Insurance Adjuster/Payer User Agreement

Welcome to Trust Certified LLC (“Trust Certified,” “we” or “us“) and to the Trust Certified website and system (the “TC System,” “Site,” or “System”). Trust Certified is in the business of, among other things, helping patients, insurance adjusters, and other payors of medical services (collectively “Payors”) identify, select, and communicate with physicians and providers of healthcare. Trust Certified collects data and other information from numerous sources, including physicians and their practices, to improve healthcare by identifying and rewarding providers who are focused on the best health outcomes for their patients. We do this pursuant to the Trust Certified System.

Trust Certified member physicians (collectively, “Healthcare Providers“; also referred to as “Providers” and individually as a “Provider”) submit information to us that enables us to list those Providers for review by potential users of their services, including to parties engaged in the business of insurance, medical claims, and decisions relating to the selection of physicians (“Insurance Adjusters/Payers,” “You,” “you”), thereby allowing Insurance Adjusters/Payers to make more informed decisions regarding the appropriate Healthcare Provider for their needs. 

1. Overview

This Insurance Adjuster/Payer User Agreement (“Insurance Adjuster/Payer Agreement“), as it might be revised from time to time, governs among other things (i) your access to and use of this TC System and its related products and services, including TC System Materials, (ii) your provision of any and all information to Trust Certified by any means and at any time after clicking “I Agree,” (iii) your receiving communications from us with respect to this TC System and related products and services and other Trust Certified products and services, and (iv) membership in the Trust Certified system (“System”). Trust Certified has the right to accept or reject any member in its sole discretion to the System.

This Insurance Adjuster/Payer User Agreement constitutes a binding agreement between you and Trust Certified. PLEASE NOTE THAT WE RESERVE THE RIGHT, AT OUR SOLE DISCRETION, TO CHANGE THIS INSURANCE ADJUSTER/PAYER USER AGREEMENT FROM TIME TO TIME. YOUR CONTINUED USE OF THIS TC SYSTEM AFTER ANY SUCH CHANGE TAKES EFFECT WILL BE DEEMED TO CONSTITUTE YOUR ACCEPTANCE OF AND AGREEMENT TO THE NEW INSURANCE ADJUSTER/PAYER AGREEMENT. PLEASE READ THIS INSURANCE AJDUSTER / PAYER AGREEMENT CAREFULLY BEFORE USING THIS TC SYSTEM. BY CLICKING ON “I AGREE,” OR BY USING THIS TC SYSTEM OR OTHERWISE ENGAGING WITH TRUST CERTIFIED, YOU, ON BEHALF OF YOURSELF OR YOUR ENTITY, AS APPLICABLE, ACKNOWLEDGE AND CONFIRM THAT:

(A) YOU HAVE READ AND UNDERSTAND ALL OF THE TERMS AND CONDITIONS OF THIS INSURANCE ADJUSTER/PAYER AGREEMENT;

(B) YOU EITHER ARE THE INSURANCE ADJUSTER/PAYER IDENTIFIED IN THE PROFILE ACCESSED THROUGH THIS TC SYSTEM (THE “PROFILE”), OR ARE WORKING WITH THE EXPRESS AUTHORIZATION OF THE INSURANCE ADJUSTER/PAYER IDENTIFIED IN THE PROFILE;

(C) YOU OR YOUR ENTITY, AS APPLICABLE, AGREE TO BE BOUND BY ALL OF THE TERMS AND CONDITIONS OF THIS INSURANCE ADJUSTER/PAYER AGREEMENT AND ACKNOWLEDGE THAT THIS INSURANCE ADJUSTER/PAYER AGREEMENT IS THE LEGAL EQUIVALENT OF A SIGNED, WRITTEN CONTRACT BETWEEN TRUST CERTIFIED AND YOU OR YOUR ENTITY, AS APPLICABLE; AND 

(D) IF USING THIS TC SYSTEM ON BEHALF OF YOUR ENTITY, YOU HAVE FULL AUTHORITY TO BIND YOUR ENTITY TO ALL OF THE TERMS AND CONDITIONS OF THIS INSURANCE ADJUSTER/PAYER AGREEMENT AND YOU HEREBY DO BIND YOUR ENTITY.

IF YOU OR YOUR ENTITY, AS APPLICABLE, ARE NOT WILLING TO BE BOUND BY ALL TERMS AND CONDITIONS OF THIS AGREEMENT, INCLUDING WITHOUT LIMITATION THE PRECEDING ACKNOWLEDGEMENT AND AGREEMENT, THEN DO NOT SELECT THE ‘I AGREE’ BUTTON ASSOCIATED WITH THIS INSURANCE ADJUSTER/PAYER AGREEMENT AND DO NOT ACCESS OR USE OUR TC SYSTEM. TRUST CERTIFIED DOES NOT AND WILL NOT GRANT YOU ANY RIGHT OR LICENSE TO ACCESS OR USE THIS TC SYSTEM, TC SYSTEM MATERIALS OR THE RELATED PRODUCTS OR SERVICES.

2. No Referrals or Recommendations

Trust Certified neither acts as a referral service nor recommends or endorses any particular Healthcare Provider. Rather, Trust Certified acts as an intermediary that provides selected information about Healthcare Providers. Trust Certified uses its proprietary processes and system to select, compile, train, certify, and identify various Healthcare Providers. On its Site, when requested by an Insurance Adjuster/Payer, Trust Certified may make available certain information, profiles and materials regarding Healthcare Providers (the “Site Materials“).

The Healthcare Provider information consists of identification of potential providers and not recommendations to utilize the services of any specific Healthcare Provider. You acknowledge and agree that if and when you access, browse or use any portion of the Site and the TC System, or if you use any of the Site Materials, then such access, browsing or use is subject to all terms and conditions which can be accessed at https://trustcertified.org/terms-and-conditions/.

Trust Certified may facilitate communications between Payors and Healthcare Providers.

3. Registering and Password Maintenance

If you wish to access and use this TC System, then you must choose a password and/or provide other security information during your completion of this TC System’s registration process. By registering, you represent, warrant and covenant that: 

• you are the insurance adjuster/payer identified in the Profile, or are expressly authorized to act on behalf of the insurance adjuster/payer identified in the Profile and are at least 18 years of age; 
• you are using your actual identity and you have provided only true, accurate, complete and current information about yourself and, if you are not the insurance adjuster/payer him- or herself, the insurance adjuster/payer during the registration process; and
• you will maintain and promptly update the information that you provide to keep it true, accurate, current and complete. You may update your information at any time by logging into the TC System and clicking on “Account Log In.”

By logging onto this TC System using any password, you represent, warrant and covenant that you are authorized to use such password and to engage in the activities that you conduct therein. You are solely responsible for the confidentiality and use of your password and/or security information, as well as for any activities conducted on or through this TC System using your password and/or security information. If you wish to cancel a password, or if you become aware of any loss, theft or unauthorized use of a password, please notify us immediately. We reserve the right to delete or change any password and/or security information at any time and for any reason.

 

4. License

Within this TC System, and should you engage with Trust Certified in other ways that supplement the activities of this TC System, Trust Certified may make available certain analytics, statistics and other information and materials sourced either by Trust Certified or third parties (collectively the “TC System Materials“). Upon your Insurance Adjuster/Payer Agreement Acceptance, Trust Certified grants you a revocable, non-exclusive, non-transferable, limited license to access and view this TC System and the TC System Materials solely for your non-commercial, view-only, personal use and not for resale, disclosure or distribution to anyone else. All rights not expressly granted to you herein are reserved by Trust Certified; there are no implied licenses under this Insurance Adjuster/Payer Agreement. The license granted to you in this Insurance Adjuster/Payer Agreement is expressly conditioned on your continued compliance with this Insurance Adjuster/Payer Agreement.

5. Ownership

As between you and Trust Certified, all right, title and interest in and to the TC System and TC System Materials, together with all intellectual property rights embodied therein, are the property of Trust Certified, Trust Certified’ affiliates or Trust Certified third party licensors. The TC System and TC System Materials are protected by law, including but not limited to U.S. and international copyright law, trademark law, trade secret law, as well as other state, federal, and international laws, regulations and treaties. Trust Certified does not claim any rights in unaltered government data.

6. Your Information; and Our Relationship

Upon clicking “I Agree,” or otherwise engaging the services of Trust Certified, you agree to each of the following: 

• You may provide material and information to Trust Certified for the purpose of your finding and selecting Providers
• Materials that you provide for the above purpose shall be complete and accurate to the best of your knowledge
• Trust Certified may rely upon those materials to assist you in finding and selecting Providers
• Trust Certified will endeavor to identify Providers that are likely to be appropriate matches for the provision of medical services that you as an Insurance Adjuster/Payer may be seeking and specifically request on the TC System

• You authorize Trust Certified to conduct discussions with Medical Providers in order to bring to you potentially suitable Providers for your specific requirements
• Trust Certified makes no representations or warranties as to its ability to identify a Provider to you, or as to the outcome(s) of such relationship that may ensue between you, the patients entrusted to you, and the Provider, should you choose to engage a Provider ; 

• You agree that Trust Certified may contact you and/or your entity, via telephone, e-mail, facsimile or other appropriate means about Trust Certified products and services.

7. Term and Termination

This Insurance Adjuster/Payer Agreement will take effect at the time you click “I Agree” or use this TC System or execute any other electronic form of this Agreement. We reserve the right, at any time and for any reason, without notice to you: (a) to deny you access to this TC System or related products or services; (b) to change, remove or discontinue this TC System or any related products or services; or (c) to terminate this Insurance Adjuster/Payer Agreement. Upon termination of this Insurance Adjuster/Payer Agreement, you may no longer access, browse or use this TC System.

8. Confidentiality on the Internet; Communications with Trust Certified

Use of the Internet is solely at your own risk and is subject to all applicable local, state, federal, and international laws and regulations. While we have endeavored to create a secure and reliable website, please be advised that the confidentiality of any communication or material transmitted to us over the Internet cannot be guaranteed. Consequently, neither we nor our affiliates are responsible for the security of any information transmitted via the Internet or the accuracy of the information contained on this Site.

Should you elect to send or receive e-mail communications of any kind to or from Trust Certified, you represent to Trust Certified that your e-mail service has appropriate and adequate security systems necessary to prevent unauthorized access to outbound or inbound e-mail transmissions, such that Trust Certified may rely upon the information in such e-mail communications. You also agree that Trust Certified may use de-identified information received from you and from users in accordance with the provisions of Trust Certified’ privacy policy. You agree that you will not transmit any protected health information, as that term is defined in the Health Insurance Portability and Accountability Act, to us through the TC System, or by any other means.

9. TC System Monitoring

We reserve the right to view, monitor and record activity on this TC System without notice to or permission from you. We may disclose any non-confidential information, materials, or other content of any kind at our sole discretion.

10. Events Beyond Our Control; Disclaimers; Limitations of Liability

You absolve and release us and our affiliates from any claim of harm resulting from any cause(s) over which we or they do not have direct control, including but not limited to failure of electronic or mechanical equipment or communication lines, telephone or other interconnect problems, computer viruses or other damaging code or data, unauthorized access, theft, operator errors, severe weather, earthquakes, natural disasters, strikes or other labor problems, wars, or governmental restrictions.

THIS TC SYSTEM AND THE RELATED PRODUCTS AND SERVICES, INCLUDING TC SYSTEM MATERIALS, ARE PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS. THE TC SYSTEM AND THE RELATED PRODUCTS AND SERVICES, INCLUDING TC SYSTEM MATERIALS, MIGHT CONTAIN TECHNICAL OR OTHER INACCURACIES OR TYPOGRAPHICAL ERRORS.

TO THE FULLEST EXTENT PERMISSIBLE PURSUANT TO APPLICABLE LAW, WE DISCLAIM ALL WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED OR STATUTORY, INCLUDING BUT NOT LIMITED TO: (A) ANY WARRANTIES CONCERNING THE AVAILABILITY, ACCURACY, RELIABILITY, COMPLETENESS, CURRENCY, QUALITY, PERFORMANCE OR SUITABILITY OF THIS TC SYSTEM AND THE RELATED PRODUCTS AND SERVICES, INCLUDING TC SYSTEM MATERIALS; AND (B) ANY IMPLIED WARRANTIES OF TITLE, NON-INFRINGEMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. WE MAKE NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED OR STATUTORY, THAT THIS TC SYSTEM OR THE RELATED PRODUCTS AND SERVICES, INCLUDING TC SYSTEM MATERIALS, WILL ASSIST YOU IN YOUR PRACTICE OR FOR ANY OTHER PURPOSE. WE DO NOT REPRESENT OR WARRANT THAT THIS TC SYSTEM OR THE RELATED PRODUCTS OR SERVICES, INCLUDING TC SYSTEM MATERIALS, WILL BE UNINTERRUPTED, ERROR-FREE, OR FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS, OR THAT DEFECTS, IF ANY, WILL BE CORRECTED. YOU EXPRESSLY AGREE THAT YOUR USE OF THIS TC SYSTEM AND THE RELATED PRODUCTS AND SERVICES, INCLUDING TC SYSTEM MATERIALS, IS ENTIRELY AT YOUR OWN RISK. FURTHER, WE EXPRESSLY DISCLAIM ANY AND ALL RESPONSIBILITY AND LIABILITY WITH RESPECT TO SEPARATE AGREEMENTS YOU MAY MAKE WITH PATIENTS, CONSUMERS OR SITE USERS, AND YOU WILL LOOK SOLELY TO SUCH PERSONS AND/OR ENTITIES WITH RESPECT TO ANY AND ALL CLAIMS ARISING OUT OF SUCH AGREEMENTS.

NEITHER WE NOR OUR AFFILIATES WILL BE LIABLE FOR ANY DAMAGES RESULTING FROM YOUR USE OF, OR RELIANCE UPON, THIS TC SYSTEM OR ITS RELATED PRODUCTS AND SERVICES, INCLUDING TC SYSTEM MATERIALS. IN THE EVENT OF ANY PROBLEM WITH THIS TC SYSTEM OR THE RELATED PRODUCTS OR SERVICES, INCLUDING TC SYSTEM MATERIALS, YOUR SOLE REMEDY IS TO CEASE USING THIS TC SYSTEM AND THE RELATED PRODUCT OR SERVICE AND TC SYSTEM MATERIALS.

UNDER NO CIRCUMSTANCES WILL WE OR OUR AFFILIATES, OR ANY OF OUR OR THEIR RESPECTIVE DIRECTORS, OFFICERS, SHAREHOLDERS, PROPRIETORS, PARTNERS, EMPLOYEES, AGENTS, REPRESENTATIVES, SERVANTS, ATTORNEYS, PREDECESSORS, SUCCESSORS OR ASSIGNS, BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, PUNITIVE, EXEMPLARY OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT NOT LIMITED TO, LOST PROFITS AND DAMAGES THAT RESULT FROM INCONVENIENCE, DELAY, OR LOSS OF USE) ARISING OUT OF USE OF THIS TC SYSTEM, OR ANY RELATED PRODUCTS OR SERVICES,INCLUDING THE TC SYSTEM MATERIALS, EVEN IF WE OR THEY HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. Some states do not allow the exclusion or limitation of liability for consequential or incidental damages; thus, this limitation might not apply to you.

11. Indemnity

You will defend, indemnify, and hold harmless Trust Certified and our affiliates, and our and their respective directors, officers, shareholders, proprietors, partners, employees, agents, representatives, servants, attorneys, predecessors, successors and assigns, from and against any and all claims, proceedings, damages, injuries, liabilities, losses, costs and expenses (including reasonable attorneys’ fees and litigation expenses), relating to or arising from (a) your use of this TC System and/or any related products or services, including the TC System Materials, (b) your otherwise engaging with Trust Certified to obtain the services offered on this TC System, (c) any breach by you of this Insurance Adjuster/Payer Agreement, or (d) the services of Providers selected by you while using the Trust Certified referral System.

12. Governing Law and Selection of Venue

Regardless of the jurisdiction in which you work or reside, this Insurance Adjuster/Payer Agreement is made in the State of Florida and will be construed and enforced in accordance with Florida law (without regard to its provisions governing conflicts of law), as applied to agreements entered into and completely performed in Florida, and except and to the extent that the Health Insurance Portability and Accountability Act (“HIPAA“) Privacy Rule applies to any health-related information you provide to Trust Certified (in which case such HIPAA Privacy Rule governs), the privacy laws of the State of Florida will govern.

ANY ACTION ARISING OUT OF THIS TC SYSTEM, TC SYSTEM MATERIALS OR ANY ACTION TO ENFORCE THIS INSURANCE ADJUSTER/PAYER AGREEMENT WILL BE BROUGHT ONLY IN THE FEDERAL OR STATE COURTS PRESIDING IN Punta Gorda, Florida, U.S.A., AND YOU EXPRESSLY AGREE TO BE SUBJECT TO THE JURISDICTION OF SUCH COURTS. USE OF THIS TC SYSTEM, TC SYSTEM MATERIALS IS LIMITED SOLELY TO PERSONS WHO AGREE TO RESOLVE ANY AND ALL DISPUTES PERTAINING TO THIS TC SYSTEM, TC SYSTEM MATERIALS IN THE FEDERAL AND STATE COURTS OF [Florida, AND SUCH AN AGREEMENT IS AN EXPRESS CONDITION TO USE OF THIS TC SYSTEM.

This TC System and the related products and services, including the TC System Materials, are controlled and operated by Trust Certified from its offices within the United States. We make no representation that this TC System, TC System Materials or the related products or services are appropriate or available for use outside of the United States, and access to this TC System or its related products or services from territories where its contents or purpose is illegal is prohibited. Those who choose to access this TC System from locations outside the United States do so of their own volition and are responsible for compliance with applicable local laws.

13. Notices; Contacting Trust Certified

Any notices to you may be sent to the e-mail address that you provide to us when you register and will be deemed given one business day after the e-mail is sent. If you have any questions about this Insurance Adjuster/Payer Agreement, or if you need to notify us, then contact us at info@trustcertied.com or at the following address: 

Trust Certified, LLC

602 Via Tunis

Punta Gorda, FL 33950

14. Miscellaneous

Failure to insist on strict performance of any provisions of this Insurance Adjuster/Payer Agreement will not operate as a waiver of any subsequent default or failure of performance. No waiver of any provision of this Insurance Adjuster/Payer Agreement will be valid unless in writing and acknowledged in writing or electronically by both parties. If any portion of this Insurance Adjuster/Payer Agreement is adjudged invalid or unenforceable by a court of competent jurisdiction, the remaining portions will remain valid, enforceable, and in effect, and the parties will promptly substitute for the invalid provision an enforceable provision which resembles the invalid provision as closely as possible in intent and economic effect. No joint venture, partnership, employment or agency relationship exists between you and Trust Certified as a result of this Insurance Adjuster/Payer Agreement or your use of this TC System. Providers that may be selected by Insurance Adjusters/Payers through Trust Certified are independent of Trust Certified. This Insurance Adjuster/Payer Agreement constitutes the entire agreement between you and Trust Certified with respect to your use of this TC System and supersedes any and all prior understandings or agreements between you and Trust Certified, whether written or oral. You acknowledge that, in providing you access to and use of this TC System, we have relied on your acceptance of this Insurance Adjuster/Payer Agreement.

15. Fees and Payments

Your membership on this TC System will continue, unless you terminate it OR if we terminate it for a violation of these Terms.

We have elected to offer free pricing for your use of the TC System.

If you choose to cancel your membership with Trust Certified, you must notify us by sending us an email at info@trustcertified.com.

 

16. Non-Circumvention.

You, as an Insurance Adjuster/Payer, understand and agree that a condition of the use of the TC System is to allow Trust Certified to monitor relationships between Insurance Adjusters/Payers and Providers. You agree not to utilize, either directly or indirectly, any confidential information of Trust Certified in order to circumvent the TC System. Furthermore, once a Provider has been offered and/or selected by the Insurance Adjuster/Payer through the TC System, you agree that you will continue to provide to Trust Certified such reasonably requested information relating to your activities with that Provider.

Date Last Updated: 4/18/23