Patient Access Production Services SLA Addendum
BY ENTERING INTO AN ORDER UNDER WHICH CUSTOMER WILL BE GIVEN ACCESS TO AND/OR USE OF ANY PATIENT ACCESS PRODUCTION SERVICES WHICH ARE PRICED BASED ON A PER-BILLABLE TRANSACTION BASIS (WITH OR WITHOUT A MINIMUM), CUSTOMER HEREBY ENTERS INTO THIS PATIENT ACCESS PRODUCTION SERVICES SLA ADDENDUM (THIS “ADDENDUM”) AND IS LEGALLY BOUND THEREBY. THIS ADDENDUM IS HEREBY ATTACHED TO AND MADE A PART OF THE GENERAL TERMS AND CONDITIONS (“GENERAL TERMS”) SET FORTH AT HTTPS://WWW.INFINX.COM/TERMS-AND-CONDITIONS-FOR-CUSTOMER-AGREEMENTS BY AND BETWEEN THE CONTRACTING INFINX ENTITY PROVIDER DESIGNATED IN THE ORDER(S) ON BEHALF OF ITSELF AND ITS AFFILIATES (INCLUDING WITHOUT LIMITATION, ITS OFF-SHORE AFFILIATES WHICH INCLUDE INFINX SERVICES PVT. LTD., LOCATED IN INDIA AND INFINX HEALTHCARE PHILIPPINES, INC., LOCATED IN THE PHILIPPINES) (COLLECTIVELY, “INFINX”), AND THE PURCHASING BUSINESS OR OTHER ENTITY WHO IS ENTERING INTO THE ORDER(S) (“CUSTOMER”), REGARDING THE PROVISION AND USE OF SUCH PATIENT ACCESS PRODUCTION SERVICES AS SET FORTH IN SUCH ORDER(S). THE PERSON EXECUTING THE ORDER(S) ON BEHALF OF CUSTOMER REPRESENTS AND WARRANTS TO INFINX THAT THEY HAVE FULL LEGAL AUTHORITY TO ACCEPT THE TERMS OF THIS ADDENDUM AND THAT THEY, CUSTOMER AND EACH USER OF SUCH PRODUCTION SERVICES ARE NOT BANNED FROM USING THE PATIENT ACCESS PRODUCTION SERVICES UNDER THE LAWS OF THE UNITED STATES OR ANY OTHER COUNTRY. ALL CAPITALIZED TERMS USED IN THIS ADDENDUM BUT NOT DEFINED WILL HAVE THE SAME MEANINGS GIVEN IN THE GENERAL TERMS, THE PRODUCTION SERVICES ADDENDUM OR APPLICABLE ORDER. IN THE EVENT OF A CONFLICT BETWEEN THE TERMS OF THIS ADDENDUM, THE PRODUCTION SERVICES ADDENDUM, THE GENERAL TERMS AND THE ORDER, THE FOLLOWING DESCENDING ORDER OF PRECEDENCE WILL CONTROL: THE ORDER, THIS ADDENDUM, THE PRODUCTION SERVICES ADDENDUM AND THE GENERAL TERMS.
- Patient Access Production Services SLAs. Infinx will work to achieve the following performance metrics (collectively, the “Patient Access Production Services SLAs”):
- Accuracy SLA: Infinx will work to achieve a ninety-eight percent (98%) accuracy rate for Billable Transactions in any particular calendar month (“Accuracy SLA”), as confirmed per audits. Infinx audits are conducted by its quality cell and track the agreed upon broad metrics. Customer shall have access to the results of such audits upon request, and Infinx shall consider Customer’s guidance and inputs for such process.
- Turn Around Time SLA: The “TAT SLA” shall collectively consist of the following Standard TAT SLA and (where applicable) the Same Day SLA and the STAT TAT SLA. Any other Infinx statements or estimates as to completion date or timing are not included within the TAT SLA as they are non-binding approximations subject to various factors.
- Standard TAT SLA. After receiving a request for a prior authorization (“PA”) or eligibility verification benefit check (“EV/BC”) Billable Transaction from Customer in the Patient Access SaaS Services, Infinx will work to initiate such Billable Transaction within one (1) business day (i.e., other than during Holidays and weekends) excepting SLA Excluded Events (“Standard TAT SLA”); provided, however, that the Standard TAT SLA shall not apply: (A) to Billable Transactions in excess of one hundred and five percent (105%) of the Monthly Baseline; or, (B) to Billable Transactions in any particular business day which exceed one hundred and five percent (105%) of the pro rata daily portion of the Monthly Baseline with the same applicable priority (Standard PA or Standard EV/BC) (although Infinx will use reasonable efforts to initiate such Billable Transactions within three (3) business days after request). “Monthly Baseline” means the average monthly number of Billable Transactions in the prior 3 months for the same applicable Infinx service offering (Standard PA or Standard EV/BC). In the event Customer anticipates increased workloads as described in (A) and/or (B) above, upon request of Customer, Customer and Infinx may agree in writing (including email) that Infinx will work overtime (outside of normal business hours on business days, or any hours worked on Holidays or weekends) to complete such work for discrete, designated periods and/or workloads, and such work will not be subject to the Standard TAT SLA and will be billed at one and three-fourths (1.75x) the applicable pricing set forth in the main body of the Order.
- Same Day TAT SLA. Where applicable, after receiving a request for a PA or EV/BC Billable Transaction from Customer in the Patient Access SaaS Services, Infinx will work to initiate such Billable Transaction designated as “Same Day” priority within four (4) business hours (i.e., other than during Holidays, weekends and after regular business hours) excepting SLA Excluded Events (“Same Day TAT SLA”); provided, however, that the Same Day TAT SLA shall not apply: (A) to Billable Transactions in excess of one hundred and five percent (105%) of the Monthly Baseline for Billable Transactions with the same applicable priority (Same Day PA or Same Day EV/BC); or, (B) to all Billable Transactions designated as “Same Day” priority in any particular business day which exceed one hundred and one percent (101%) of the pro rata daily portion of the Monthly Baseline with the same applicable priority (Same Day PA or Same Day EV/BC).
- STAT TAT SLA. Where applicable, after receiving a request for a PA or EV/BC Billable Transaction from Customer in the Patient Access SaaS Services, Infinx will work to initiate such Billable Transaction designated as “STAT” priority within thirty (30) business minutes for STAT PA only requests and for STAT EV/BC only requests, and within sixty (60) business minutes for combined STAT PA and EV/BC requests, all excepting SLA Excluded Events (“STAT TAT SLA”); provided, however, that the STAT TAT SLA shall not apply: (A) to Billable Transactions in excess of one hundred and five percent (105%) of the Monthly Baseline for Billable Transactions with the same applicable priority (STAT PA only, STAT EV/BC only or STAT combined PA and EV/BC); or, (B) to all Billable Transactions designated as “STAT” priority in any particular business day which exceed one hundred and one percent (101%) of the pro rata daily portion of the Monthly Baseline with the same applicable priority (STAT PA only, STAT EV/BC only or STAT combined PA and EV/BC).
- Credits for SLA Failures:
- Accuracy SLA and TAT SLA: Customer’s sole remedies and Infinx’s sole liability for any failures to achieve the Accuracy SLA and TAT SLA, as measured by reported and confirmed errors, mutual review, discussion and agreement, shall be as follows: (i) Infinx shall not charge Customer for any fees for the processing of an applicable Billable Transaction which does not meet the Accuracy SLA; (ii) if five percent (5%) or more of the Billable Transactions in any particular calendar month do not meet the Accuracy SLA, Customer shall receive a one-time credit in an amount equal to five percent (5%) of the total fees payable for Patient Access Production Services under the applicable Order for such month; (iii) if five percent (5%) or more of the Billable Transactions in any particular calendar month do not meet the TAT SLA, Customer shall receive a one-time credit in an amount equal to five percent (5%) of the total fees payable for Patient Access Production Services under the applicable Order for such month, and (iv) Infinx shall not charge Customer the increased fees applicable to Same Day Billable Transactions or STAT Billable Transactions if Infinx fails to meet the applicable TAT SLA.
- SLA credits may only be applied to fees next coming due from Customer, are not transferable and may not be redeemed for cash or other refunds.
- SLA Excluded Events: Except as provided for herein, Infinx will not be responsible or liable for any failure to achieve the SLAs resulting from or attributable to and downtimes for scheduled maintenance, upgrades, and emergency or other maintenance/repairs or the following events and circumstances (none of which will be considered in determining an SLA failure): (i) failures in any telecommunications services, networks or systems, (ii) Customer’s or any third party’s negligence, acts or omissions, (iii) any force majeure events or other cause beyond Infinx’s reasonable control, (iv) unauthorized access to the Patient Access SaaS Services platform or other Services, breach of firewalls or other hacking unless resulting from Infinx’s gross negligence or willful misconduct, or (v) any limitations upon or the inability to access and use Customer’s systems and software as reasonably necessary to perform Infinx’s obligations, if applicable (collectively, the “SLA Excluded Events”).
Patient Access Production Services SLA Addendum to General Terms and Conditions, Version 1.0, Promulgated February 5, 2025.