Terms and Conditions for use of BCBSND’s Online Provider Fee Schedule System
Read the following terms and conditions carefully before continuing. User must accept these terms and conditions to obtain access to the Online Provider Fee Schedule System. If user does not agree to these terms and conditions, user will not be able to use the Online Provider Fee Schedule System. It is suggested that user check these terms periodically for changes. The terms can be accessed from the link at the bottom of the Online Provider Fee Schedule main menu. If the Online Provider Fee Schedule System is accessed after changes to these terms and conditions are posted, user will be deemed to have accepted any changes.
Terms and Conditions as of: January 1, 2017.
User shall have access to such applications as Blue Cross Blue Shield of North Dakota (BCBSND) makes available through the Online Provider Fee Schedule System. BCBSND reserves the right to determine the applications and level of access granted to each user.
BCBSND may, without advance notice or liability, add, discontinue, or revise any aspect of the Online Provider Fee Schedule System, including without limitation such aspects as scope of service, availability of service, time of service availability, or the hardware and/or software required for user to access and use the Online Provider Fee Schedule applications. BCBSND will make reasonable efforts to provide user with advance notice of such events when practicable.
User shall be responsible for obtaining and maintaining, at users’ own expense, all computer hardware, software, communication equipment and access lines necessary to access and utilize the Online Provider Fee Schedule System.
Role based security is enforced to ensure information is accessible on a need to know basis. User’s access is restricted to identification numbers assigned by BCBSND.
The application requires a minimum of 128-bit encryption (cypher-strength).
Role based security is enforced to ensure information is accessible on a need to know basis. User access is restricted to assigned BCBSND provider identification numbers.
User is responsible for maintaining the confidentiality of the user code and password and is responsible for all activities resulting from their use, including Online Provider Fee Schedule use. User is responsible to immediately notify ‘Online Provider Fee Schedule Support Services’ when discontinuing use of the Online Provider Fee Schedule System, or in the event the user code and password are compromised or abused.
User agrees to use the Online Provider Fee Schedule System only for lawful purposes. User will not post or transmit on or through the Online Provider Fee Schedule System any libelous, obscene, or otherwise unlawful information of any kind, and user will not engage in any conduct involving the Online Provider Fee Schedule System that would constitute a criminal offense or give rise to civil liability under any local, state, federal or other law or regulation, including, but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). User will not upload, post, reproduce or distribute to or through the Online Provider Fee Schedule System any material protected by copyright, privacy or other proprietary right without first obtaining the written permission of the owner thereof. User acknowledges that the Online Provider Fee Schedule System contains copyrighted and other proprietary and confidential information and material, and user will respect all such proprietary rights and take such precautions as may be reasonably necessary to protect private, confidential and other proprietary information and material from Online Provider Fee Schedule use or disclosure.
User is responsible for compliance with all policies and procedures set forth in newsletters and bulletins published by payors or government agencies.
The data presented is not a guarantee of benefits. Benefits are only available for medically appropriate and necessary treatment that is covered according to the terms of the benefit plan and subject to the patient’s eligibility on the date of service. Benefits will be denied if the member is not eligible on the date of service.
BCBSND will make reasonable efforts to ensure that information it contributes to the Online Provider Fee Schedule System is timely and accurate. However, BCBSND does not warrant and assumes no responsibility whatsoever for the timeliness, accuracy, reliability, completeness or usefulness of any statement, opinion, advice, service or other information contributed by any third party.
BCBSND may, in its discretion and without notice, monitor the Online Provider Fee Schedule System and user's use thereof to determine and ensure compliance and to protect itself and other users of the Online Provider Fee Schedule system from fraudulent, unlawful or abusive use, or for any other reason deemed necessary by BCBSND. BCBSND may also intercept and disclose any content, record, use or other information to the extent reasonably necessary to protect the rights of BCBSND, for mechanical or service quality control as permitted by law, or to comply with any law, regulation, or governmental request. BCBSND may also, in its discretion and without notice, review, edit, refuse to post or remove any material or information submitted or transmitted to the Online Provider Fee Schedule System.
BCBSND may, when feasible, update the Online Provider Fee Schedule System either with or without notice to user. Such updates will occur automatically on-line upon user's signing into the Online Provider Fee Schedule System or may occur pursuant to prompts, which appear on user's web screen during use of the Online Provider Fee Schedule System. User hereby consents to the process of the on-line updates, waiving any and all claims for damages, etc., related thereto.
Planned availability to the Online Provider Fee Schedule System will be 24 hours a day 7 days a week. The system will be brought down for occasional maintenance. To the extent possible, this maintenance will be scheduled on the weekends and off-hours when it will be least likely to cause an interruption in production. Notification of this downtime will be communicated to the user through the broadcast news messaging board on the Online Provider Fee Schedule main menu.
A toll free, telephone support line to assist users with the Online Provider Fee Schedule System will be available. Online Provider Fee Schedule Support Services hours are 8:00 a.m. to 4:30 p.m. central standard time. These hours are also posted on the Online Provider Fee Schedule bulletin board.
The Online Provider Fee Schedule System and the content provide therein, are protected by copyright. All rights in the pages, site content, graphics, and arrangement are owned by BCBSND. User is prohibited from modifying, copying, distributing, transmitting, displaying, publishing, selling, licensing, creating derivative works of or using any of the content from the Online Provider Fee Schedule System for commercial or public purposes.
BCBSND uses the “Blue Cross Blue Shield” trademarks and service marks under license from the Blue Cross and Blue Shield Association. Any use of these trademarks or service marks, without the prior written consent of BCBSND and/or BCBSA, is expressly prohibited. All other trademarks and/or service marks used herein are the property of their respective owners.
All products and services provided through the Online Provider Fee Schedule System are subject to all applicable state and federal laws. This includes, but is not limited to, all laws related to insurance, employee benefits, equal employment opportunity, and the Americans with Disabilities Act.
While BCBSND is committed to protecting the privacy of its members and others, it is possible that any transmission of data on or through the Internet may be intercepted, monitored, or downloaded by an Online Provider Fee Schedule third party. To the extent allowed by state and federal law, BCBSND expressly disclaims any liability for any data transmitted by the user, intentionally or otherwise, over the Internet. USER ASSUMES ALL RISK FOR THE SENDING OF ANY INFORMATION, BY ANY MEANS, INTENTIONAL OR OTHERWISE, VIA THE INTERNET.
The professional judgement of the physician or other provider and the member’s discretion are the only factors in determining whether the member can, may or should receive such medical services and/or supplies. BCBSND's only responsibility is to determine whether benefits will be paid under a contract for health care.
EXCEPT AS EXPRESSLY PROVIDED ABOVE, THE Online Provider Fee Schedule SYSTEM, AND INFORMATION AVAILABLE THROUGH THE Online Provider Fee Schedule SYSTEM ARE FURNISHED BY BCBSND AND ACCEPTED BY USER "AS IS" AND "AS AVAILABLE", WITHOUT ANY WARRANTY WHATSOEVER. ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, INCLUDING ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE, ARE SPECIFICALLY EXCLUDED AND DISCLAIMED. BCBSND DOES NOT WARRANT THAT THE Online Provider Fee Schedule SYSTEM, OR INFORMATION OBTAINED THROUGH THE Online Provider Fee Schedule SERVICES, WILL MEET USER'S REQUIREMENTS, THAT THE OPERATION OF THE Online Provider Fee Schedule SYSTEM WILL BE UNINTERRUPTED OR ERROR FREE, OR THAT ALL FAILURES OF THE BCBSND Online Provider Fee Schedule SYSTEM TO SUBSTANTIALLY CONFORM TO OR PERFORM SUBSTANTIALLY IN ACCORDANCE WITH BCBSND'S SPECIFICATIONS WILL BE CORRECTED. EXCEPT AS EXPRESSLY PROVIDED ABOVE AND IN SUCH WARRANTIES, IF ANY, AS MAY BE PROVIDED BY THIRD PARTY VENDORS OF EQUIPMENT OR SOFTWARE UTILIZED IN CONNECTION WITH Online Provider Fee Schedule, THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE Online Provider Fee Schedule SYSTEM, AND INFORMATION OBTAINED THROUGH THE Online Provider Fee Schedule SYSTEM IS WITH USER.
Either party may, at its election and in its sole discretion, terminate access to the Online Provider Fee Schedule System. Online Provider Fee Schedule Support may, at any time, terminate a user's access to any or all of the Online Provider Fee Schedule applications without advance notice if the user has prolonged inactivity or commits any violation.
These terms and conditions set forth the entire agreement and understanding between BCBSND and user regarding the subject matter hereof and supersede any prior representations, advertisements, statements, proposals, negotiations, discussions, understandings, or agreements regarding the same subject matter. If user has entered into an Electronic Trading Partner Agreement with BCBSND, the terms of the Electronic Trading Partner Agreement remain in effect and are not superseded by this Agreement.
IN NO EVENT WILL BCBSND BE LIABLE TO USER OR ANY OTHER PERSON FOR ANY LOST PROFITS, LOST SAVINGS, LOST DATA, OR OTHER SPECIAL, CONSEQUENTIAL OR INCIDENTAL DAMAGES ARISING OUT OF OR RELATING TO THIS AGREEMENT OR ANY INFORMATION, PRODUCT OR SERVICE FURNISHED OR TO BE FURNISHED BY BCBSND UNDER THIS AGREEMENT OR THE USE THEREOF, EVEN IF BCBSND HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSS OR DAMAGE, AND THE AGGREGATE LIABILITY OF BCBSND UPON ANY CLAIMS HOWSOEVER ARISING OUT OF OR RELATING TO THIS AGREEMENT OR ANY INFORMATION, PRODUCTS OR SERVICES FURNISHED OR TO BE FURNISHED BY BCBSND UNDER THIS AGREEMENT WILL IN ANY EVENT BE ABSOLUTELY LIMITED TO THE AMOUNT PAID TO BCBSND BY USER UNDER THIS AGREEMENT; PROVIDED, HOWEVER, THAT NOTHING IN THIS AGREEMENT SHALL OPERATE TO RELIEVE BCBSND FROM LIABILITY FOR ITS OWN WILLFUL OR WANTON RECKLESSNESS OR INTENTIONAL TORTS.