Terms & Conditions
Last updated: October 17, 2026
These Terms & Conditions (“Terms”) are an agreement between Cactus Billing Solutions, an Arizona business (“Cactus,” “we,” “us”), and the healthcare provider, practice or organization buying or signing up for our services (“Client,” “you”). By placing an order, checking the agreement box at checkout, signing a service agreement, or using our services, you accept these Terms. If you are accepting for an organization, you confirm that you have authority to bind it.
1. Services
1.1 Credentialing services. These include preparing, submitting and following up on enrollment and credentialing applications with insurance companies, government programs (such as Medicare and Medicaid) and other payers (“Payers”). They also include setting up or updating CAQH Provider Data Portal, NPI, PECOS, EDI/ERA/EFT and related profiles, and re-credentialing, as described in your order. Each credentialing fee covers one application to one Payer for the provider(s) and state named in your order.
1.2 Medical billing services. These include preparing and submitting claims, following up on claims, managing denials and appeals, A/R follow-up, posting payments, and patient statements, using the information and systems you provide.
1.3 Out of scope. Unless agreed in writing, our services do not include legal, tax, compliance or coding-certification advice; clinical documentation; contract negotiation outcomes; collection agency or litigation activity; or work for Payers, providers or states not listed in your order. Extra work can be quoted separately.
1.4 Third parties. Payers, clearinghouses, government agencies and software vendors are independent third parties. We do not control their decisions, rules, systems, fees or processing times.
2. Fees
2.1 Credentialing and setup fees are the prices shown at checkout or in your written quote at the time of purchase, charged per Payer (and per state, where applicable) or as a one-time fee. Bundle discounts apply only as described at checkout.
2.2 Medical billing fees are four and one-half percent (4.5%) of Collections, or the rate in your signed service agreement if different, plus any other fees listed there. A minimum monthly fee of $250 applies: for each calendar month (or part of a month) that billing services are active, you pay the greater of 4.5% of that month’s Collections or $250. “Collections” means all payments received for services we billed or worked, from Payers and patients, during the term, whether the payment goes to you, to us, or to your account. Fees are charged on Collections in the month they are received, including payments on claims submitted before termination (see Section 10).
2.3 Price changes. We may change prices for future orders at any time. For ongoing billing services, we will give at least 30 days’ written notice before a rate change takes effect.
2.4 Taxes and third-party costs. Fees do not include taxes, Payer or government application fees, background checks, clearinghouse charges or other third-party costs. You are responsible for these.
3. Payment Terms
3.1 Credentialing and setup services must be paid in full at checkout before work begins.
3.2 Medical billing fees are invoiced monthly and are due within 15 days of the invoice date. You authorize us to charge the card or account you keep on file for these invoices. You agree to give us access to remittances, deposit reports or payment data we need to calculate Collections.
3.3 Late payment. Unpaid balances accrue a late fee of 1.5% per month (or the highest rate allowed by law, if lower) from the due date, plus a $25 administrative fee per late invoice. We may pause work on any account that is more than 15 days past due until it is paid in full. You are responsible for reasonable costs of collecting overdue amounts, including attorneys’ fees and collection agency fees.
4. Refunds and Non-Refundable Work
4.1 Our fees pay for the work we do, not for a particular result. Once we have started work on an order (including intake review, document preparation, profile setup, or submitting an application to a Payer), the fee for that item is non-refundable, even if the Payer delays, denies or closes the application.
4.2 All fees are final and non-refundable once an order is placed, including if you cancel before work begins. You may cancel future services at any time, but cancellation does not entitle you to a refund for services already purchased. Medical billing fees already earned on Collections are non-refundable. See our Refund Policy.
4.3 If a Payer denies or closes an application because of an error made solely by Cactus, we will resubmit it once at no extra charge. This is your only remedy for such errors.
5. No Guarantees
We do not guarantee, and nothing on our website or in our communications promises: (a) that any Payer will approve, accept or panel any provider; (b) any timeline for approval, effective dates or processing (timelines we quote are estimates based on past experience); (c) any amount of reimbursement, Collections, revenue increase, claim acceptance rate or denial rate; or (d) that a Payer’s network is open. Statistics on our website describe past or typical results and are not promises of future results.
6. Client Responsibilities
You agree to: (a) give us complete, accurate, current and truthful information and documents, and promptly tell us about changes (licenses, addresses, malpractice coverage, sanctions, ownership, etc.); (b) review and sign applications, attestations and authorizations quickly; (c) keep your licenses, DEA, malpractice insurance and CAQH attestations current; (d) make sure services billed are medically necessary, properly documented and correctly coded by your providers; (e) give us timely access to your EHR/PM systems, Payer portals and remittance data as needed; and (f) respond to our requests within 5 business days. We rely on the information you provide and are not responsible for delays, denials, overpayments, recoupments or penalties caused by inaccurate, incomplete or late information or by your failure to meet these responsibilities. You remain solely responsible for your clinical services, coding decisions, documentation and compliance with Payer and government rules.
7. HIPAA, Business Associate Agreement and Confidentiality
7.1 HIPAA. To the extent we create, receive, maintain or transmit protected health information (“PHI”) for you, we act as your Business Associate under HIPAA. The parties will sign a Business Associate Agreement (“BAA”) before we access PHI. If the BAA and these Terms conflict on PHI, the BAA controls. You agree to send PHI to us only through the secure methods we provide.
7.2 Confidentiality. Each party will keep the other’s non-public business information confidential and use it only to perform or receive the services, except where disclosure is required by law. This includes your provider, financial and practice data and our pricing, processes, templates and tools. This obligation continues for 3 years after termination, and for as long as the information remains a trade secret.
7.3 Our materials. Our processes, templates, software, reports and know-how remain our property. You receive the completed deliverables for your own internal use.
8. Limitation of Liability
To the fullest extent permitted by law: (a) we are not liable for any indirect, incidental, special, consequential, exemplary or punitive damages, or for lost revenue, lost profits, lost or delayed reimbursements, Payer recoupments, penalties or lost business opportunities, however caused, even if we were told they were possible; and (b) our total liability for all claims arising out of or relating to the services or these Terms will not exceed the fees you actually paid to us for the specific service giving rise to the claim during the six (6) months before the claim arose. Services are provided “as is” except as expressly stated in these Terms, and we disclaim all implied warranties, including merchantability and fitness for a particular purpose. Some laws do not allow certain limits, so these limits apply only as far as the law allows.
9. Indemnification
You will defend, indemnify and hold harmless Cactus and its owners, employees and contractors from all claims, losses, damages, penalties, recoupments, costs and expenses (including reasonable attorneys’ fees) arising out of or related to: (a) inaccurate, incomplete or false information you or your providers supply; (b) your clinical services, documentation, coding or billing decisions; (c) your violation of law, Payer rules or these Terms; or (d) your breach of HIPAA or of the BAA, except to the extent caused by our gross negligence or willful misconduct.
10. Term and Termination
10.1 Credentialing orders end when the ordered work is completed or the application is finally decided or closed by the Payer.
10.2 Medical billing services continue month to month until either party ends them with at least 30 days’ written notice. We may end services immediately if you fail to pay, breach these Terms or the BAA, ask us to do anything we believe is unlawful or non-compliant, or provide false information.
10.3 After termination: (a) all unpaid fees become due immediately; (b) our percentage fee applies to all Collections received within 90 days after termination on claims we submitted, worked or appealed before termination, and you will report those Collections to us; (c) a transition or file-transfer fee of $150 may apply if you ask for data exports or work beyond the notice period; and (d) Sections 2–9 and 11–14 continue to apply.
11. Chargebacks and Payment Disputes
If you have a concern about a charge, contact us first at info@cactusbillingsolutions.com or 623-267-4182 so we can resolve it. Filing a chargeback or payment dispute for services we performed or fees properly owed under these Terms is a breach of these Terms. In that case: (a) we may suspend all services; (b) you will owe the disputed amount plus any chargeback fees and a $35 administrative fee; and (c) we may submit these Terms, your checkout acceptance, order records and work history to the payment processor as evidence.
12. Governing Law and Dispute Resolution
12.1 These Terms are governed by the laws of the State of Arizona, without regard to its conflict-of-laws rules, and by applicable federal law.
12.2 Informal resolution. Before filing any claim, a party must send written notice describing the dispute, and the parties will try in good faith to resolve it for 30 days.
12.3 Arbitration. Any dispute not resolved informally will be settled by binding arbitration by a single arbitrator in Maricopa County, Arizona, under the American Arbitration Association Commercial Arbitration Rules. Judgment may be entered in any court with jurisdiction. Either party may bring an individual claim in small claims court, or seek injunctive relief in court to protect confidential information or intellectual property. Claims may be brought only individually, not as part of a class or representative action. The courts located in Maricopa County, Arizona have exclusive jurisdiction over any matter not subject to arbitration.
12.4 Any claim must be brought within one (1) year after it arises, where the law allows.
13. Changes to These Terms
We may update these Terms from time to time. We will post the updated version on this page with a new “Last updated” date and, for active billing clients, give notice by email at least 30 days before material changes take effect. Orders placed after an update are governed by the version in effect at the time of the order. Continuing to use ongoing services after the effective date means you accept the changes.
14. General
These Terms, together with your order, any signed service agreement and the BAA, are the entire agreement between us about the services. If a written service agreement signed by both parties conflicts with these Terms, the signed agreement controls. If any part is found unenforceable, the rest remains in effect. Failure to enforce a right is not a waiver. You may not assign these Terms without our written consent. We are not liable for delays caused by events beyond our reasonable control, including Payer, government or system outages. Notices may be given by email to the addresses on file.
15. Contact
Cactus Billing Solutions · Tempe, Arizona · 623-267-4182 · info@cactusbillingsolutions.com