Terms of Service

By accessing or using MedCascade you agree to these Terms. MedCascade operates in South Africa and supports healthcare billing-assist workflows subject to South African law, including the Protection of Personal Information Act 4 of 2013 (POPIA) and the regulatory framework of the Council for Medical Schemes (CMS).

If you do not accept these Terms, do not use the Service.

MedCascade provides billing assistance services with the following characteristics:

• Billing-assist only: MedCascade helps you prepare clinically aligned coding, motivations and documentation. We do not submit claims to medical schemes and are not a medical scheme or administrator.
• No guarantee of payment: Recommendations are guidance only and do not guarantee scheme benefit entitlement, PMB recognition, authorisation or reimbursement.
• Professional responsibility: Clinical and financial responsibility remains with the healthcare provider and/or practice. Always verify coding, PMB status and tariff applicability with your professional judgement and the patient's scheme rules.

• RPL and NHRPL terminology: RPL (Reference Price List) and NHRPL (National Health Reference Price List) historically refer to the same SAMA/MDCM procedure coding set. Schemes may apply their own tariffs, rules and benefit restrictions; outcomes vary per scheme and option.
• PMB (Prescribed Minimum Benefits): Diagnosis and Treatment Pairs (DTPs) and PMB rules are scheme-administered. Provider coding must be clinically justified. PMB entitlement is determined by the scheme in line with the regulations and applicable clinical protocols.
• Tariffs functionality: "Tariffs" functionality is a coming soon feature and may list scheme tariff references where available; such references are indicative only and not a quotation or guarantee.

As a user of MedCascade, you are responsible for:

• Data accuracy and lawfulness: Provide accurate, lawful data and maintain all necessary patient consents/authorisations. You warrant that you have a lawful basis under POPIA to disclose special (health) information to us for processing.
• Review and validation: Review, validate and, where necessary, amend all recommendations before use. You are responsible for final coding, claims and communications to schemes.
• Regulatory compliance: Comply with professional, HPCSA, CMS and scheme requirements applicable to your practice.

You agree not to:

• Make unlawful, defamatory, discriminatory or misleading submissions
• Upload personal information without a lawful basis (consent, contract or other POPIA ground)
• Reverse engineer, interfere with, scrape, or circumvent security or rate limits
• Use the Service to build competing datasets/models from our outputs without our written consent

For patient and practice data you upload, your organisation is the POPIA "responsible party". MedCascade acts as an "operator" processing such information under your instructions. For our own account, security, billing and communications data, MedCascade is a responsible party.

Our Privacy Policy forms part of these Terms and contains detailed information about:

• Security safeguards, operator agreements with sub-processors and cross-border transfer controls
• Your obligations to implement appropriate access controls and obtain/record consents and authorisations where required

The Service may be billed on a credit-based or subscription basis. Fees are payable in advance and are non-refundable, save where required by law. We may suspend access for non-payment. Usage beyond plan limits may incur additional charges.

Details of your current plan and usage are available in your account settings.

• Clinical and coding disclaimer: Content may contain errors or be incomplete. It is intended for use by qualified professionals and must be independently reviewed.
• No warranties: The Service is provided "as is" and "as available" without warranties of any kind, express or implied, including warranties of merchantability, fitness for a particular purpose, or non-infringement.
• Third-party content: Scheme rules, tariffs and clinical protocols may change without notice. We are not responsible for the accuracy or currency of third-party information.

To the maximum extent permitted by law, MedCascade shall not be liable for indirect, incidental, special, consequential or punitive damages, including without limitation, loss of profits, data, use, goodwill, or other intangible losses, resulting from:

• Your access to or use of or inability to access or use the Service
• Any conduct or content of any third party on the Service
• Any content obtained from the Service
• Unauthorized access, use or alteration of your transmissions or content

Our aggregate liability for all claims in any 12-month period is limited to the fees you paid for the Service in that period.

You agree to indemnify and hold harmless MedCascade, its affiliates, officers, directors, employees and agents from and against any claims, liabilities, damages, losses, costs, expenses or fees (including reasonable legal fees) arising from:

• Your unlawful processing of personal information
• Your breach of these Terms
• Your misuse of the Service
• Claims by patients, schemes, regulators or other third parties related to your use of MedCascade recommendations

We may suspend or terminate your access to the Service immediately, without prior notice or liability, for any reason, including without limitation if you breach these Terms.

You may terminate your account at any time by contacting us. Upon termination, we will follow the data return/deletion process described in our Privacy Policy and any Data Processing Addendum in place.

All provisions of these Terms which by their nature should survive termination shall survive, including ownership provisions, warranty disclaimers, indemnity and limitations of liability.

These Terms are governed by and construed in accordance with the laws of the Republic of South Africa, without regard to its conflict of law provisions.

Disputes relating to medical scheme benefits (including PMB) must be pursued through the scheme's internal dispute resolution processes and, where applicable, the Council for Medical Schemes.

Any disputes with MedCascade arising out of or relating to these Terms or the Service will be resolved in the South African courts of competent jurisdiction.

We reserve the right to modify or discontinue, temporarily or permanently, the Service (or any part thereof) with or without notice. We may also update these Terms from time to time.

Material changes will be communicated via the platform, email, or by posting a notice on our website. Your continued use of the Service after such changes constitutes acceptance of the updated Terms.

We will not be liable to you or any third party for any modification, suspension or discontinuance of the Service.

For legal notices, queries about these Terms, or general support questions, please contact us: