Billing Novice Addendum

This Addendum (“Addendum”) is intended to amend and supplement the Customer Software Agreement (“Agreement”) made and entered into by and between CollaborateMD, Inc. (hereinafter referred to as “CollaborateMD”) with its principal place of business at 111 N. Magnolia Ave, Suite 1100, Orlando, FL 32801, and the individual or legal business entity agreeing to the terms set forth herein (“Customer”). The parties agree to the following terms that shall be additive to the terms found in the Agreement and restate and recite all other terms as defined in the Agreement. Unless otherwise specifically defined in this Addendum, terms shall have the same meaning as in the Agreement in effect between both parties.

Customer acknowledges its acceptance and execution of this Agreement by electronic means and agrees that the electronic signatures of the parties included in this Agreement are intended to authenticate this writing and to have the same force and effect as manual signatures.

Purpose

The purpose of this Addendum is to outline the following terms for Customers who have no or limited billing / coding knowledge.

1. Terms.

(a) Customer agrees that the monthly service Plan(s) fees still apply to the Account regardless of the length of training or claim / billing capabilities, and agrees to pay all fees by or prior to their due dates.

(b) Customer agrees that the free CollaborateMD training and support offered pertains only to the functional use of the CollaborateMD application. CollaborateMD is not responsible for providing any training related to coding, billing or advice on how Payer’s require claims to be submitted. Customer understands that it is their responsibility to contact the Payer(s) directly when seeking Payer specific advice and / or Payer questions pertaining to claims and / or payments.

(c) Customer agrees that it is the responsibility of their office staff to properly manage their claims once they are submitted to the Payer(s) for processing.

(d) Customer agrees that it is the responsibility of their office staff to properly manage their claim rejections.

General.

(a) Any modifications or extensions of the terms defined in this Addendum must be made in writing and agreed to by both parties.

By signing below, you acknowledge receipt of Addendum and agree to the terms outlined in this Addendum.

Last Modified February 04, 2016