Terms of Service

These Terms of Service ("Terms") are a legally binding agreement between you and AuthFight, Inc. ("AuthFight," "we," "us," or "our") governing your access to and use of the AuthFight platform, website, and all related services (collectively, the "Service").

By creating an account, clicking "I agree," or using any part of the Service, you confirm that you have read, understood, and agree to be bound by these Terms and our Privacy Policy and HIPAA Notice of Privacy Practices, each of which are incorporated into these Terms by reference.

If you do not agree to these Terms, do not use the Service.

Understanding what AuthFight does and does not do is important before you use the Service.

Who can use AuthFight

To use the Service, you must be at least 18 years old and legally capable of entering into a binding agreement. If you are using AuthFight on behalf of a minor patient (such as a child or dependent), you represent that you are their legal parent or guardian and are authorized to consent to these Terms and to share their health information on their behalf.

Account registration

You must create an account to access the Service. You agree to provide accurate, current, and complete information during registration and to keep it up to date. You are responsible for maintaining the confidentiality of your account credentials and for all activity that occurs under your account.

One account per person

Each account may only be used by the individual who registered it, or by a parent or legal guardian managing an appeal on behalf of a minor. You may not share account access with others or use the Service on behalf of multiple patients from a single account.

Account security

Notify us immediately at privacy@authfight.com if you become aware of any unauthorized use of your account or any other security breach. We are not liable for any loss or damage arising from your failure to keep your credentials secure.

AuthFight provides the following features as part of the Service:

Denial Decoder

We translate your denial code and denial letter into plain English so you understand exactly why your insurer denied your request and what obligations your insurer has in responding to an appeal.

Fight Score

We calculate a Fight Score using publicly available CMS-reported overturn data, your denial code's historical reversal rates, and the urgency of your case. The Fight Score is an informational estimate only. See Section 05 for important disclaimers about the Fight Score.

AI Appeal Letter

We generate a personalized appeal letter using information you provide in a short intake form, combined with relevant clinical evidence and legal frameworks. All letters are reviewed by a licensed physician before being submitted. See Section 05 for important disclaimers about AI-generated content.

Deadline Tracker

We calculate your appeal deadlines based on your insurer, plan type, and denial date, and send you reminders before those deadlines expire. Deadlines are calculated based on available information and applicable law; you remain responsible for meeting all deadlines applicable to your situation.

Submission Guide & Submission

We provide verified submission contacts for major insurers and, where you authorize us to do so, submit your appeal on your behalf via fax, portal, or mail. Submission contact information is updated regularly but we cannot guarantee it remains current at all times.

Escalation to External Review

If your internal appeal is denied, we help you identify whether external independent review is available and assist you in initiating that process. External review is conducted by independent organizations and decisions are beyond our control.

AI-generated appeal letters

Your appeal letter is drafted by an AI system using the information you provide and relevant clinical and legal sources. This draft is then reviewed by a licensed physician in the relevant specialty, who may revise it, add supporting clinical opinion, and signs it before submission.

By proceeding with submission, you confirm that you have reviewed the letter and that the information it contains is accurate and reflects your situation. You are responsible for the accuracy of the content in your appeal letter. AuthFight is not responsible for inaccuracies arising from information you provided incorrectly or incompletely.

Your data is not used to train AI

Your personal and health information is never used to train, fine-tune, or improve our AI models or any third-party AI system. See our Privacy Policy for full details.

Fight Score disclaimer

Your Fight Score is calculated using publicly available CMS-reported data that Medicare Advantage insurers are federally required to disclose, combined with your denial code's historical reversal frequency and case urgency classification.

To use the Service effectively and lawfully, you agree to the following:

Provide accurate information

You will provide complete and truthful information about your denial, health condition, insurance coverage, and any other details requested. Providing false or misleading information may constitute insurance fraud, which is a serious federal and state crime. AuthFight is not responsible for any consequences — including appeal denial, coverage loss, or legal liability — arising from inaccurate information you provide.

Review before submission

You will carefully review your AI-generated appeal letter and all supporting documents before authorizing submission. Once an appeal is submitted to your insurer, it cannot be unsent. If you notice errors, notify us before authorizing submission.

Act on deadline alerts

We will send you reminders about upcoming appeal deadlines. You are ultimately responsible for meeting all applicable deadlines. AuthFight's reminder system supplements but does not replace your own diligence in tracking your appeal timeline.

Maintain your account

Keep your contact information current so we can reach you with status updates, deadline alerts, and insurer responses. Appeals that cannot progress due to outdated contact information are not our responsibility.

By using the Service and authorizing submission of your appeal, you grant AuthFight a limited, specific authorization to act as your agent for the purpose of:

• Submitting your appeal letter and supporting documents to your health insurer via their designated submission channel.
• Communicating with your insurer on administrative matters related to the submission, such as confirming receipt or obtaining a case reference number.
• Sharing your appeal record with an independent review organization (IRO) if you elect to pursue external review.
• Coordinating with the physician reviewer who reviews and signs your appeal letter.

This authorization is limited strictly to the above purposes. We do not have authority to make healthcare decisions on your behalf, to waive any of your rights, or to enter into agreements with your insurer beyond the scope of your appeal submission.

You may revoke this authorization at any time by contacting us at support@authfight.com. Revocation will stop all future actions on your behalf but cannot undo submissions already made.

AuthFight works with a network of licensed, independent physicians who review and sign appeal letters before submission. These physicians are independent contractors, not employees of AuthFight.

The physician reviewer's role is to evaluate the clinical accuracy of the AI-generated appeal letter, ensure it correctly applies applicable clinical guidelines, and co-sign the letter in their professional capacity. The reviewing physician may revise the letter's clinical content.

AuthFight is not liable for the independent professional judgment exercised by physician reviewers in reviewing or modifying your appeal letter.

AuthFight does not guarantee, promise, or warrant any particular outcome from the use of the Service, including but not limited to:

• Approval of your prior authorization appeal by your insurer.
• Approval of coverage for any specific medication, procedure, or service.
• A particular decision timeline from your insurer or an external reviewer.
• Any specific outcome in external or judicial review proceedings.

Insurance appeal decisions are made solely by your health insurer or, in the case of external review, by an independent review organization. These entities are not under AuthFight's control. Our role is to give you the strongest possible appeal — the decision belongs to the insurer.

You may not use the Service for any of the following purposes. Violation may result in immediate account termination and, where applicable, referral to law enforcement.

AuthFight's intellectual property

The AuthFight platform, including its software, algorithms, design, text, graphics, Fight Score methodology, and all other content created by AuthFight, is owned by AuthFight, Inc. and protected by U.S. and international copyright, trademark, and other intellectual property laws.

You may not copy, reproduce, modify, distribute, or create derivative works based on AuthFight's proprietary content without our prior written permission.

Limited license to use the Service

AuthFight grants you a personal, non-exclusive, non-transferable, revocable license to access and use the Service solely for the purpose of preparing and submitting your own insurance appeal, in accordance with these Terms.

Feedback

If you submit feedback, suggestions, or ideas about the Service, you grant AuthFight a perpetual, royalty-free license to use that feedback without restriction or obligation to you.

You retain ownership of all documents, images, records, and information you upload to AuthFight ("Your Content"). By uploading Your Content, you grant AuthFight a limited license to use, process, and transmit it solely for the purpose of building and submitting your appeal, as described in these Terms and our Privacy Policy.

You represent and warrant that:

• You have the right to upload Your Content and to grant AuthFight this license.
• Your Content does not infringe the intellectual property, privacy, or other rights of any third party.
• Your Content is accurate and is not submitted for any fraudulent purpose.

AuthFight does not claim ownership of Your Content. When you delete your account or request deletion of your data, we will remove Your Content in accordance with our Privacy Policy retention schedule.

These limitations apply regardless of the form of action — whether in contract, tort (including negligence), strict liability, or otherwise — and regardless of whether the limited remedies available to you fail of their essential purpose.

Some jurisdictions do not allow the exclusion or limitation of certain damages. In such jurisdictions, our liability is limited to the greatest extent permitted by law.

You agree to defend, indemnify, and hold harmless AuthFight, Inc. and its officers, directors, employees, contractors, and agents from and against any claims, liabilities, damages, losses, and expenses — including reasonable legal fees — arising out of or in any way connected with:

• Your access to or use of the Service in violation of these Terms.
• Your provision of inaccurate, false, or misleading information to AuthFight.
• Your violation of any applicable law or regulation.
• Your infringement of any third-party right, including intellectual property or privacy rights.

Termination by you

You may close your account at any time by using the account deletion option in your account settings or by emailing support@authfight.com. Closing your account will stop all active appeal processing. Deletion of your personal data will follow the schedule described in our Privacy Policy.

Termination by AuthFight

We may suspend or terminate your account and access to the Service at any time, with or without notice, if we believe you have violated these Terms, provided false information, or used the Service in a way that creates legal risk for AuthFight or harm to others.

Effect of termination

Upon termination, your license to use the Service ends immediately. Sections of these Terms that by their nature should survive termination — including Sections 13 (Limitation of Liability), 14 (Disclaimer of Warranties), 15 (Indemnification), and 17 (Governing Law) — will survive.

Governing law

These Terms are governed by the laws of the State of [Your State], without regard to its conflict of law provisions. Any legal action arising under these Terms must be brought exclusively in the state or federal courts located in [Your County, State], and you consent to personal jurisdiction in those courts.

Informal resolution first

Before filing any legal claim, you agree to contact us at legal@authfight.com and give us 30 days to try to resolve the dispute informally. Most issues can be resolved quickly through direct communication.

Class action waiver

To the extent permitted by law, you agree that any dispute arising under these Terms will be resolved on an individual basis and not as part of a class, consolidated, or representative action.

We may update these Terms from time to time. When we make material changes, we will:

• Update the effective date at the top of this page.
• Send an email notification to all registered users.
• Display a notice within the platform when you next log in.

Your continued use of the Service after the updated Terms take effect constitutes your acceptance of the new Terms. If you do not agree with the changes, you must stop using the Service and close your account before the effective date.

For non-material changes — such as corrections to typos, formatting updates, or clarifications that do not affect your rights — we may update the Terms without prior notice.

Questions about these Terms? Reach out to us directly:

Legal disclaimer:These Terms of Service are a starting-point draft tailored to AuthFight's described product and business model. They do not constitute legal advice. Before publishing these Terms in a production environment, they should be reviewed and finalized by a qualified attorney familiar with healthcare technology, consumer protection law, and the laws of your specific jurisdiction. In particular, the governing law, arbitration, and liability cap provisions should be reviewed by counsel.