1. Definitions
   Any terms not otherwise defined herein have the meaning ascribed to them in our Terms of Service.
   1. Subscription User Levels
      1. Provider. Any provider of billable medical services to patients who is a Customer, or who has an employment, contractor, or agent relationship with a Customer, to whom Tebra provides clinical, billing, or marketing services.
      2. Physician Provider. An individual Provider that is authorized to directly bill Medicare or commercial insurance companies for professional healthcare services rendered to patients, and holds a degree of, including but not limited to, DDS, DO, DMD, DPM, MD, ND, NMD, or OD.
      3. Non-Physician Provider. Any individual Provider other than a Physician Provider or Therapist. This includes, but is not limited to, acupuncturists, audiologists, chiropractors, mid-wives, nurse practitioners, physician assistants or registered dieticians.
      4. Supervising Provider. A Physician Provider who monitors and aids Non-Physician Providers by signing/counter-signing notes, as well as prescribing medications. A Provider that has duties in addition to the foregoing shall not constitute a Supervising Provider.
      5. Facility Provider. An organization, facility, or lab that is authorized to directly bill Medicare or commercial insurance companies for institutional healthcare services rendered to patients. All Facility Providers must be on a transactional agreement.
      6. Therapist. A physical therapist (PT), occupational therapist (OT), speech language pathologist (SLP), marriage and family therapist (MFT), social worker (LCSW, MSW), or psychologist.
   2. Billing Transaction. In connection with subscription pricing based on billing transaction volume, billing transactions include the following: (i) electronic claims, (ii) eligibility checks, and (iii) each request/claim submitted, paid and/or denied within an electronic remittance advice (ERA).
   3. Fees. All fees charged by Tebra are described herein and are determined by the software subscription level selected (Billing, Clinical, or Patient Experience) and specific provider characteristics (Physician or Non-Physician Provider, full- or part- time, or specialty). All prices may change with 30 days’ electronic notice. Customer is responsible for keeping email addresses updated with Tebra.
      1. Mailing fees. Any fees for mailings like paper insurance claims or paper patient statements, which may be increased at any time to reflect a change in the USPS postage or processing costs.
      2. Software Subscription Fees. Per Provider/Therapist fees for Billing, Clinical, and Patient Experience modules. Software Subscription Fees are set forth in the applicable Order Form signed by Customer. Customer is responsible for paying the Software Subscription Fees for the duration of their subscription term.
      3. Transactional Fees. Per transaction fees for electronic claims, eligibility checks, electronic remittance advice, paper claims, and patient statements. Transactional Fees are set forth in Section II below.
      4. Professional Services Fees. Fees for professional services provided by Tebra outside of a Customer’s software subscription, which may include, for example, Robotic Processing Automation, Cloud, Blog, Social, data import or migration, or live training services. Professional Services Fees are set forth in the applicable Order Form or other written agreement between Customer and Tebra.
   4. Legacy Products. For Customers who signed a Customer Agreement for legacy products, all references to legacy products correspond to the following terms:
      1. “Kareo Billing” mean “Billing”
      2. “Kareo Clinical” and Clinical Essentials mean “Clinical”
      3. “Kareo Engage,” “Kareo Office,” and “Practice Growth” means “Patient Experience”
2. Support. All subscription levels include unlimited access to general customer support through our Customer Care Center and by phone or live chat, and to Billing Support by phone or email. For more information, please contact us or visit our Customer Support Policy.
3. Assisted Enrollment Service. Assisted enrollment services include clearinghouse sign-up and setup of electronic services with insurance companies. Assisted enrollments with unlimited number of payers on initial enrollment are included for all customers without additional fees. Subsequent payers are not included.
4. Notice of Non-Renewal. To prevent renewal of a Customer Agreement, either party must give written notice of non-renewal and this written notice must be received at least sixty (60) days in advance of the end of the Customer Agreement then in effect. If Customer decides not to renew, Customer must send the notice of non-renewal by contacting the assigned Account Manager directly or via the communications methods in Tebra’s Customer Support Policy. Any notice received with less than sixty (60) days’ notice will result in auto-renewal of the Customer Agreement for an additional Renewal Term.
5. No Refunds/Credits. All fees are nonrefundable and non-cancellable. Tebra does not refund or credit subscription fees for partial months, or any portion of a prepaid plan upon a deactivation of a Provider or account cancellation. Customer is responsible for all fees (including any monthly minimum) for the entire term of the applicable order or subscription agreement.
6. Excess Claims. Tebra may change Customer’s pricing from a subscription to a transactional plan after thirty (30) days’ notice if Customer exceeds 500 claims per month.
7. Tebra Platform. Any discounted or bundled prices are for the three-module bundle of Clinical, Billing, and Patient Experience only. If one or more modules are canceled at any time, remaining modules revert to full price.
8. Practices. All practices must have at least one active Provider within a practice for the practice to remain active. There is a minimum monthly fee for any account that has not activated a Provider as listed in Section II(F) below.
9. Multi-Practice Provider. Providers activated within multiple practices within a single Tebra account will be charged one subscription fee, at the highest applicable subscription level (e.g., Practice Operations Clinical, Billing, or Patient Experience), subject to the Provider using and correctly inputting the same name, NPI, and other user information in connection with all relevant practices.
10. Fee Changes. Tebra reserves the right to increase its prices by no greater than 4.9% at any one time, no more frequently than once per 12-month period, upon thirty (30) days’ notice to the Customer. This provision shall not apply to RPA customers.
    1. For Customers with month-to-month agreements, all fees may be changed with sixty (60) days’ notice to Customer.
    2. For all Customers, Tebra may increase fees to cover the cost of postage rate increases as well as regulatory, compliance, and other cost increases imposed by changes to applicable federal and state rules. Tebra will automatically apply the rate increase to all services impacted by the change with thirty (30) days’ notice to the Customer.
11. Invoice Frequency
    

    FEE	INVOICE FREQUENCY
    Onboarding fee	One-time fee; billed at sign-up
    Software subscription fees	Billed monthly in advance*
    EHR integration services fee	Billed monthly in advance
    Website hosting	Billed monthly in advance
    Transactional fees	Billed monthly in arrears
    Professional services	Billed monthly in arrears
    Data import and migration fees	Billed monthly in arrears
    ROBOTIC PROCESSING AUTOMATION INVOICE FREQUENCY
    Onboarding Fees	Billed in advance on a per practice basis
    Subscription fees	Billed monthly in advance on a per practice basis
    Transactional Fees (Smart Connector for HL7 & Patient Data; Automated Clinical Note Creation)	Billed monthly in arrears for each transaction/encounter above the standard monthly allotment
    Transactional Fees (PDF Note Creation)	Billed monthly in arrears for each transaction

    *Adding or Removing Providers. Any Providers that are removed or deactivated are charged in advance for the last full month and, at Tebra’s discretion, may be subject to an early termination fee for the remainder of the term. Any Providers added or activated during the Term will be charged on a pro-rata basis for the first month.

1. Data Import
   1. Data import services for the Tebra platform is available for the following data sets:
      • Patient Demographics
      • Appointments
      • Patient Case (Insurance Policy)
      • Payer List
      • Provider List
      • Service Locations
      • Patient Balances Forward
      • Scanned Documents (Clinical and Non- Clinical)
      • Fee Schedule
      • Care Summary Document (C-CDA)
   2. Fees for data imports are determined based on the data sets requested and volume of the specific import. To receive a quote for data import services, please submit a data import to request
2. Data Migration
   1. A data migration is the process of moving practice data from a multi-practice account (e.g., a billing company) into a newly created customer account.
   2. Migrated data may include, but is not limited to, patients, appointments, encounters, claims, payments, documents, settings, and clinical data.
   3. Data migrations require written permission from the company administrator of the account from which the data originates (e.g., a billing company).
   4. Fees for data migration are determined based on the details for the specific migration. For more information, please contact us.

What types of files can we accept for data imports?

Last updated effective January 20, 2025.
To see previous versions, click here.