Terms of Service

Merits is a software tool that helps US clinicians and their billing staff draft appeal letters for denied health-insurance claims. You give us a denial you received; we produce a draft letter with citations to public sources. That is the whole service.

Merits is not a law firm, a medical practice, or an insurer, and using it does not create any professional relationship. Nothing Merits produces is legal advice, medical advice, or a promise about how an insurer will decide.

Every letter is a draft for you to review. You read it, edit it where needed, and sign and submit it under your own name and credentials. The clinical judgment, the accuracy of what’s stated, and the decision to file are yours.

Before a letter can be downloaded, you confirm each cited statement and attest that you’ll sign it yourself. That step exists because the responsibility for what you submit to a payer rests with you, not with Merits.

Appeals succeed or fail on their own merits and on the payer’s decision. Merits does not guarantee that any appeal will be approved, that any payment will be made, or that any deadline will be met. We never promise a reversal — and we’ll tell you before you pay when a denial rarely wins on appeal.

Letters cite sources — federal regulations, statutes, and public coverage policies — that we match against the primary materials. You are responsible for confirming each cited statement applies to your case before you rely on it; the review step in the app is there for exactly this.

Merits does not store or display proprietary code descriptions (for example, AMA CPT® descriptors). Procedure codes are shown as codes; any plain-language descriptions are generated for usability, not copied from licensed materials.

Merits offers two ways to pay, both shown before you pay: pay-per-use — buy a letter or a bundle of credits when you need one, and purchased credits never expire — and an optional subscription ($20 per month, or $200 per year) that includes 20 appeal letters each billing cycle.

Subscriptions renew automatically until cancelled. You can cancel any time from your account; cancellation takes effect at the end of the current billing period, and you keep access through the period you’ve paid for. The 20 monthly letters reset each cycle and don’t roll over; any pay-per-use credits you’ve purchased remain yours and never expire. Subscribers get 20% off additional pay-per-use credits.

We won’t charge you for a losing appeal: when we assess that a denial isn’t worth appealing, you see that before checkout and it never costs a credit. If a letter fails to generate after you’ve paid, the credit is automatically returned so you’re never charged for a letter you didn’t receive. Credits are for your own use and aren’t transferable for cash.

Use Merits only for legitimate appeals you’re authorized to pursue. Don’t upload another party’s information without the authority to do so, don’t attempt to reverse-engineer or overload the service, and don’t use it to create anything false or misleading. We may suspend access that violates these terms.

Patient identity is removed in your browser before anything is sent to us, and the patient’s details are filled back into the letter on your own device at download. See the Privacy Policy for exactly what is and isn’t handled.

Merits is provided “as is,” without warranties of any kind, to the fullest extent permitted by law. We are not liable for an appeal that is denied, for a missed deadline, or for indirect or consequential damages. To the extent liability cannot be excluded, it is limited to the amount you paid for the letter at issue.

These terms are governed by the laws of the United States and of the state in which Merits is established, without regard to conflict-of-law rules.

We may update these terms; the “last updated” date above reflects the current version, and continued use means you accept the changes. Questions? Reach us at [email protected].