Terms of Service

Effective: April 30, 2026

Plain-English summary. We draft an insurance-appeal letter for $59. We are not your doctor or your lawyer. The letter is a draft your physician decides whether to sign. If your physician won't sign it, reply "DECLINED" within 7 days and we refund the full $59 — no questions.

1. What this service is — and isn't

PriorAuthAppeal ("we," "us") is an AI-assisted drafting service. We generate a personalized prior-authorization appeal letter, a one-page summary, and a document checklist based on information you submit. We are not a medical practice, a law firm, or a healthcare provider. We do not give medical or legal advice, do not communicate with your insurance company on your behalf, and do not file appeals for you. The letters we produce are drafts — your physician and you decide whether to use, edit, or discard them.

2. Eligibility

You must be at least 18 years old. You must be the patient described in the form, or have explicit authorization from that patient to submit on their behalf.

3. Pricing and the money-back guarantee

The fee for one appeal letter is $59 USD, charged once at the time of order. We do not subscribe you to anything; there are no recurring charges.

Money-back guarantee. If your physician declines to sign the letter as drafted, reply to the delivery email with the word "DECLINED" within 7 days of delivery and we will refund the full $59 — typically within 1–2 business days of receipt of your DECLINED reply. Refunds are processed back to the original payment method.

The guarantee does not apply if (a) more than 7 days have passed since delivery, (b) the denial pertains to a drug or insurer outside the scope of the service, or (c) you did not actually present the letter to a licensed physician.

Anti-abuse. We reserve the right to deny refund requests where we detect evidence of bad-faith use of the service, including but not limited to: multiple orders from the same individual for the same drug-and-insurer combination, repeated DECLINED replies after substantively identical orders, evidence the letter was never actually presented to a licensed physician, or other patterns suggesting abuse rather than genuine physician refusal. Customers acting in good faith have nothing to fear from this clause.

4. Your responsibilities — accuracy of information

The letter is built from the information you submit. If you misrepresent your BMI, comorbidities, prior-treatment history, or other facts, the letter will reflect those misrepresentations and may constitute fraud against your insurer. You are solely responsible for verifying the accuracy of your submission and reviewing the letter before presenting it to your physician. We are not liable for consequences arising from inaccurate information.

5. No professional relationship

Use of the service does not create a doctor-patient, attorney-client, or fiduciary relationship between you and us. We are a software service. All decisions about your medical care must be made by you in consultation with a licensed healthcare provider.

6. The letter — your rights, our limits

The letter we draft is yours to use. Your prescribing physician's signature signals their professional clinical judgment that the contents accurately reflect your condition. We do not warrant that your appeal will succeed. Approval depends on the specifics of your case, your insurer's policies, your physician's documentation, and other factors outside our control.

7. Acceptable use

You agree not to:

• Use the service to commit fraud against your insurer or any third party
• Submit false, misleading, or fabricated medical information
• Resell, sublicense, redistribute, or scrape the service
• Reverse-engineer the system, prompts, or workflow
• Use the service in violation of applicable law

8. Intellectual property

You retain ownership of the personal information you submit and of the letter we produce on your behalf. We retain ownership of the underlying system, prompts, models, policy database, and workflow.

9. Limitation of liability

To the maximum extent permitted by law, our total liability for any claim arising from your use of the service is limited to the amount you paid us — i.e., up to $59. We are not liable for indirect, incidental, consequential, or punitive damages, including lost insurance benefits, denied prescriptions, or treatment delays.

10. Termination

We may decline service or terminate access for any user who violates these terms. You may discontinue use at any time. Termination does not affect refund rights for orders within the 7-day guarantee window.

11. Changes to these terms

We may update these terms. The "Effective" date at the top reflects the latest version. Material changes will be communicated by email to existing customers when reasonably practicable. Continued use after an update constitutes acceptance.

12. Governing law and disputes

These terms are governed by the laws of the State of Delaware, USA, without regard to conflict-of-laws rules. Any dispute will be resolved by binding individual arbitration in English, except where prohibited by law. To the extent permitted, you waive participation in class actions.

13. Contact

Questions about these terms: hello@priorauthappeal.com