Terms and Conditions

Gold Kidney Health Plan

Accessing or using any area of Gold Kidney Health Plan websites and the information contained therein constitutes acceptance of the terms and conditions below. Oral representations or agreements not set forth in this agreement are not binding. This agreement supersedes any preceding agreement between the parties relating to the website or the services available through it.

1. Terms and Conditions Governing Information Submission and Use on the Gold Kidney Health Plan

One purpose of the website is to provide an additional medium for providers to obtain, or in certain instances to submit information to Gold Kidney Health Plan, and may or may not include, among other issues, information regarding claims, referrals, pre-certifications, prior authorizations, eligibility, and formulary status. The accuracy, authenticity, security, and confidentiality of the information submitted to Gold Kidney Health Plan is the sole responsibility of the provider submitting the information. The use of the website does not, in any manner whatsoever, supersede, replace, or supplement any terms or conditions of any contract between you and Gold Kidney Health Plan or any terms and conditions contained in any written documentation disseminated by Gold Kidney Health Plan in any other manner, other than through the website. Unless indicated otherwise, documents published and mailed to your office shall control.

2. Provider Agreement Compliance Agreement

By use of the website, you expressly agree that you will continue to abide by all terms and conditions regarding authorizations, claim format requirements, claims submission procedures, claim timeliness, eligibility and benefit interpretations standards of your provider agreement and as communicated to you from time to time by Gold Kidney Health Plan.

3. HIPAA Compliance and Protected Health Information Access

You may have access through the website to Protected Health Information as that term is defined by the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (HIPAA) and you confirm that you are entitled to such Protected Health Information as: a HIPAA Covered Entity, or the Business Associate of a HIPAA Covered Entity, or because such individual has authorized you to have such access. You represent that you shall not allow any user within your organization to have access to PHI available through the website unless such user's access is consistent with your obligations as: a HIPAA Covered Entity, or the Business Associate of a HIPAA Covered Entity, or with the individual's authorization. All capitalized terms in this section shall have the meanings set forth under HIPAA.

4. Disclaimer and Limitation of Liability

The information contained in or conveyed to you via the website is inherently limited in nature, does not contain all applicable terms, conditions, limitations, or exclusions of the products and services referenced, may contain inaccuracies, typographical errors, and is subject to change without notice. Your use of the website and the information therein are at your own risk.

5. Access and Reliance Disclaimer

Gold Kidney Health Plan acknowledges no obligation to grant access to the website, update its content, or maintain its accuracy. The plan denies any responsibility for the website's content or the precision of the information presented therein. By using the website or downloading materials from it, you agree that Gold Kidney Health Plan

1. Reliance Limitation

Shall not be held liable for any decisions made or actions taken by you or any other individual based on materials or information acquired from the website.

2. Limitation of Damages

Any direct, indirect, consequential, incidental, special, or similar damages even if Gold Kidney Health Plan is advised of the possibility of such damages. You expressly agree that in no event shall Gold Kidney Health Plan be liable for any loss or damages arising from the use of the website or the information therein.

6. Administrator Responsibilities for User Access Management

If you are an Administrator for a multiple provider Organization, you may grant access to other users (or their administrators) to the restricted information available via the website about your Organization. In doing so you accept responsibility for creating, updating, deleting such users, as well as granting and revoking their passwords and permissions. You also accept responsibility for their use of the website and agree to ensure their adherence to these terms and conditions.

7. Incorporation of General Terms of Use for Gold Kidney Health Plan

The general terms of use regarding Gold Kidney Health Plan website are incorporated herein in by reference, only to the extent they are not in conflict with the conditions contained herein.

8. Email Use and Data Collection Policy

By providing your e-mail address, you are consenting to Gold Kidney’s policies and practices regarding e-mail use and data collection. Gold Kidney may communicate with you via e-mail. Gold Kidney collects and stores e-mail addresses as part of the Web registration process for all of Gold Kidney’s Web sites and any of its affiliates.