Terms Of Services

These Terms of Service (“Terms”) govern access to and use of the MyALW website, software platform, billing services, administrative services, and related products and services (collectively, the “Services”).

These Terms constitute a legal agreement between you and MyALW (“MyALW,” “we,” “us,” or “our”).

By accessing or using the Services, creating an account, or engaging MyALW to provide services, you agree to these Terms.

If you are using MyALW on behalf of a facility, corporation, organization, or other entity, you represent that you have authority to accept these Terms on behalf of that entity.

01 MyALW Services

MyALW provides technology and administrative services designed to assist Assisted Living Waiver providers and other authorized organizations with services that may include:

Billing administration
Claim preparation
Claim submission
Claim tracking
Payment reconciliation
Resident billing records
Eligibility-related administrative workflows
Authorization tracking
Share-of-cost tracking
Reporting
Documentation management
Facility and resident account management
Communication and administrative support

The specific Services provided to a customer may also be governed by a separate service agreement, order form, Business Associate Agreement, pricing agreement, or other written contract.

If a separate written agreement conflicts with these Terms, the separate written agreement will control with respect to the conflicting provision.

02MyALW Is Not a Government Agency

MyALW is an independent private company.

MyALW is not the California Department of Health Care Services (“DHCS”), Medi-Cal, the Centers for Medicare & Medicaid Services (“CMS”), or any other federal, state, county, or local government agency.

Use of MyALW does not create any guarantee of:

All eligibility, authorization, reimbursement, and program decisions remain subject to the applicable government agency, health plan, program administrator, or other responsible organization.

03 Eligibility to Use the Services

You must be at least 18 years old and legally capable of entering into a binding agreement to use MyALW.

If you access MyALW on behalf of an assisted living facility, RCFE, healthcare provider, company, or other organization, you represent and warrant that you are authorized to act on behalf of that organization.

You may only access resident, billing, health, facility, or program information that you are legally authorized to access.

04User Accounts

Certain Services may require an account.

You agree to:

Provide accurate and complete account information
Maintain current account information
Protect your username and password
Restrict unauthorized access to your account
Immediately notify MyALW of suspected unauthorized access
Accept responsibility for activities occurring through your account where permitted by law

You may not share login credentials with unauthorized individuals.

MyALW may require additional verification, authentication, or security measures before permitting access to sensitive information.

05 Customer Responsibilities

You are responsible for the accuracy, completeness, legality, and timeliness of information submitted to MyALW.

This includes information concerning:

Residents
Dates of service
Facility licensing
Provider enrollment
Authorizations
Eligibility
Service levels
Share of cost
Billing amounts
Claims
Medical or service records
Supporting documentation

You agree not to knowingly provide false, misleading, fraudulent, incomplete, or unauthorized information.

You remain responsible for reviewing information submitted through MyALW and notifying us promptly of errors.

06Billing and Claims

MyALW may assist customers with preparing, submitting, correcting, monitoring, and reconciling claims.

MyALW does not guarantee that any claim will be:

Payment decisions may depend on information and systems controlled by DHCS, Medi-Cal, managed care organizations, clearinghouses, financial intermediaries, government agencies, and other third parties.

Customers remain responsible for ensuring that services billed were actually provided, properly documented, appropriately authorized, and legally billable.

MyALW may rely on information supplied by the customer when performing billing services.

07No Guarantee of Reimbursement

MyALW may provide administrative assistance, software tools, reports, recommendations, or billing support intended to improve billing operations.

Past payment history, estimated reimbursement, claim status information, expected payment calculations, or other projections do not guarantee future payment.

Government reimbursement rates, rules, eligibility requirements, authorization requirements, and payment methodologies may change.

08 Healthcare and Professional Disclaimer

MyALW provides billing, administrative, software, and related services.

Unless expressly stated otherwise in writing, MyALW does not provide:

Information provided through MyALW should not be treated as a substitute for professional medical, legal, accounting, compliance, or regulatory advice.

Customers are responsible for obtaining professional advice when appropriate.

09 Resident and Health Information

The Services may involve access to personal, healthcare-related, billing, eligibility, or resident information.

Users may only submit or access such information when authorized to do so.

Where applicable, MyALW may enter into a Business Associate Agreement or other data protection agreement with a customer.

The handling of Protected Health Information may also be governed by HIPAA, applicable California law, contractual obligations, and MyALW’s Privacy Policy.

Users may not use resident information for unauthorized purposes.

10 Privacy

Your use of the Services is also subject to the MyALW Privacy Policy.

By using the Services, you acknowledge that information may be collected, processed, stored, and disclosed as described in the Privacy Policy and any applicable agreements between MyALW and your organization.

11 Third-Party Systems

MyALW may interact with or provide links, integrations, or administrative support involving third-party systems, including:

Government portals
Medi-Cal systems
DHCS systems
Clearinghouses
Payment processors
Electronic healthcare systems
Provider portals
Eligibility systems
Financial institutions
Software vendors

MyALW does not control these third-party systems.

We are not responsible for third-party:

The terms and privacy policies of third-party providers may separately apply.

12 Service Availability

We work to maintain reliable access to MyALW, but we do not guarantee uninterrupted or error-free availability.

The Services may occasionally be unavailable because of:

We may modify, improve, suspend, or discontinue portions of the Services when reasonably necessary.

13 Fees and Payment

Customers agree to pay all fees associated with their selected MyALW Services according to the applicable pricing agreement, subscription agreement, service agreement, invoice, or order form.

Fees may be structured as:

Applicable pricing will be disclosed separately.

Unless otherwise stated in writing, fees owed to MyALW are independent of whether a third-party payer ultimately reimburses the customer.

Late or unpaid balances may result in suspension or termination of Services where permitted by law and contract.

14 Taxes

Customers are responsible for taxes, assessments, or governmental charges applicable to their purchase or use of the Services, excluding taxes imposed on MyALW’s income.

15 Acceptable Use

You may not use MyALW to:

Submit fraudulent claims
Falsify documentation
Misrepresent services provided
Access another person’s information without authorization
Circumvent security measures
Introduce malware or malicious software
Attempt unauthorized access to MyALW systems
Reverse engineer the platform except where legally permitted
Interfere with platform operation
Use the Services for unlawful activity
Violate healthcare, privacy, billing, or fraud and abuse laws

MyALW may investigate suspected misuse and may suspend access where necessary to protect users, residents, the platform, or third parties.

16 Compliance With Law

Customers are responsible for complying with laws and regulations applicable to their own facilities, businesses, staff, residents, documentation, services, and billing activities.

This may include applicable requirements involving:

MyALW’s assistance does not transfer the customer’s legal or regulatory obligations to MyALW.

17 Audits, Recoupments, and Reviews

Government agencies, health plans, auditors, program administrators, or other authorized entities may review or audit claims.

Claims previously paid may later be adjusted, denied, investigated, or recouped.

Unless otherwise agreed in writing, MyALW is not financially responsible for reimbursement recoupments, penalties, claim reversals, or audit findings resulting from:

MyALW may assist customers with records and administrative responses when included within the customer’s Services.

18 Intellectual Property

The MyALW website, platform, software, branding, designs, workflows, documentation, databases, content, and related materials are owned by or licensed to MyALW and are protected by applicable intellectual property laws.

Subject to these Terms, MyALW grants authorized users a limited, revocable, non-exclusive, non-transferable right to use the Services for legitimate business purposes.

You may not copy, sell, license, distribute, reproduce, or commercially exploit MyALW’s proprietary materials without written permission.

19 Customer Data

As between MyALW and the customer, customers retain their rights in data they lawfully provide to MyALW, subject to applicable law and contractual obligations.

Customers grant MyALW permission to process that information as reasonably necessary to:

Provide the Services
Perform billing activities
Maintain accounts
Provide customer support
Protect platform security
Meet legal obligations
Improve service reliability and functionality where legally permitted

MyALW does not acquire ownership of resident healthcare information merely because it is processed through the platform.

20 Feedback

If you provide ideas, suggestions, recommendations, or feedback regarding MyALW, you authorize us to use that feedback to improve our products and services without payment or obligation to you.

This does not grant MyALW ownership of confidential resident or customer information.

21 Confidentiality

Users may receive access to confidential or proprietary information through MyALW.

You agree to protect confidential information and not disclose it except as authorized or legally required.

Confidential information may include:

Resident records
Billing information
Facility information
Financial information
Business processes
Software functionality
Pricing
Proprietary materials

Additional confidentiality obligations may be established through separate agreements.

22 Suspension and Termination

MyALW may suspend or terminate access to the Services if:

Fees remain unpaid
These Terms are violated
Unauthorized access is suspected
Fraudulent activity is suspected
Security is threatened
Applicable law requires suspension
Continued service presents unreasonable legal or operational risk

Customers may terminate their Services according to the applicable service agreement or subscription terms.

Termination does not eliminate amounts already owed.

Certain provisions of these Terms will continue after termination where their nature requires survival, including confidentiality, intellectual property, disclaimers, indemnification, limitations of liability, and payment obligations.

23 Disclaimer of Warranties

TO THE MAXIMUM EXTENT PERMITTED BY LAW, THE SERVICES ARE PROVIDED “AS IS” AND “AS AVAILABLE.”

MYALW DISCLAIMS WARRANTIES THAT ARE NOT EXPRESSLY PROVIDED IN WRITING, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, AND NON-INFRINGEMENT.

MYALW DOES NOT WARRANT THAT:

THE SERVICES WILL ALWAYS BE AVAILABLE
ALL CLAIMS WILL BE ACCEPTED
ALL DATA WILL BE ERROR-FREE
THIRD-PARTY SYSTEMS WILL FUNCTION PROPERLY
USE OF THE SERVICES WILL RESULT IN ANY PARTICULAR FINANCIAL OUTCOME

Some jurisdictions may not permit certain warranty exclusions, in which case these provisions apply only to the extent permitted by law.

24 Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY LAW, MYALW AND ITS OWNERS, OFFICERS, EMPLOYEES, CONTRACTORS, AFFILIATES, AND SERVICE PROVIDERS WILL NOT BE LIABLE FOR INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES ARISING FROM OR RELATING TO THE SERVICES.

THIS INCLUDES, WHERE PERMITTED BY LAW:

LOST PROFITS
LOST REVENUE
LOST BUSINESS
CLAIM DENIALS
DELAYED REIMBURSEMENT
LOST DATA
BUSINESS INTERRUPTION
THIRD-PARTY SYSTEM FAILURE

To the maximum extent permitted by law, MyALW’s aggregate liability arising from or relating to the Services will not exceed the amounts paid by the customer to MyALW during the [three/six/twelve] months immediately preceding the event giving rise to the claim.

Nothing in these Terms excludes liability that cannot legally be excluded or limited.

25 Indemnification

To the extent permitted by law, you agree to defend, indemnify, and hold harmless MyALW and its owners, officers, employees, contractors, affiliates, and representatives from claims, damages, liabilities, penalties, losses, and reasonable legal expenses arising from or relating to:

Your misuse of the Services
Your violation of these Terms
Fraudulent or inaccurate billing information supplied by you
Unauthorized access or disclosure caused by you
Your violation of applicable law
Services billed by you that were not properly provided, documented, authorized, or legally billable

This section does not require indemnification for liability caused solely by MyALW’s own conduct where such indemnification is prohibited by law.

26Force Majeure

MyALW will not be responsible for delays or failures caused by circumstances reasonably outside our control, including:

Natural disasters
Fires
Power outages
Internet outages
Cyberattacks
Government actions
Government system failures
Labor disruptions
Telecommunications failures
Public health emergencies
Acts of war or terrorism
Third-party infrastructure failures

27Governing Law

Unless another written agreement states otherwise, these Terms are governed by the laws of the State of California, without regard to conflict-of-law principles.

28Dispute Resolution

Before initiating formal legal proceedings, you and MyALW agree to make a reasonable effort to resolve disputes informally by providing written notice describing the dispute.

The parties will have at least 30 days from receipt of that notice to attempt an informal resolution.

Any additional arbitration, court venue, jury waiver, or class-action waiver terms should be stated in the applicable customer agreement or an updated version of these Terms after review by legal counsel.

29Electronic Communications

By using MyALW, you consent to receive electronic communications relating to your account and Services, including:

Account notifications
Billing notices
Security alerts
Service announcements
Administrative communications

Electronic communications may satisfy legal requirements that communications be provided in writing where permitted by law.

Marketing communications may be subject to separate consent and opt-out rights.

30 Changes to These Terms

MyALW may update these Terms from time to time to reflect changes in:

Services
Technology
Business operations
Legal requirements
Regulatory requirements

The updated Terms will be posted with a revised effective date.

Where required or appropriate, users may receive additional notice of material changes.

Continued use of the Services after revised Terms become effective constitutes acceptance of the revised Terms to the extent permitted by law.

31Severability

If any provision of these Terms is determined to be invalid or unenforceable, the remaining provisions will remain in effect.

The invalid provision will be modified or interpreted to most closely reflect its original purpose to the extent permitted by law.

32 No Waiver

Failure by MyALW to enforce any provision of these Terms does not waive our right to enforce that provision later.

33 Entire Agreement

These Terms, together with the Privacy Policy and any applicable service agreement, Business Associate Agreement, order form, or other written agreement, constitute the agreement governing use of the Services.

34 Contact Information

Questions regarding these Terms may be directed to:

MyALW

info@myalw.com