Step 1 of 4 - Accept Terms
MyParamount - Providers
- That it is Provider’s intent to conduct the submission of claims by electronic means;
- That the medical services provided were medically necessary;
- That Provider will comply with all applicable federal and state laws;
- That Provider will comply with applicable handbooks and policies and procedures issued by Paramount;
- That all information submitted to Paramount is accurate and complete and the submission of false claims, statements, documents, or concealment of a material fact, may be prosecuted under applicable federal and state laws;
- To retain all records and documentation that are necessary to support the full extent of the services provided and to provide this information to Paramount when requested and at no cost.
- Claims payment is subject to member eligibility and benefits on the date of service, coordination of benefits, covered services available under the member’s plan, referral/authorization and utilization management guidelines when applicable.
- Provider will accept as payment in full the amount paid by Paramount with the exception of cost sharing amounts determined by Paramount,
- Paramount has the right to conduct audits and investigations of all claims submitted to ensure compliance with federal and state laws as well as Paramount policies and procedures. You agree that if such an audit determines that your office/facility did not comply with appropriate federal and state laws and/or Paramount’s policies and procedures, then your office/facility will refund all payments related to non-compliance to Paramount immediately, unless such non-compliance is cured to Paramount’s satisfaction within a reasonable period of time as established by Paramount. In event that a refund is required due to non-compliance, you agree to allow Paramount in, its discretion, to off-set any future payments due to you in order to allow Paramount to recoup any monies paid to you that were paid in error.
- To cooperate with Paramount during any audit or investigation and to provide, at no cost, any documentation requested by Paramount within twenty days of Paramount’s request.
- That all disputes must first be handled through Paramount’s internal dispute resolution process. In the event a dispute still exists after exhaustion of Paramount’s internal dispute resolution process, then you agree to resolve the dispute through binding arbitration according to the commercial rules of the American Health Lawyers Association to be conducted in Lucas County, Ohio, with the cost to be shared equally by the parties. All demands for arbitration should be made in writing to: Paramount Health Care, Attn: Legal Department, 1901 Indian Wood Circle, Maumee, Ohio 43537.
- Paragraphs 1-11 apply to Provider except to the extent expressly inconsistent with the terms of a Provider Agreement between Provider and Paramount.
Grant of Restricted License
Paramount may also terminate your license or suspend your account for inactivity, which is defined as failing to sign-in to the Service for an extended period of time, as determined by Paramount. Upon termination of the license, your right to use the Service immediately ceases.
If you wish to terminate your account, your only recourse is to discontinue the use of the Service.
Privacy / Security
Paramount takes the security of member information very seriously and has established safeguards and procedures to prevent unauthorized access to and use and disclosure of member information. We maintain physical, electronic and procedural safeguards to protect personal information.
You agree to notify Paramount immediately of any unauthorized use of your account or any other breach of security.
- Use the Service in connection with surveys, contests, pyramid schemes, chain letters, junk email, spamming or any duplicative or unsolicited messages (commercial or otherwise).
- Defame, abuse, harass, stalk, threaten or otherwise violate the legal rights (such as rights of privacy and publicity) of others.
- Publish, distribute or disseminate any inappropriate, profane, defamatory, infringing, obscene, indecent or unlawful material or information.
- Advertise or offer to sell or buy any goods or services for any non-personal purpose.
- Harvest or otherwise collect information about others, including email addresses, without their consent.
- Create a false identity for the purpose of misleading others as to the identity of the sender or the origin of a message.
- Use, download or otherwise copy, or provide (whether or not for a fee) to a person or entity any information other than in the context of your use of the Service as permitted under this Agreement.
- Transmit or upload any material that contains viruses, Trojan horses, worms, time bombs, cancel bots, or any other harmful or deleterious programs.
- Transmit or upload any material that contains software or other material protected by intellectual property laws, rights of privacy or publicity or any other applicable law unless you own or control the rights thereto or have received all necessary consents.
- Interfere with or disrupt networks connected to the Service or violate the regulations, policies or procedures of such networks.
- Attempt to gain unauthorized access to the Service, other accounts, computer systems or networks connected to the Service, through password mining or any other means.
- Violate any applicable laws or regulations including, without limitation, laws regarding the transmission of technical data or software exported from the United States through the service.
- Interfere with a member's use and enjoyment of the Service or another individual's or entity's use and enjoyment of similar services.
- Paramount has no obligation to monitor the Service or any user's use thereof or retain the content of any user session.
- However, Paramount reserves the right at all times to monitor, review, retain and/or disclose any information as necessary to satisfy any applicable law, regulation, legal process or governmental request.
Links to Third Party Sites
THE LINKS INCLUDED WITHIN THE SERVICE MAY LET YOU LEAVE THE SERVICE WEB SITES ("LINKED SITES"). THE LINKED SITES ARE NOT UNDER THE CONTROL OF PARAMOUNT AND PARAMOUNT IS NOT RESPONSIBLE FOR THE CONTENTS OF ANY LINKED SITE OR ANY LINK CONTAINED IN A LINKED SITE, OR ANY CHANGES OR UPDATES TO SUCH SITES. PARAMOUNT IS NOT RESPONSIBLE FOR WEBCASTING OR ANY OTHER FORM OF TRANSMISSION RECEIVED FROM ANY LINKED SITE. PARAMOUNT IS PROVIDING THESE LINKS TO YOU ONLY AS A CONVENIENCE, AND THE INCLUSION OF ANY LINK DOES NOT IMPLY ENDORSEMENT BY PARAMOUNT OF THE SITE OR ANY ASSOCIATION WITH THEIR OPERATORS.
Disclaimers / Limitation of Liability
The information and services included in or available through the Service may include inaccuracies or typographical errors. Changes are periodically added to the information herein. Paramount and/or its respective suppliers may make improvements and/or changes in the Service at any time.
Paramount does not represent or warrant that the Service will be uninterrupted or error-free, that defects will be corrected, or that the Service or the server that makes it available, are free of viruses or other harmful components. Paramount does not warrant or represent that the use or the results of the use of the Service or the materials made available as part of the Service will be correct, accurate, timely, or otherwise reliable.
You specifically agree that Paramount shall not be responsible for unauthorized access to or alteration of your transmissions or data, any material or data sent or received or not sent or received, or any transactions entered into through the Service. You specifically agree that Paramount is not responsible or liable for any threatening, defamatory, obscene, offensive or illegal content or conduct of any other party or any infringement of another's rights, including intellectual property rights. You specifically agree that Paramount is not responsible for any content sent using and/or included in the Service by any third party.
PARAMOUNT AND/OR ITS RESPECTIVE SUPPLIERS MAKE NO REPRESENTATIONS ABOUT THE SUITABILITY, RELIABILITY, AVAILABILITY, TIMELINESS, AND ACCURACY OF THE SERVICE FOR ANY PURPOSE. THE SERVICE IS PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. PARAMOUNT AND/OR ITS RESPECTIVE SUPPLIERS HEREBY DISCLAIM ALL WARRANTIES AND CONDITIONS WITH REGARD TO THE SERVICE, INCLUDING ALL IMPLIED WARRANTIES AND CONDITIONS OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE AND NON- INFRINGEMENT.
You agree to indemnify and hold Paramount, its parents, subsidiaries, affiliates, officers and employees, harmless from any claim, demand, or damage, including reasonable attorneys' fees, asserted by any third party due to or arising out of your use of or conduct on the Service.
Participation in Promotions of Advertisers
Any dealings with Advertisers on the Service or participation in promotions, including the delivery of and the payment for goods and services, and any other terms, conditions, warranties or representations associated with such dealings or promotions, are solely between you and the Advertiser or other third party. Paramount shall not be responsible or liable for any part of any such dealings or promotions.
Proprietary Rights to Content
Paramount reserves the right to change this Agreement or the policies regarding the use of the Service at any time and to notify you by posting an updated version of the Agreement on this Web site. You are responsible for regularly reviewing the Agreement. Continued use of the Service after any such changes shall constitute your consent to such changes.
This Agreement is governed by the laws of the State of Ohio and the United States of America. Use of the Service is unauthorized in any jurisdiction that does not give effect to all provisions of these terms and conditions, including without limitation this paragraph. You agree that no joint venture, partnership, employment, or agency relationship exists between you and Paramount as a result of this Agreement or use of the Service. Paramount's performance of this Agreement is subject to existing laws and legal process, and nothing contained in this Agreement is in derogation of Paramount's right to comply with governmental, court and law enforcement requests or requirements relating to your use of the Service or information provided to or gathered by Paramount with respect to such use. If any part of this Agreement is determined to be invalid or unenforceable pursuant to applicable law including, but not limited to, the warranty disclaimers and liability limitations set forth above, then the invalid or unenforceable provision will be deemed superseded by a valid, enforceable provision that most closely matches the intent of the original provision and the remainder of the Agreement shall continue in effect. Unless otherwise specified herein, this Agreement constitutes the entire agreement between the user and Paramount with respect to the use of the Service (excluding the use of any software which may be subject to an end-user license agreement) and it supersedes all prior or contemporaneous communications and proposals, whether electronic, oral or written, between the user and Paramount with respect to the use of the Service. A printed version of this Agreement and of any notice given in electronic form shall be admissible in judicial or administrative proceedings based upon or relating to this Agreement to the same extent and subject to the same conditions as other business documents and records originally generated and maintained in printed form. You and Paramount agree that any cause of action arising out of or related to this Service must commence within one (1) year after the cause of action arose; otherwise, such cause of action is permanently barred. The section titles in this Agreement are solely used for the convenience of the parties and have no legal or contractual significance.
Smartsheets Imaging Authorization Criteria
(Copyright © 2005 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved. U.S. Pat. No. 6049794.)
In order to provide access to the Imaging authorization criteria (InterQual® SmartSheets™) through MyParamount Provider Portal, you will need to review the additional terms and conditions below.
- Paramount provides access to utilization management criteria and associated clinical content (“criteria/content”) to its Providers subject to the terms and conditions contained in this supplemental agreement (“Supplemental Agreement”), which may be updated from time to time at Paramount’s or its licensors’ sole discretion without notice.
- Provider’s right to access and use the criteria/content is non-transferable, nonexclusive, and is for the sole purpose of providing care for the Paramount members.
- Provider will limit access to the criteria/content to (i) only employees and agents of Provider and further (ii) only to the extent necessary to review/evaluate the clinical content relevant to the Provider’s specialty area or related to the care of a specific member’s condition.
- Provider shall protect the confidentiality of the information contained in and provided by the criteria/content and to which it has access to under this Supplemental Agreement, by using at least the degree of care and security it uses to protect its own confidential information. Provider acknowledges and agrees that any unauthorized disclosure or distribution of the confidential information may result in irreparable injury to Paramount or Paramount’s licensor(s), entitling the injured entity to obtain immediate injunctive relief in addition to any other legal remedies available.
- Provider shall not modify, translate, decompile, disclose, create nor attempt to create any derivative work of the criteria/content.
- Provider acknowledges that the criteria/content is in no way intended to prescribe, designate or limit medical care to be provided or procedures to be performed. Provider accepts responsibility for and acknowledges that it will exercise its own independent judgment in its use of the criteria/content and shall be solely responsible for such use. Provider agrees to indemnify and hold Paramount, and its affiliates, officers, agents, licensors or other partners, and employees, harmless from any claim, demand or damages, including reasonable attorneys’ fees, arising out of Provider’s use of the criteria/content or from its violation of the intellectual property rights or confidentiality obligations contained in this Supplemental Agreement.
- Provider acknowledges that the criteria/content incorporates the CPT terminology developed and copyrighted by the American Medical Association (“AMA”). The CPT codes and terminology are provided pursuant to licenses granted by the AMA, and Provider’s access to updated versions of such terminology depend on Paramount’s or its licensors’ continuing contractual relations with the AMA. AMA reserves the right to modify the CPT codes at any time.
- Provider acknowledges that the criteria/content, and the CPT terminology, including all applicable rights to patents, copyrights, trademarks and trade secrets inherent therein and appurtenant thereto, are the sole and exclusive properties of third parties, including Paramount’s licensors and/or the AMA, who have licensed such rights to Paramount. Provider agrees that no rights in the criteria/content and CPT terminology are hereby conveyed to Provider except to the extent that Provider has the right to access the criteria/content.
- THE CRITERIA/CONTENT INCLUDING CPT TERMINOLOGY, ARE PROVIDED TO PROVIDERS “AS IS,” “WITH ALL FAULTS,” AND “AS AVAILABLE.” i. In addition, Paramount’s licensors shall not for any reason be deemed a party to this Supplemental Agreement, and Provider shall look solely to Paramount for the performance of any obligations due Provider hereunder. ii. PARAMOUNT, ITS AFFILIATES, AGENTS AND LICENSORS CANNOT AND DO NOT (i) WARRANT THE ACCURACY, COMPLETENESS, CURRENTNESS, NONINFRINGEMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE OF THE MATERIALS, INFORMATION AND SERVICES AVAILABLE THROUGH THE WEBSITE, OR (ii) GUARANTEE THAT THE MATERIALS, INFORMATION OR SERVICES WILL BE ERROR-FREE, OR CONTINUOUSLY AVAILABLE, OR FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS.
- Paramount has the right to modify or terminate Provider’s access to the criteria/content at any time or for any reason, including but not limited to Provider’s violation of any terms of this Supplemental Agreement.
- CPT codes, descriptions, and material only are copyright 2004 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Restrictions Apply to Government Use