Billing and Claims Responsibility Addendum

Addendum to the Master Services Agreement. This Billing and Claims Responsibility Addendum (this “Addendum”) is entered into as of the Effective Date of the Master Services Agreement (the “MSA”) between [MOVRA LEGAL ENTITY] (“Movra”) and [CUSTOMER LEGAL NAME] (“Customer”), and is incorporated into the MSA. Capitalized terms not defined here have the meanings given in the MSA.

1. Purpose

Movra’s platform generates documentation that summarizes remote monitoring activity, clinician attestations, and patient-reported data (each, an “Audit Packet”). Customer may use Audit Packets as supporting documentation for claims Customer submits to third-party payers. This Addendum states, unambiguously, who is responsible for what.

2. Movra’s Role: Documentation Only

2.1 Movra does not submit claims. Movra does not act as a billing company, a claims clearinghouse, a billing agent, or a third-party biller for Customer. Movra does not submit, transmit, or cause to be transmitted any claim for payment to Medicare, Medicaid, TRICARE, any other federal or state healthcare program, or any commercial payer, on Customer’s behalf or otherwise.

2.2 Movra does not select codes. The Current Procedural Terminology (CPT) codes, modifiers, diagnosis codes, and units reflected in an Audit Packet are computed from data recorded on the platform and are presented as decision support. They are not a coding recommendation, a certification of medical necessity, or an assurance of payment.

2.3 Movra makes no representation of reimbursability. Movra does not represent, warrant, or guarantee that any service documented in an Audit Packet is covered, medically necessary, correctly coded, adequately documented, or payable by any payer. Coverage rules, National and Local Coverage Determinations, Medicare Administrative Contractor guidance, and commercial payer policies change and vary by jurisdiction.

2.4 Movra is not a provider. Movra does not practice medicine, physical therapy, chiropractic, or any other licensed profession, does not furnish any billable service, and does not supervise any clinician.

2.5 No percentage-based compensation. Movra’s fees under the MSA are fixed and are not calculated as a percentage of, and do not vary with, the amount Customer bills, collects, or is reimbursed. The Parties intend that Movra’s compensation not implicate the federal Anti-Kickback Statute (42 U.S.C. 1320a-7b(b)) or the Physician Self-Referral Law (42 U.S.C. 1395nn), and Movra makes no payment of remuneration to Customer or any clinician for referrals.

3. Customer’s Responsibilities

3.1 Customer is solely responsible for every claim it submits. Customer, as the enrolled provider or supplier, is solely responsible for: the decision to bill; selection of CPT codes, modifiers, and diagnosis codes; determination of medical necessity; verification of coverage and beneficiary eligibility; compliance with supervision, incident-to, and plan-of-care requirements; the accuracy and completeness of the medical record; and the truthfulness of every certification made on a claim form.

3.2 Independent clinical judgment. All clinical content generated by the platform, including exercise programs and care plans produced with the assistance of software, is a draft for clinician review. It has no clinical effect and is not visible to a patient until a licensed clinician reviews it and records a sign-off. Customer represents that each sign-off recorded on the platform reflects the signing clinician’s actual, independent clinical judgment, that the signing clinician is licensed and in good standing, and that the National Provider Identifier recorded with the sign-off belongs to that clinician.

3.3 RTM scope for this engagement. As of the Effective Date, the Parties acknowledge that Movra’s documentation for Remote Therapeutic Monitoring is limited to CPT 98975 (initial set-up and patient education) and CPT 98977 (device supply, musculoskeletal, 16 or more days of data in 30 days). The platform does not produce evidence of clinician interactive treatment-management time and therefore does not support CPT 98980 or 98981, and Customer shall not rely on the platform as documentation for those codes. Customer acknowledges that the platform’s day counts are computed on a calendar-month basis as a proxy for the rolling 30-day period, and that Customer must confirm this methodology against its Medicare Administrative Contractor’s guidance before submitting a claim.

3.4 Chiropractic limitation. Customer acknowledges that under 42 U.S.C. 1395x(r)(5), a doctor of chiropractic is a “physician” under Medicare only for manual manipulation of the spine to correct a subluxation, and that Medicare does not reimburse a doctor of chiropractic for Remote Therapeutic Monitoring services. Customer shall not submit RTM claims to Medicare for services furnished by a doctor of chiropractic. Customer is solely responsible for confirming, with each commercial payer, workers’ compensation carrier, or other payer, whether RTM services furnished by a doctor of chiropractic are covered under that payer’s policy before submitting any such claim.

3.5 Plan of care and order. Customer is responsible for ensuring that RTM services are furnished pursuant to a valid order and, where furnished by a physical therapist, under a certified therapy plan of care with any modifier required by the applicable payer.

3.6 Consent and cost-sharing. Customer is responsible for obtaining and documenting each patient’s consent to remote monitoring, including disclosure of any applicable cost-sharing, before the first billable service.

3.7 Record retention and audit response. Customer is responsible for maintaining the medical record and for responding to payer audits. Audit Packets are supporting documentation and do not substitute for the medical record.

4. Data Accuracy and Known Limitations

4.1 Customer acknowledges that data recorded by the platform originates in part from a patient-controlled mobile device, that a device’s clock and locale determine how activity is dated, and that a patient may fail to record activity that occurred or may record activity in a manner that does not reflect therapeutic engagement.

4.2 Movra will use commercially reasonable efforts to compute day counts and time totals accurately, and will correct material computational defects it identifies. Movra does not warrant that recorded data is a complete or accurate account of a patient’s conduct.

4.3 Customer shall not submit a claim in reliance on an Audit Packet that Customer knows or reasonably should know contains inaccurate data.

5. Notice of Defects

If either Party becomes aware that the platform has produced materially incorrect billing-support output, including an incorrect count of qualifying monitoring days or an incorrect eligibility determination, that Party shall notify the other without unreasonable delay. Movra shall, at its expense, correct the defect and inform Customer of the affected period so that Customer may evaluate whether any submitted claim requires correction or refund. Movra does not, and cannot, direct Customer’s response to a payer.

6. Indemnification

6.1 Customer shall defend, indemnify, and hold harmless Movra from any claim, demand, investigation, penalty, or proceeding brought by a payer, government agency, or relator arising out of a claim for payment submitted by or on behalf of Customer, including any allegation under the False Claims Act, the Anti-Kickback Statute, or any state analogue, except to the extent such claim arises from Movra’s material breach of this Addendum or Movra’s fraud, gross negligence, or willful misconduct.

6.2 Movra shall defend, indemnify, and hold harmless Customer from any third-party claim alleging that the platform, as furnished by Movra and used in accordance with the Documentation, infringes a United States patent, copyright, or trade secret.

6.3 Nothing in this Addendum limits either Party’s liability for its own fraud or willful misconduct.

7. No Guarantee of Revenue

Customer acknowledges that Movra has made no representation, in any marketing material, proposal, demonstration, or conversation, regarding the amount of revenue Customer may earn, the number of patients who may qualify for a given code, or the likelihood that any payer will pay any claim. Any illustrative figures shown to Customer are hypothetical. Customer has not relied on any such figure in entering this Addendum.

8. Survival

Sections 2, 3, 6, 7, and this Section 8 survive termination of the MSA.

IN WITNESS WHEREOF, the Parties execute this Addendum as of the Effective Date.