Terms of Service

These Terms of Service ("Terms") are a legally binding agreement between you and AuthFight, Inc. ("AuthFight," "we," "us," or "our") governing your access to and use of the AuthFight platform, website, and all related services (collectively, the "Service").

By creating an account, clicking "I agree," or using any part of the Service, you confirm that you have read, understood, and agree to be bound by these Terms and our Privacy Policy and HIPAA Notice of Privacy Practices, each of which is incorporated into these Terms by reference.

These Terms primarily govern use of the patient appeal Service. Partner pharmacies and physicians may also be subject to separate or supplemental agreements applicable to their accounts and roles, including Business Associate Agreements where required. If a supplemental agreement conflicts with these Terms, the supplemental agreement controls for that relationship.

If you do not agree to these Terms, do not use the Service.

Understanding what AuthFight does and does not do is important before you use the Service.

Who can use AuthFight

To use the Service for yourself, you must be at least 18 years old and legally capable of entering into a binding agreement. You may use AuthFight for another patient only if you are that patient's parent or legal guardian or otherwise have documented legal authority to act for them. By doing so, you represent that your authority is valid and permits you to accept these Terms, provide the patient's information, sign applicable authorizations, and manage the appeal on the patient's behalf.

Account registration

You must create an account to access the Service. You agree to provide accurate, current, and complete information during registration and to keep it up to date. You are responsible for maintaining the confidentiality of your account credentials and for all activity that occurs under your account.

One account per person

Each patient account may be used only by the individual who registered it or by a person with documented legal authority to manage an appeal for the patient identified in that account. You may not share account access or use a patient account to manage appeals for multiple patients.

Account security

Notify us immediately at support@authfight.com if you become aware of any unauthorized use of your account or any other security breach. We are not liable for any loss or damage arising from your failure to keep your credentials secure.

AuthFight provides the following features as part of the Service:

Denial Decoder

We use the denial information you provide to explain, in plain language, the stated reason for the denial and provide general information about the appeal process. Our explanation is informational and may not identify every reason, requirement, or legal issue affecting your case.

Fight Score

We calculate a Fight Score using publicly available CMS-reported overturn data, your denial code's historical reversal rates, and the urgency of your case. The Fight Score is an informational estimate only. See Section 05 for important disclaimers about the Fight Score.

AI Appeal Letter

We generate a personalized appeal letter using information you provide in a short intake form, combined with relevant clinical evidence and the published rules governing insurance appeals. All letters are sent to your treating physician for clinical review and signature before being submitted. See Section 05 for important disclaimers about AI-generated content.

Deadline Tracker

We estimate appeal deadlines using the insurer, plan type, denial date, and other information available to us, and may send reminders before those estimated deadlines. Insurer notices and plan documents control, and you remain responsible for confirming and meeting every deadline applicable to your case.

Submission Handling

We provide verified submission contacts for major insurers and, where you authorize us to do so, submit your appeal on your behalf via fax, portal, or mail. Submission contact information is updated regularly but we cannot guarantee it remains current at all times.

Escalation to External Review

If an internal appeal is denied, we may help identify whether an external independent review appears available and, where the Service supports it and you elect to proceed, assist with initiating that process. Eligibility, deadlines, procedures, and the effect of a decision depend on your plan and applicable law. External review is conducted by an independent organization and remains beyond our control.

Fees, payment & refunds

Patients referred by a participating partner pharmacy pay nothing — the pharmacy's subscription covers your appeal. For all other patients, a one-time service fee (currently $34.99 per appeal) applies. The exact amount is displayed at checkout, and you are charged only when you choose to proceed. Payment is processed by our payment provider; AuthFight does not store your card details.

Refunds. If your appeal is never submitted to your insurer for any reason — including your physician declining to sign, your revocation of authorization, or your cancellation before submission — you are entitled to a full refund of the service fee. Request it at support@authfight.com and we will process it to your original payment method within 10 business days. Once your appeal has been submitted to your insurer, the fee has been earned and is non-refundable regardless of the insurer's decision.

AI-generated appeal letters

Your appeal letter is drafted by an AI system using the information you provide, relevant clinical sources, and published appeal regulations. This draft is then sent to your treating physician, who may revise it, add supporting clinical opinion, and sign it before submission.

By proceeding with submission, you confirm that you have reviewed the letter and that the information it contains is accurate and reflects your situation. You are responsible for the accuracy of the content in your appeal letter. AuthFight is not responsible for inaccuracies arising from information you provided incorrectly or incompletely.

Your data is not used to train AI

Your personal and health information is never used to train, fine-tune, or improve our AI models or any third-party AI system. See our Privacy Policy for full details.

Fight Score disclaimer

Your Fight Score is calculated using publicly available CMS-reported data that Medicare Advantage insurers are federally required to disclose, combined with your denial code's historical reversal frequency and case urgency classification.

To use the Service effectively and lawfully, you agree to the following:

Provide accurate information

You will provide complete and truthful information about your denial, health condition, insurance coverage, and any other details requested. Providing false or misleading information may constitute insurance fraud, which is a serious federal and state crime. AuthFight is not responsible for any consequences — including appeal denial, coverage loss, or legal liability — arising from inaccurate information you provide.

Review before submission

You will carefully review your AI-generated appeal letter and all supporting documents before authorizing submission. Once an appeal is submitted to your insurer, it cannot be unsent. If you notice errors, notify us before authorizing submission.

Act on deadline alerts

We will send you reminders about upcoming appeal deadlines. You are ultimately responsible for meeting all applicable deadlines. AuthFight's reminder system supplements but does not replace your own diligence in tracking your appeal timeline.

Maintain your account

Keep your contact information current so we can reach you with status updates, deadline alerts, and insurer responses. Appeals that cannot progress due to outdated contact information are not our responsibility.

AuthFight may act on your behalf only after you electronically sign the case-specific Authorization to Release Information and Appointment of Authorized Representative presented during intake. Within the scope of those signed records, you authorize AuthFight to:

• Send the appeal letter to your treating physician for clinical review and signature, follow up with the physician's office, and receive records or information relevant to the appeal as authorized by you.
• File and pursue the appeal and submit the appeal letter and supporting documents to your health insurer by phone, fax, mail, portal, or another designated channel.
• Communicate with your insurer about the appeal, confirm receipt, obtain a case reference number, request and receive the case file and criteria relied upon, and follow the appeal's status.
• Receive notices, correspondence, documents, and the appeal decision related to the case.
• Share the appeal record with an independent review organization and assist with external review if you elect to pursue it and it is available.

Our authority is limited to the purposes and scope stated in your signed records. We cannot make healthcare decisions for you, waive your rights, or enter into agreements unrelated to the appeal. If these Terms differ from a signed authorization or representative appointment, the signed case-specific record controls.

Each signed record applies only to the identified case, expires one year after signing or when the case concludes (whichever comes first), and can be viewed in full from the Settings page of your account.

You may revoke this authorization at any time from the Settings page of your account or by contacting us at support@authfight.com. Revocation stops all future actions on your behalf but cannot undo submissions already made.

AuthFight does not employ or contract with physicians and does not operate a physician network. When your appeal letter is ready, we send it to your own treating physician — the provider who prescribed the denied treatment — for clinical review and signature. Your physician may revise the letter's clinical content before signing, and we follow up with their office on your behalf until a response is received. Your treating physician exercises independent professional judgment in deciding whether and in what form to sign your appeal letter; AuthFight does not control that decision and is not responsible for whether or when your physician responds.

AuthFight does not guarantee, promise, or warrant any particular outcome from the use of the Service, including but not limited to:

• Approval of your prior authorization appeal by your insurer.
• Approval of coverage for any specific medication, procedure, or service.
• A particular decision timeline from your insurer or an external reviewer.
• Any specific outcome in external or judicial review proceedings.

Insurance appeal decisions are made solely by your health insurer or, in the case of external review, by an independent review organization. These entities are not under AuthFight's control. Our role is to give you the strongest possible appeal — the decision belongs to the insurer.

You may not use the Service for any of the following purposes. Violation may result in immediate account termination and, where applicable, referral to law enforcement.

AuthFight's intellectual property

The AuthFight platform, including its software, algorithms, design, text, graphics, Fight Score methodology, and all other content created by AuthFight, is owned by AuthFight, Inc. and protected by U.S. and international copyright, trademark, and other intellectual property laws.

You may not copy, reproduce, modify, distribute, or create derivative works based on AuthFight's proprietary content without our prior written permission.

Limited license to use the Service

AuthFight grants you a personal, non-exclusive, non-transferable, revocable license to access and use the Service solely for the purpose of preparing and submitting your own insurance appeal, in accordance with these Terms.

Feedback

If you submit feedback, suggestions, or ideas about the Service, you grant AuthFight a perpetual, royalty-free license to use that feedback without restriction or obligation to you.

You retain ownership of all documents, images, records, and information you upload to AuthFight ("Your Content"). By uploading Your Content, you grant AuthFight a limited license to use, process, and transmit it solely for the purpose of building and submitting your appeal, as described in these Terms and our Privacy Policy.

You represent and warrant that:

• You have the right to upload Your Content and to grant AuthFight this license.
• Your Content does not infringe the intellectual property, privacy, or other rights of any third party.
• Your Content is accurate and is not submitted for any fraudulent purpose.

AuthFight does not claim ownership of Your Content. When you delete your account or request deletion of your data, we will remove Your Content in accordance with our Privacy Policy retention schedule.

These limitations apply regardless of the form of action — whether in contract, tort (including negligence), strict liability, or otherwise — and regardless of whether the limited remedies available to you fail of their essential purpose.

Some jurisdictions do not allow the exclusion or limitation of certain damages. In such jurisdictions, our liability is limited to the greatest extent permitted by law.

You agree to defend, indemnify, and hold harmless AuthFight, Inc. and its officers, directors, employees, contractors, and agents from and against any claims, liabilities, damages, losses, and expenses — including reasonable legal fees — arising out of or in any way connected with:

• Your access to or use of the Service in violation of these Terms.
• Your provision of inaccurate, false, or misleading information to AuthFight.
• Your violation of any applicable law or regulation.
• Your infringement of any third-party right, including intellectual property or privacy rights.

Termination by you

You may close your account at any time by using the account deletion option in your account settings or by emailing support@authfight.com. Closing your account will stop all active appeal processing. Deletion of your personal data will follow the schedule described in our Privacy Policy.

Termination by AuthFight

We may suspend or terminate your account and access to the Service at any time, with or without notice, if we believe you have violated these Terms, provided false information, or used the Service in a way that creates legal risk for AuthFight or harm to others.

Effect of termination

Upon termination, your license to use the Service ends immediately. Sections of these Terms that by their nature should survive termination — including Sections 13 (Limitation of Liability), 14 (Disclaimer of Warranties), 15 (Indemnification), and 17 (Governing Law) — will survive.

Governing law

These Terms are governed by the laws of the State of Florida, without regard to its conflict of law provisions. Any legal action arising under these Terms must be brought exclusively in the state or federal courts located in Florida, and you consent to personal jurisdiction in those courts.

Informal resolution first

Before filing any legal claim, you agree to contact us at support@authfight.com and give us 30 days to try to resolve the dispute informally. Most issues can be resolved quickly through direct communication.

Class action waiver

To the extent permitted by law, you agree that any dispute arising under these Terms will be resolved on an individual basis and not as part of a class, consolidated, or representative action.

We may update these Terms from time to time. When we make material changes, we will:

• Update the effective date at the top of this page.
• Send an email notification to all registered users.
• Display a notice within the platform when you next log in.

For material changes affecting fees, authorization, dispute rights, or other significant obligations, we may require you to review and affirmatively accept the updated Terms before continuing to use the affected Service. Where affirmative acceptance is not required, your continued use after the effective date constitutes acceptance. If you do not agree with an update, you must stop using the affected Service and may close your account.

For non-material changes — such as corrections to typos, formatting updates, or clarifications that do not affect your rights — we may update the Terms without prior notice.

Questions about these Terms? Reach out to us directly: