{children}
Questions about this document? Contact{' '} legal@criterionmd.com {' '}or reach the team via the{' '} { e.preventDefault(); go('contact'); }} style={{ color: 'var(--accent)', fontWeight: 500 }}>Contact page.
LAST UPDATED · {updated}
)}Questions about this document? Contact{' '} legal@criterionmd.com {' '}or reach the team via the{' '} { e.preventDefault(); go('contact'); }} style={{ color: 'var(--accent)', fontWeight: 500 }}>Contact page.
These Terms of Use govern your access to and use of the websites, web pages, software interfaces, portals, content, tools, applications, and services made available by CriterionMD, including any domain or subdomain operated by CriterionMD, any CriterionMD product pages, and any login portals or software environments associated with CriterionMD products, including Insurify.
In these Terms, "CriterionMD," "we," "us," and "our" refer to CriterionMD and its affiliates, subsidiaries, owners, officers, directors, employees, agents, contractors, vendors, licensors, and representatives. "Site" refers to the CriterionMD website, product pages, portals, software interfaces, and related online services.
By accessing, browsing, registering for, or using the Site, you agree to these Terms. You also represent that you are at least eighteen years old, have the legal authority to accept these Terms, and will use the Site only in compliance with applicable law.
If you do not agree to these Terms, you should not access or use the Site.
CriterionMD may update these Terms at any time by posting revised Terms on the Site. Continued use of the Site after revised Terms are posted means you accept the revised Terms. CriterionMD may also modify, suspend, restrict, or discontinue any part of the Site or any related service at any time.
If any provision of these Terms is found to be invalid or unenforceable, the remaining provisions will remain in effect.
CriterionMD is a healthcare technology company building software products for physicians, advanced practice providers, medical practices, healthcare organizations, and related users.
CriterionMD products may include tools that assist with documentation review, medical necessity analysis, payer policy mapping, prior authorization preparation, appeal preparation, revenue cycle workflows, and related administrative or clinical-support functions.
The Site may include general company information, product descriptions, educational materials, account registration, software access points, login functionality, product dashboards, and other resources.
Unless a separate written agreement states otherwise, the Site is provided for informational, administrative, educational, and software-access purposes only.
CriterionMD does not provide medical advice, diagnosis, treatment recommendations, or independent clinical judgment.
CriterionMD does not practice medicine, provide healthcare services, establish a physician-patient relationship, or replace the professional judgment of licensed clinicians.
Any documentation prompts, payer policy references, medical necessity indicators, criteria matches, summaries, alerts, or software-generated outputs made available through the Site or any CriterionMD product are intended only to assist qualified healthcare professionals with documentation, administrative review, payer policy interpretation, or workflow support.
The treating clinician remains solely responsible for all clinical decisions, documentation, patient care decisions, procedure recommendations, coding decisions, billing decisions, authorization submissions, appeals, and compliance with applicable payer, professional, legal, and regulatory requirements.
The Site and CriterionMD products should not be used as the sole basis for medical, legal, billing, coding, reimbursement, compliance, or patient-care decisions.
CriterionMD may provide tools that assist users in comparing clinical documentation against payer policies, medical necessity criteria, or reimbursement-related requirements.
CriterionMD does not guarantee that any claim, prior authorization, appeal, procedure, service, CPT code, diagnosis code, documentation statement, or medical necessity submission will be approved, reimbursed, covered, accepted, or deemed compliant by any payer, government program, commercial insurer, Medicare contractor, Medicaid program, third-party administrator, employer plan, or other entity.
Payer policies, coverage criteria, coding rules, billing requirements, medical necessity standards, and regulatory requirements may change at any time. CriterionMD does not guarantee that information on the Site or within its products is complete, current, accurate, or applicable to any specific patient, payer, jurisdiction, procedure, service, or clinical circumstance.
Users are responsible for independently verifying payer policies, coding rules, coverage criteria, documentation requirements, and applicable laws before submitting any claim, authorization request, appeal, or healthcare-related documentation.
CriterionMD grants you a limited, revocable, non-exclusive, non-transferable license to access and use the Site for lawful purposes and in accordance with these Terms.
You may not reproduce, duplicate, copy, scrape, download, sell, resell, sublicense, distribute, modify, reverse engineer, or otherwise exploit any portion of the Site or its content for commercial purposes without CriterionMD's prior written consent.
This license terminates automatically if you violate these Terms.
Certain areas of the Site or certain CriterionMD products may be limited to licensed physicians, advanced practice providers, healthcare professionals, medical practices, healthcare organizations, authorized personnel, or other approved users.
CriterionMD may require account registration, identity verification, NPI verification, professional credential verification, email verification, organizational verification, or other eligibility review before granting access to certain products or services.
You agree that any information you provide to CriterionMD will be accurate, complete, and current. You agree not to misrepresent your identity, credentials, professional status, institutional affiliation, licensure, NPI number, authority to act on behalf of an organization, or eligibility to access any restricted part of the Site.
CriterionMD may deny, suspend, restrict, or terminate access to any user or account if CriterionMD determines that the user is ineligible, has provided inaccurate information, has violated these Terms, or presents a legal, compliance, security, operational, or reputational risk.
If you create an account, you are responsible for maintaining the confidentiality of your login credentials and for all activity under your account.
You agree not to share your username, password, authentication codes, access credentials, or account access with any unauthorized person. You agree to notify CriterionMD promptly if you suspect unauthorized access to your account or any security breach.
CriterionMD is not responsible for losses, damages, liabilities, or claims arising from unauthorized account access caused by your failure to protect your credentials.
CriterionMD takes healthcare data privacy seriously. Unless CriterionMD has entered into a written Business Associate Agreement or other applicable data protection agreement with you or your organization, you should not submit, upload, transmit, disclose, or enter protected health information, patient-identifiable information, or other regulated healthcare data into the Site or any CriterionMD system.
If CriterionMD offers products or services that involve protected health information or other regulated healthcare data, use of those products may be subject to a separate written agreement, Business Associate Agreement, data processing agreement, subscription agreement, enterprise agreement, or other applicable contract.
If these Terms conflict with a separate written agreement signed by CriterionMD, the separate written agreement will control for the subject matter it covers.
You are responsible for ensuring that your use of the Site and any CriterionMD product complies with HIPAA, HITECH, state privacy laws, professional obligations, payer requirements, institutional policies, patient consent requirements, and all other applicable legal and regulatory obligations.
You agree to use the Site only for lawful purposes and in accordance with these Terms.
You may not use the Site in any way that violates applicable federal, state, local, or international law.
You may not use the Site to submit false, misleading, fraudulent, unlawful, defamatory, obscene, abusive, threatening, harassing, discriminatory, or otherwise inappropriate content.
You may not use the Site to generate, support, submit, or facilitate false claims, fraudulent billing, improper coding, medically unnecessary services, misleading documentation, or any other unlawful healthcare, billing, coding, reimbursement, or compliance activity.
You may not upload, transmit, or distribute viruses, malware, trojan horses, worms, time bombs, bots, malicious code, corrupted files, or other harmful software or content.
You may not attempt to gain unauthorized access to the Site, user accounts, computer systems, servers, networks, databases, source code, APIs, or related infrastructure.
You may not interfere with, disrupt, overload, damage, disable, impair, or compromise the Site or any server, network, system, or resource connected to the Site.
You may not conduct denial-of-service attacks, credential stuffing, scraping, crawling, data mining, automated harvesting, vulnerability scanning, penetration testing, or similar activity without CriterionMD's prior written authorization.
You may not reverse engineer, decompile, disassemble, copy, modify, translate, or create derivative works from the Site, software, algorithms, workflows, prompts, databases, payer policy mappings, user interfaces, or other proprietary components.
You may not use the Site to train, develop, benchmark, or improve a competing product, artificial intelligence system, machine learning model, software tool, database, or commercial service without CriterionMD's prior written consent.
You may not remove, obscure, or alter copyright, trademark, proprietary, legal, or disclaimer notices.
You may not use CriterionMD's name, trademarks, logos, product names, branding, metadata, hidden text, or other identifiers without prior written permission.
You may not frame, mirror, embed, or display any portion of the Site on another website or service without CriterionMD's prior written consent.
You may not misrepresent your identity, affiliation, credentials, licensure, authority, or relationship with CriterionMD.
You may not use the Site in a manner that could harm CriterionMD, its users, patients, healthcare providers, payers, vendors, partners, or third parties.
Any outputs, suggestions, prompts, alerts, criteria matches, missing-documentation indicators, summaries, payer policy references, or other information generated or displayed by CriterionMD products are provided for assistive purposes only.
You are responsible for reviewing, validating, editing, and independently confirming all outputs before relying on them or using them in any clinical, billing, coding, compliance, authorization, appeal, administrative, or reimbursement-related workflow.
CriterionMD is not responsible for user-submitted information, incomplete documentation, inaccurate clinical facts, incorrect payer selection, outdated payer policies, coding mistakes, payer decisions, denial outcomes, claim outcomes, audit outcomes, professional discipline, regulatory review, or any other consequence arising from your use or misuse of the Site or any product output.
When you visit the Site, create an account, submit information through the Site, or send emails or other electronic communications to CriterionMD, you are communicating with CriterionMD electronically.
You consent to receive communications from CriterionMD electronically, including by email, account notification, product notification, or posting on the Site.
You agree that agreements, notices, disclosures, and other communications provided electronically satisfy any legal requirement that such communications be in writing.
The Site, including all content, software, source code, object code, user interfaces, workflows, designs, text, graphics, logos, icons, images, videos, documentation, databases, payer policy mappings, algorithms, product names, trademarks, service marks, and other materials, is owned by CriterionMD or its licensors and is protected by United States and international intellectual property laws.
CriterionMD reserves all rights not expressly granted in these Terms. Nothing in these Terms gives you any ownership interest in the Site, CriterionMD products, CriterionMD content, CriterionMD software, or CriterionMD intellectual property.
You may not use CriterionMD's trademarks, service marks, logos, trade names, product names, branding, or other proprietary identifiers without CriterionMD's prior written permission.
If you provide CriterionMD with comments, suggestions, ideas, recommendations, enhancement requests, bug reports, product feedback, or other feedback regarding the Site or CriterionMD products, you grant CriterionMD a perpetual, irrevocable, worldwide, royalty-free, fully paid, sublicensable, transferable license to use, reproduce, modify, distribute, display, perform, commercialize, and otherwise exploit that feedback for any purpose without restriction or compensation to you.
CriterionMD may use feedback to improve existing products, develop new products, refine workflows, enhance user experience, improve payer policy mapping, support research and development, or advance other business purposes.
If you submit, upload, enter, transmit, or otherwise provide content through the Site, you represent that you have all rights, permissions, consents, and authority necessary to provide that content and to permit CriterionMD to use it as reasonably necessary to operate, provide, maintain, secure, and improve the Site and related services.
You are solely responsible for the accuracy, legality, reliability, appropriateness, and completeness of any content you submit.
CriterionMD may monitor, review, remove, restrict, or refuse user-submitted content that CriterionMD determines may violate these Terms or create legal, compliance, operational, security, or reputational risk.
The Site may contain links to third-party websites, payer websites, government websites, professional society materials, vendor services, external policies, articles, tools, or other third-party resources.
These links are provided for convenience only. CriterionMD does not control and is not responsible for third-party websites, services, content, policies, practices, availability, accuracy, or security.
The inclusion of a third-party link does not imply endorsement, sponsorship, approval, affiliation, or recommendation by CriterionMD.
Your use of third-party websites or services is at your own risk and may be governed by separate terms and privacy policies.
CriterionMD's collection, use, storage, and disclosure of information is described in its Privacy Policy, which may be made available on the Site.
By using the Site, you acknowledge that you have reviewed the Privacy Policy and understand that CriterionMD may collect and use information as described in that policy.
If you access or use any CriterionMD product under a separate written agreement, additional privacy, security, data use, and confidentiality terms may apply.
You agree to indemnify, defend, and hold harmless CriterionMD and its affiliates, subsidiaries, owners, officers, directors, employees, agents, contractors, vendors, licensors, partners, and representatives from and against any claims, liabilities, damages, losses, judgments, penalties, fines, costs, expenses, and fees, including reasonable attorneys' fees, arising out of or relating to your use of the Site, your violation of these Terms, your violation of applicable law, your violation of payer rules or professional obligations, your user-submitted content, your clinical or administrative decisions, your misuse of any CriterionMD product or output, inaccurate or unlawful information submitted through your account, or activity occurring under your account.
CriterionMD reserves the right to assume the exclusive defense and control of any matter subject to indemnification. You agree to cooperate with CriterionMD's defense of any such claim. You may not settle any claim affecting CriterionMD without CriterionMD's prior written consent.
THE SITE AND ALL INFORMATION, CONTENT, SOFTWARE, PRODUCTS, SERVICES, OUTPUTS, TOOLS, FEATURES, AND MATERIALS MADE AVAILABLE THROUGH THE SITE ARE PROVIDED "AS IS," "AS AVAILABLE," AND "WITH ALL FAULTS."
TO THE FULLEST EXTENT PERMITTED BY LAW, CRITERIONMD DISCLAIMS ALL WARRANTIES AND REPRESENTATIONS OF ANY KIND, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHERWISE, INCLUDING WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, NON-INFRINGEMENT, ACCURACY, COMPLETENESS, RELIABILITY, AVAILABILITY, SECURITY, AND WARRANTIES ARISING FROM COURSE OF DEALING, USAGE, OR TRADE PRACTICE.
CRITERIONMD DOES NOT WARRANT THAT THE SITE OR ANY PRODUCT WILL BE UNINTERRUPTED, TIMELY, SECURE, ERROR-FREE, COMPLETE, CURRENT, ACCURATE, OR FREE FROM VIRUSES OR OTHER HARMFUL COMPONENTS.
CRITERIONMD DOES NOT WARRANT THAT ANY PRODUCT OUTPUT, DOCUMENTATION PROMPT, PAYER POLICY MAPPING, MEDICAL NECESSITY ANALYSIS, AUTHORIZATION SUPPORT TOOL, OR OTHER INFORMATION WILL RESULT IN APPROVAL, PAYMENT, COVERAGE, REIMBURSEMENT, COMPLIANCE, OR ANY PARTICULAR BUSINESS, CLINICAL, ADMINISTRATIVE, OR FINANCIAL OUTCOME.
CRITERIONMD DOES NOT WARRANT THAT ANY INFORMATION ON THE SITE REFLECTS THE MOST CURRENT PAYER POLICY, CODING REQUIREMENT, COVERAGE STANDARD, LEGAL REQUIREMENT, OR REGULATORY GUIDANCE.
TO THE FULLEST EXTENT PERMITTED BY LAW, CRITERIONMD AND ITS AFFILIATES, SUBSIDIARIES, OWNERS, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, CONTRACTORS, VENDORS, LICENSORS, PARTNERS, AND REPRESENTATIVES WILL NOT BE LIABLE FOR INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, PUNITIVE, OR ENHANCED DAMAGES, INCLUDING LOST PROFITS, LOST REVENUE, LOST SAVINGS, LOSS OF DATA, LOSS OF GOODWILL, BUSINESS INTERRUPTION, CLAIM DENIALS, AUTHORIZATION DENIALS, PAYMENT DENIALS, AUDIT EXPOSURE, COMPLIANCE EXPOSURE, PROFESSIONAL DISCIPLINE, OR REPUTATIONAL HARM, ARISING OUT OF OR RELATING TO YOUR USE OF OR INABILITY TO USE THE SITE OR ANY CRITERIONMD PRODUCT.
THIS LIMITATION APPLIES WHETHER THE CLAIM IS BASED ON WARRANTY, CONTRACT, TORT, NEGLIGENCE, STRICT LIABILITY, STATUTE, OR ANY OTHER LEGAL THEORY, EVEN IF CRITERIONMD HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
TO THE FULLEST EXTENT PERMITTED BY LAW, CRITERIONMD'S TOTAL LIABILITY FOR ANY CLAIM ARISING OUT OF OR RELATING TO THE SITE OR THESE TERMS WILL NOT EXCEED ONE HUNDRED DOLLARS ($100) OR THE AMOUNT YOU PAID TO CRITERIONMD FOR USE OF THE SITE DURING THE THREE MONTHS PRECEDING THE EVENT GIVING RISE TO THE CLAIM, WHICHEVER IS GREATER.
Some jurisdictions do not allow certain limitations of liability. In those jurisdictions, CriterionMD's liability will be limited to the greatest extent permitted by law.
CriterionMD may update, modify, suspend, replace, restrict, or discontinue all or part of the Site or any product feature at any time, with or without notice.
CriterionMD does not guarantee that the Site will be available at all times or that access will be uninterrupted. CriterionMD is not liable for unavailability, downtime, data loss, service interruption, or feature limitation.
CriterionMD may suspend, restrict, or terminate your access to the Site or any product at any time, with or without notice, if CriterionMD believes that you have violated these Terms, created risk for CriterionMD or others, used the Site unlawfully or improperly, or acted inconsistently with the intended purpose of the Site.
Upon termination, your right to access and use the Site will immediately cease. Provisions that by their nature should survive termination will survive, including provisions relating to intellectual property, disclaimers, limitation of liability, indemnification, governing law, and dispute resolution.
You agree to comply with all applicable export control, sanctions, and trade compliance laws and regulations.
You represent that you are not located in, organized under the laws of, or ordinarily resident in any country or territory subject to comprehensive sanctions, and that you are not listed on any government restricted-party list.
You may not access or use the Site if doing so would violate applicable export control or sanctions laws.
These Terms and your use of the Site will be governed by the laws of the State of [Insert State], without regard to conflict-of-law principles.
Any legal action or proceeding arising out of or relating to these Terms, the Site, or your use of the Site will be brought exclusively in the state or federal courts located in [Insert County and State]. You consent to the personal jurisdiction and venue of those courts.
You acknowledge that unauthorized use of the Site, misuse of CriterionMD intellectual property, unauthorized access, reverse engineering, scraping, competitive misuse, or violation of these Terms may cause immediate and irreparable harm to CriterionMD for which monetary damages may be inadequate.
CriterionMD may seek injunctive or equitable relief without the need to prove actual damages or post bond, in addition to any other remedies available at law or in equity.
These Terms, together with any applicable Privacy Policy and any separate written agreement expressly incorporated by reference, constitute the entire agreement between you and CriterionMD regarding your use of the Site.
If you or your organization enters into a separate written agreement with CriterionMD covering a specific product, subscription, enterprise service, data arrangement, Business Associate Agreement, or commercial relationship, that separate agreement will control for the matters it specifically addresses.
Questions about these Terms may be sent to:
We, at CriterionMD, are dedicated to serving our customers and contacts to the best of our abilities. Part of our commitment involves the responsible management of personal information collected through our website{' '} www.criterionMD.com, and any related interactions. Our primary goals in processing this information include:
It is our policy to process personal information with the utmost respect for privacy and security. We adhere to all relevant regulations and guidelines to ensure that the data we handle is protected against unauthorized access, disclosure, alteration, and destruction. Our practices are designed to safeguard the confidentiality and integrity of your personal information, while enabling us to deliver the services you trust us with.
Your privacy is our priority. We are committed to processing your personal information transparently and with your safety in mind. This commitment extends to our collaboration with third-party services that may process personal information on our behalf, such as in the case of sending invoices. Rest assured, all activities are conducted in strict compliance with applicable privacy laws.
Our privacy policy is designed to protect the personal information of all our stakeholders, including website visitors, registered users, and customers. Whether you are just browsing our website{' '} www.criterionMD.com, using our services as a registered user, or engaging with us as a valued customer, we ensure that your personal data is processed with the highest standards of privacy and security. This policy outlines our practices and your rights related to personal information.
Our commitment to transparency and data protection extends to how we collect and use your personal information. We gather personal data through various interactions, including but not limited to, when you utilize our services or products such as healthcare workflow solutions including software, browser extensions, and RCM services, among other products, or directly provide information to us.
The following list details the types of personal information we may process:
At CriterionMD, we understand the importance of protecting your personal information and take proactive measures to safeguard it. In the event of a data breach that poses a risk to your privacy rights and freedoms, we have established clear procedures for promptly identifying, assessing, and mitigating the impact of the breach. Our data breach notification procedures are designed to comply with applicable data protection laws and regulations, including the General Data Protection Regulation (GDPR).
In the event of a data breach, we are committed to providing affected individuals with the support and assistance they need, including guidance on steps they can take to mitigate the potential risks associated with the breach.
Point of contact: If you have any questions or concerns about a data breach or believe you may have been affected, please contact us immediately at{' '} support@criterionmd.com or +1 347-200-6044.
At CriterionMD, we are committed to keeping you informed about how we handle your personal information and any changes to our privacy practices. We may update this privacy policy from time to time to reflect changes in legal requirements, industry standards, or our business operations. We want to assure you that any updates will be communicated transparently and in accordance with applicable data protection laws.
If you have any questions or concerns about our privacy policy or any updates to it, please don't hesitate to contact us at{' '} support@criterionmd.com or +1 347-200-6044. We are here to address any inquiries you may have and to ensure that you have the information you need to feel confident about how your personal information is handled.
CriterionMD is built with the security expectations of healthcare organizations in mind. We maintain administrative, technical, and physical safeguards designed to protect sensitive healthcare information, including protected health information when applicable. Data transmitted through CriterionMD systems is encrypted in transit using industry-standard protocols, and stored data is encrypted at rest where supported by the underlying infrastructure. Access to production systems is restricted based on role, business need, and least-privilege principles, with authentication controls, activity monitoring, and internal security procedures intended to reduce the risk of unauthorized access, disclosure, alteration, or loss.
CriterionMD is designed to support HIPAA-compliant use by covered entities and healthcare organizations. Where CriterionMD receives, creates, maintains, or transmits protected health information on behalf of a covered entity or another business associate, CriterionMD operates as a business associate and will enter into a Business Associate Agreement as appropriate. Our privacy and security practices are intended to align with the HIPAA Privacy Rule, Security Rule, and applicable breach notification requirements, including safeguards related to access control, workforce responsibilities, vendor oversight, data handling, incident response, and permitted uses and disclosures of protected health information.
CriterionMD does not treat healthcare data security as a software feature alone. Security is part of our operating framework, product design, vendor management, and compliance posture. We evaluate our systems and workflows to support secure clinical documentation review, payer policy analysis, authorization support, and related healthcare administrative functions. While no technology platform can guarantee absolute security, CriterionMD takes commercially reasonable steps to protect user data, maintain system integrity, and provide physicians, practice administrators, and institutional partners with a platform designed for responsible use in regulated healthcare environments.