AxisCare Medicaid Billing Terms of Service

If User has elected the Medicaid Billing Service in the Add-On Service Description Addendum, then AxisCare shall provide those services set out in these Medicaid Billing Terms and Conditions on the additional terms and conditions provided herein:

 1. User Qualifications. The Parties acknowledge and agree that AxisCare shall provide the Medicaid Billing Service only if User is contracted with Medicaid through an agreement and is authorized to provide care to individuals receiving home care treatment paid for by Medicaid (the “Claimants”). In addition, AxisCare and User agree to comply with the Business Associate Agreement, attached hereto as Addendum A.

 2. Medicaid Billing Services.

Onboarding: AxisCare shall process Medicaid claims (each a “Claim” and collectively the “Claims”) for all Claimants receiving care, provided that User shall upload the required documents to process all new Claims through the AxisCare Online System (the “System”) within thirty (30) days of the individual receiving care.

Processing: Upon receipt of documentation from User regarding the Claims, AxisCare shall assist with submission of such Claims, including assisting User with following up on any unpaid or denied claim if required.

Reconciliation: Where applicable, AxisCare will reconcile Claim payments against User’s invoices in the System. User shall provide AxisCare with access to User’s System as necessary for AxisCare to facilitate reconciliation.

Historical Claims: Upon mutual written agreement of the Parties, AxisCare may review User’s previously submitted and non-paid Claims, and subsequently process and submit if appropriate. A separate service fee shall be charged to User for reviewing and resubmitting Historical Claims. AxisCare will create a custom quote for Historical Claims based on the body of work.

Credentialing: Upon mutual written agreement of the Parties, AxisCare may assist User with credentialing/enrollment with certain State Medicaid, Medicaid Waiver, MCO, or other similar Medicaid programs. Credentialing/Enrollment in such program(s) includes research, document completion, submission, communication with the State/Payer, contract negotiation consulting, and service/rate election consulting. All Credentialing/Enrollments require active participation and communication between AxisCare and the Agency to complete as efficiently as possible. Application denials based on circumstances out of AxisCare’s control or lack of collaboration by the Agency are not refundable. A separate service fee apply to any such services. AxisCare will create a custom quote for Credentialing services based on the anticipated body of work.

Services Not Provided: User hereby acknowledges that AxisCare’s Services are limited strictly to the billing services expressly described in this Addendum. Except as otherwise agreed in writing, AxisCare Services and do not include, among other things, the handling of User’s relationship as a provider with Medicaid or any insurance plan including, but not limited to, User’s enrollment, disenrollment, or negotiation of fee schedules or changes of any kind. AxisCare shall not be responsible for assigning codes for User’s professional services. The proper coding and documentation of the professional services rendered by User shall be the sole responsibility of User.

Billing Information. User is solely responsible for ensuring that complete, accurate and timely documentation of its professional services is provided to AxisCare on a daily basis so that AxisCare can properly and timely bill for such professional services. User shall complete such forms and provide such coding and billing information as is necessary for AxisCare to properly and timely bill for User’s professional services. User shall also reconcile billing information with its client information to assure its accuracy and completeness. 

Records. User shall have the sole responsibility and authority for the preparation and maintenance of complete and accurate client records with respect to its professional services provided to individuals. User shall retain such records for the time period required by Medicaid and shall make such records and information available to AxisCare upon AxisCare’s request for any proper purpose. 

User-Provided Services Fees. User shall have the sole responsibility and authority for setting the fees charged for User’s professional services to its clients. 

Coordination. User shall designate an employee to coordinate billings and collections activities under this ASA with AxisCare. 

Refunds. User shall promptly refund any overpayments or improper payments it receives from billings rendered under this ASA.

Updated: 06/16/2025