact Information

For questions or support, please contact Suade:

Phone: 949-345-0808
Email: support@suade.health