Acceptable Use & Honest Engagement Policy
Medical Bill Forensics LLC operates as an independent forensic auditing firm. To maintain the integrity of our forensic products and ensure compliance with federal and state regulations, all users of this website must adhere to the following standards of honest engagement.
1. Authenticity of Documentation
By uploading a document to our HIPAA compliant portal, you certify and warrant that the itemized bill is a true, accurate, and unaltered copy of an original statement issued to you by a healthcare provider. The submission of “doctored,” forged, or otherwise tampered-with billing statements is a violation of these terms. Medical Bill Forensics LLC reserves the right to report suspected document forgery to the appropriate law enforcement authorities.
2. Authorized Access and Agency
Our services are designed to protect the rights of patients and their legal guardians. You agree that you will only submit billing statements for which:
- You are the named patient on the bill;
- You are the legal guardian or possess a valid Power of Attorney for the patient named on the bill; or
- You are a specifically authorized representative with a legal right to access the patient’s medical billing records. Using this service to audit the private financial records of a third party without explicit legal authorization is strictly prohibited.
3. Prohibition of Deceptive Practices
The forensic reports generated by this firm are intended to identify structural and mathematical discrepancies in medical demands for payment (e.g. medical bills). You agree not to use our reports, findings, or branding to engage in criminal activity. We reserve the right to report suspicious activity, which may be criminal in nature, to the proper law enforcement authorities. Non-limiting examples of suspicious or criminal activity we report are:
- Accessing or attempting to access an individuals private medical record or obtaining their medical information without their express written consent (e.g. you are not a healthcare provider, provider organization, legal representative, advocate, or surrogate for the patietnt).
- Facilitation and/or submit fraudulent insurance claims;
- Supporting and/or engaging in illegal medical-related tax deductions;
- Engageing in any form of “double-dipping” or deceptive financial recovery.
4. Technical Integrity and Non-Interference
Users are prohibited from attempting to breach the technical security of our HIPAA-compliant data environment. We report attempted breaches and technical interference to our HIPAA portal provider. This technical integrity interference includes, but is not limited to:
- Using automated systems (bots, scrapers, spiders) to access our portal;
- Introducing viruses, trojans, or malicious code into the upload interface;
- Attempting to decompile or “reverse engineer” the forensic logic used in our reporting.
5. Good Faith Engagement
Medical Bill Forensics LLC provides a professional product based on HIPAA Standard Code Sets and Federally Mandated Billing Practices. We expect users to engage in the process in good faith as they interact with our website and engage our firm. We do not tolerate “test” uploads of fabricated data designed to manipulate our forensic algorithms.
6. Right to Terminate and Liquidated Damages
Medical Bill Forensics LLC reserves the right, at its sole discretion, to refuse service, cancel pending audits, and permanently ban any user found to be in violation of this policy.
- Non-Refundable Fees: In the event that an audit is cancelled due to the submission of forged documents, fraudulent data, or unauthorized third-party records, all fees paid by the user are non-refundable.
- Liquidated Damages: These fees will be retained as liquidated damages to cover the professional and administrative time required to identify and address the breach of this policy.
7. Contact and Reporting
If you become aware of any unauthorized use of your billing data or a breach of this policy, please contact us immediately here.