Terms of Service

Last updated: August 15, 2026

1. Acceptance of Terms

By accessing and using Optimize AI Tech's services, you agree to be bound by these Terms of Service and all applicable laws and regulations. These terms apply to website access, demonstrations, self-service use, and any use not governed by a separate signed agreement. Where a signed agreement, order form, Business Associate Agreement, data-processing agreement, or other written agreement exists between Optimize AI Tech and your organization, that agreement prevails over these terms to the extent of any conflict. If you do not agree with these terms, you are prohibited from using or accessing our services.

2. Service Description

Optimize AI Tech provides AI-powered healthcare workflow support for clinical documentation, documentation and coding gap analysis, and revenue-cycle operations, including:

• Ambient documentation and encounter-context support
• Documentation and coding gap analysis with reviewer-controlled clarification queries
• Suggested diagnosis and procedure-coding support
• Claim-readiness review and audit-trail reporting
• Analytics, configuration, and operational reporting

3. Use of Services

You agree to:

• Provide accurate and complete information when using our services
• Maintain the security of your account credentials
• Use the services in compliance with applicable healthcare regulations, including patient-privacy law
• Submit data to the platform only where you have the legal right to do so
• Ensure that all clinical, coding, billing, claim, appeal, medical-necessity, and payer-submission decisions are reviewed and approved by qualified personnel before use
• Maintain responsibility for payer-specific rules, government-program rules, coding compliance, documentation sufficiency, and medical-record accuracy
• Configure and maintain any client-specific coding rules, payer rules, templates, prompts, edits, approval workflows, and organization policies accurately and lawfully
• Review warnings, confidence signals, unsupported-documentation flags, and other alerts presented by the services before relying on any output
• Not override, suppress, or ignore platform warnings or known errors in a way that causes false, inaccurate, unsupported, or misleading documentation, coding, billing, or claim activity
• Not attempt to circumvent or disable any security features
• Not use the services for any illegal or unauthorized purpose

4. Nature of AI Output

The platform uses generative artificial intelligence and its output is probabilistic and non-deterministic: identical inputs may produce differing output. As with all generative artificial intelligence, output may be incomplete, incorrect, outdated, or inconsistent with current coding guidelines, payer policies, medical-necessity rules, or government-program requirements. Output is advisory and supports rather than replaces professional judgment. The service is designed for reviewer-controlled workflows: suggestions may be copied by the user or pushed back to the EHR only after client-authorized review or confirmation, and should not be relied on as final clinical, coding, billing, claim, appeal, or payer-submission decisions without that review.

Each recommendation is presented with its source text and rationale so that the professional user can independently review the basis for it. The platform is not a medical device, does not practise medicine, and does not provide medical care; responsibility for clinical decisions remains with the treating clinician. We do not guarantee reimbursement, claim acceptance, or the outcome of any audit, appeal, or payer review, and the client remains responsible for compliance with payer rules and applicable law, including, in the United States, the False Claims Act.

In particular, the information and suggestions provided by our platform:

• Are not medical opinions, diagnoses, or billing determinations
• Should not be used as the sole basis for medical, coding, or billing decisions
• Are meant to support, not replace, professional healthcare and coding judgment
• Must be verified by qualified professionals before any clinical, coding, or claim use

Responsibility for the accuracy, completeness, medical necessity, legal support, and submission of claims to any commercial payer, Medicare, Medicaid, government program, regulator, or other authority, and for the content of the medical record, remains at all times with the client and its qualified staff.

5. Coding Assistance and Government-Program Compliance

Medical Copilot is designed as a documentation and coding assistance tool. Coding, documentation, and reimbursement-related recommendations generated by the services are based on the clinical documentation and other information made available to the services, together with applicable configured coding rules, payer policies, and reference materials. The services are not designed or intended to intentionally upcode, downcode, inflate reimbursement, create unsupported diagnoses or services, or otherwise alter coding for the purpose of obtaining reimbursement not supported by applicable documentation.

The services provide recommendations and decision support only. The client and its qualified healthcare professionals, coding personnel, billing personnel, and compliance personnel remain responsible for reviewing the underlying documentation, determining whether each diagnosis, procedure, service, code, modifier, level of service, clarification query, appeal statement, certification, or other submission is adequately supported, and making the final decision regarding documentation, coding, billing, certification, and submission of any claim.

The client shall not use the services to knowingly submit or cause the submission of false, inaccurate, unsupported, or misleading claims, codes, diagnoses, services, modifiers, documentation, attestations, or certifications to any payer, Medicare, Medicaid, CMS, government healthcare program, regulator, or other authority. The services may identify coding or documentation issues that increase, decrease, or do not change reimbursement, and the client is responsible for treating those outputs symmetrically according to the documentation and applicable rules, not according to reimbursement impact.

If the client identifies an error, unsupported code, unsupported diagnosis, overpayment, duplicate billing issue, or other inaccurate submission after using the services, the client remains responsible for investigating, correcting, withdrawing, refunding, disclosing, or otherwise remediating the matter as required by applicable law, payer contract, government-program rule, or the client's compliance program. The client must not continue using a known erroneous configuration, rule, template, integration, or workflow in a way that causes or contributes to inaccurate submissions.

The services do not autonomously submit claims to Medicare, Medicaid, CMS, any government healthcare program, or any commercial payer. Any claim submission, certification, attestation, appeal, or payer communication must be initiated, reviewed, and authorized by the client or its authorized personnel through the client's systems and workflows.

Where supported by the applicable service configuration, Medical Copilot may create audit and decision records showing source documentation, generated suggestions, warnings, reviewer actions, overrides, timestamps, and user or organization identifiers. These records are intended to support review, compliance, appeal, and audit workflows, but they do not replace the client's obligation to maintain legally sufficient medical records, claim records, and compliance documentation.

6. Ambient Documentation and Clinical Review

Ambient documentation features, if enabled, process audio or conversation content from healthcare encounters to generate draft transcripts, summaries, notes, documentation suggestions, coding-related context, or other encounter-support output. Audio processing may be transient during a live session, and temporary encrypted transcripts, session artifacts, or processing logs may be retained only as described in the applicable agreement, Business Associate Agreement, Privacy Notice, product configuration, or retention setting.

The client is responsible for determining when notice, patient consent, participant consent, staff consent, or other authorization is required for recording, transcription, ambient listening, or AI-assisted documentation, and for obtaining and documenting that notice or consent before using ambient features. If the services provide consent prompts, labels, logs, configuration options, or other consent-support tooling, those tools are provided to assist the client's workflow and do not replace the client's legal responsibility.

Ambient documentation output is draft clinical documentation support only. A licensed clinician or other qualified professional designated by the client must review, edit, and approve the content before it becomes part of the medical record or is used for clinical, coding, billing, claim, referral, prior-authorization, or payer-submission purposes. The services have no autonomous clinical authority and do not make independent clinical decisions.

The client is responsible for considering the rights and expectations of all encounter participants, including patients, clinicians, interpreters, family members, caregivers, trainees, and other individuals whose speech or information may be captured or processed.

7. Data and Privacy

Each party retains ownership of its own data. The client grants Optimize AI Tech a limited right to process client data solely to provide, secure, support, and improve the services for that client. The services are designed to minimize patient-identifying information: where possible, Optimize AI Tech uses encounter identifiers and limited clinical context rather than patient names, social security numbers, addresses, or direct contact details. However, clinical notes, recordings, transcripts, or free text supplied by a client may contain protected health information or other regulated data. Where United States law applies and the services involve protected health information, clinical data is processed under a Business Associate Agreement. Our data practices are described in our Privacy Notice.

Optimize AI Tech does not use identifiable protected health information from client clinical data to train generalized models for other clients. Any service improvement, evaluation, quality assurance, support, or model-related processing involving client clinical data is limited by the applicable agreement, Business Associate Agreement, product configuration, and data-protection commitments.

8. Third-Party Services, Integrations, and Client Modifications

The services may rely on third-party cloud infrastructure, model providers, analytics tools, payment processors, communication tools, EHR integrations, coding references, and other vendors or subprocessors. Their systems, availability, terms, and performance may affect the services. Optimize AI Tech is not responsible for third-party services outside its reasonable control, but will use commercially reasonable efforts to select and manage service providers appropriate for the services.

The client is responsible for downstream modifications, custom rules, client-created templates, prompts, mappings, interface configurations, automation settings, EHR or billing-system integrations, middleware, exports, imports, and other systems or workflows that the client or its vendors configure, control, or operate. Optimize AI Tech is not responsible for errors, omissions, unsupported submissions, data loss, claim changes, or compliance failures caused by client-controlled configurations, downstream integrations, or modifications outside Optimize AI Tech's reasonable control.

9. Warranty and Liability

While we strive for accuracy and reliability in our services:

• Our services are provided "as is" without any warranties, express or implied
• We do not guarantee the accuracy, completeness, or timeliness of our services
• We do not guarantee reimbursement, payment, coding accuracy, claim acceptance, audit outcome, appeal outcome, medical necessity, or payer or regulator agreement with any code, diagnosis, documentation, or claim position
• To the maximum extent permitted by law, we are not liable for indirect, incidental, special, exemplary, punitive, or consequential damages, including lost profits, lost revenue, loss of goodwill, loss of use, loss of data, business interruption, claim denials, delayed payments, payer recoupments, overpayment demands, audit losses, medical-record correction costs, penalties, fines, sanctions, or amounts arising from information submitted to payers, government programs, regulators, patients, or other authorities
• To the maximum extent permitted by law, Optimize AI Tech's aggregate liability arising out of or relating to the services, these terms, any website use, demonstration, pilot, beta, evaluation, order, or related transaction shall not exceed the fees actually paid to Optimize AI Tech for the affected services during the 12 months immediately preceding the event giving rise to the claim. For free trials, beta access, pilots, demonstrations, or evaluation use, liability is excluded to the maximum extent permitted by law unless a signed agreement states otherwise
• The liability limitations apply in the aggregate across all claims and theories of liability, whether in contract, tort, negligence, strict liability, statute, indemnity, or otherwise, and regardless of whether the alleged damages arise from AI output, client review, client configuration, downstream integration, payer submission, audit activity, overpayment, or regulatory action

10. Indemnification

The client shall defend, indemnify, and hold harmless Optimize AI Tech from and against any third-party claims, penalties, investigations, demands, and losses, including those brought by payers, regulators, government programs, patients, or commercial counterparties, to the extent arising from claims or records submitted by the client, the client's clinical or coding decisions, the client's breach of these terms, the client's failure to obtain required rights, notices, consents, or licenses, the client's downstream modifications or integrations, client-configured rules or workflows, or reliance on output without the qualified review described in these terms.

11. Intellectual Property

All content, features, and functionality of our service are owned by Optimize AI Tech and are protected by international copyright, trademark, and other intellectual property laws. You receive a limited license to use our services as intended.

Third-party content. Current Procedural Terminology (CPT®) is copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. The services may display CPT codes and descriptors and other third-party code sets solely to support clinical documentation and coding workflows. No fee schedules, basic units, relative values, or related listings are endorsed by the American Medical Association, and the American Medical Association is not recommending their use. The client is responsible for ensuring that it holds all licenses and permissions required for its use of CPT and any other third-party code set accessed through the services, whether granted directly, through a national or governmental licensing arrangement, or otherwise.

12. Confidentiality

You agree to maintain the confidentiality of any sensitive information accessed through our services, including but not limited to:

• Healthcare provider information
• Insurance claim details
• System access credentials
• Technical documentation

13. Payment Terms

Services are sold under written agreements between Optimize AI Tech and the client, which set out fees and payment terms, or through self-service purchases on our website. Self-service payments are processed by Lemonsqueezy.com as Merchant of Record, in which case Lemonsqueezy handles payment processing, appears on your statement, provides payment-related support, and applies its own terms of service.

14. Trials, Pilots, and Beta Features

Unless a signed agreement states otherwise, demonstrations, pilots, sandbox environments, beta features, and evaluation access are provided for evaluation and configuration purposes only and should not be used for production clinical, coding, billing, claim, appeal, or payer-submission decisions. Beta features may be changed, suspended, or withdrawn at any time.

15. Term and Termination

We may suspend or terminate access for material breach of these terms. On termination of a client agreement, client data is returned or deleted as described in that agreement and our Privacy Notice.

16. Service Modifications

We reserve the right to modify or discontinue our service at any time without notice. We shall not be liable for any modification, suspension, or discontinuance of the service.

17. General

If any provision of these terms is held unenforceable, the remaining provisions continue in full force. These terms, together with any signed agreement and the Privacy Notice, form the entire agreement regarding the services.

18. Governing Law

These terms shall be governed by and construed in accordance with the laws of the State of Texas, United States, without regard to conflict-of-law rules. Any disputes shall be brought in the state or federal courts located in Texas, unless a signed agreement with your organization specifies otherwise.

19. Contact Information

For questions about these terms, please contact: legal@medcopilot.co