Refund Policy

1. Why Most Fees Aren’t Refundable Once Work Begins

When MediShields is engaged, our team starts working immediately: verifying eligibility, submitting claims, following up on payer responses, appealing denials, or completing credentialing paperwork. That work has real cost and real time attached to it the moment it’s performed. For that reason, fees tied to work already completed, claims already submitted, coding already delivered, or credentialing steps already filed, are not refundable, regardless of the eventual outcome of a claim or payer decision.

This is standard across the medical billing industry and it protects both sides: it keeps our pricing honest and predictable, and it means we’re not incentivized to slow-walk work while a refund request is pending.

2. When a Refund May Apply

A refund, in full or in part, will be considered in these situations:

• Cancellation before work starts. If you cancel in writing before any billing, coding, or credentialing work has begun on your account for the applicable billing cycle, fees paid for that cycle are refunded in full.
• Billing error on our part. If you were charged incorrectly, double-billed, or billed for a service outside your signed agreement, we will correct the charge and refund the difference.
• Documented service failure. If MediShields fails to meet a specific, written service-level commitment in your agreement (for example, a defined claim submission timeline) and that failure is verified on our end, a partial refund or service credit may apply for the affected period.
• Overpayment. If you were invoiced and paid more than what your agreement calls for, the overage is refunded.

3. What Isn’t Covered

To set expectations clearly, refunds do not apply to:

• Claims that are denied, underpaid, or delayed by a payer. Payer decisions are outside MediShields’ control and are not, by themselves, grounds for a refund; they are, however, exactly what our denial management and appeals process exists to address.
• Work already performed, including claims submitted, codes assigned, appeals filed, or credentialing applications sent to a payer.
• Third-party costs already incurred on your behalf, such as clearinghouse fees, payer application fees, or credentialing fees paid directly to a payer or licensing body.
• Dissatisfaction with reimbursement amounts that reflect accurate coding and legitimate payer contract rates, rather than an error by MediShields.
• Services cancelled mid-cycle after work has already started for that cycle; fees for that cycle are prorated only where the signed agreement specifically provides for proration.

4. Cancellation Terms

Either party may cancel services with 30 days’ written notice, or as otherwise specified in your signed service agreement. During the notice period, MediShields continues normal billing operations on the account, and standard fees apply for that period. Upon final termination, MediShields will:

• Complete or hand off any claims in progress, per your instruction
• Return or securely transfer patient and practice data relevant to your account
• Provide a final reconciliation report showing outstanding claims, A/R status, and any fees due or owed

5. How to Request a Refund

1. Email billing@medishields.com or contact your dedicated account manager directly.
2. Include your account/contract reference, the billing period in question, and the reason for the request.
3. Requests should be submitted within 30 days of the invoice date in question. Requests made after 30 days will still be reviewed but may be harder to verify against that period’s records.

We aim to acknowledge every refund request within 2 business days and issue a decision within 10 business days. Approved refunds are returned via the original payment method, or applied as a credit toward a future invoice if the client prefers.

6. Disputes

If you disagree with a refund decision, you can escalate the request in writing to your account manager’s supervisor, who will review the account history and respond within 10 business days. We would rather resolve a billing disagreement directly with you than have it become a bigger problem, so don’t hesitate to push back if something looks wrong.

7. Changes to This Policy

MediShields may update this Refund Policy from time to time to reflect changes in our services or standard industry practice. Clients under an active signed agreement will be notified of material changes in writing at least 30 days before they take effect. The version in effect on the date of your invoice governs that invoice.