Terms of Service

Last updated: March 2026

These Terms of Service ("Terms") constitute a legally binding agreement between you ("Customer," "you," or "your") and FoundryNX LLC, an Arizona limited liability company doing business as ClaimWon ("ClaimWon," "we," "us," or "our"), governing your access to and use of the ClaimWon platform, including the website at claimwon.ai, the application at app.claimwon.com, and all related services (collectively, the "Platform").

BY CREATING AN ACCOUNT OR USING THE PLATFORM, YOU AGREE TO BE BOUND BY THESE TERMS. IF YOU DO NOT AGREE, DO NOT USE THE PLATFORM.

1. Eligibility and Account Registration

The Platform is designed exclusively for licensed Applied Behavior Analysis (ABA) therapy practices operating in the United States. By registering, you represent and warrant that:

  • You are authorized to bind the ABA practice or organization on whose behalf you are registering;
  • Your organization holds valid licensure and/or certification to provide ABA therapy services in its state(s) of operation;
  • You will provide accurate, current, and complete information during registration and keep it updated;
  • You are at least 18 years of age.

You are responsible for maintaining the confidentiality of your account credentials and for all activities that occur under your account. You must notify us immediately at support@claimwon.ai of any unauthorized use.

2. Description of Service

ClaimWon is an AI-powered insurance denial appeal generation engine. The Platform enables you to:

  • Upload insurance denial letters for automated extraction of denial data;
  • Generate professional appeal letters informed by payer-specific arguments, clinical research citations, federal and state parity law references, billing code analysis, and documentation checklists;
  • Track appeal outcomes and view analytics by payer and denial category;
  • Access a centralized, curated payer intelligence database maintained by ClaimWon.

Important: Appeal letters generated by the Platform are decision-support tools. They do not constitute legal advice, medical advice, or a guarantee of appeal success. You are solely responsible for reviewing, modifying, and submitting all appeal letters. ClaimWon does not submit appeals on your behalf.

3. Subscription Plans and Payment

3.1 Plans

Current plans and pricing are published at claimwon.ai/pricing. ClaimWon offers monthly subscription tiers that include a defined number of appeal generations per billing period.

3.2 Billing

All subscriptions are billed monthly in advance via a third-party payment processor. Appeals are counted at the time of generation, regardless of outcome. Unused appeals do not roll over between billing periods.

3.3 Price Changes

We may adjust pricing with thirty (30) days' written notice. Your continued use of the Platform after the effective date of a price change constitutes acceptance of the new pricing.

3.4 Pilot / Founder Plans

We may offer free or discounted pilot plans at our sole discretion. Pilot plans are subject to these Terms and may be modified or terminated at any time with reasonable notice.

4. Intellectual Property

4.1 ClaimWon IP

The Platform, including all software, algorithms, appeal letter templates, payer intelligence databases, denial pattern analytics, clinical citation libraries, user interface designs, and documentation, is the exclusive property of ClaimWon and is protected by copyright, trade secret, and other intellectual property laws.

Appeal letters generated by the Platform are derivative works of ClaimWon's proprietary templates and algorithms. You receive a non-exclusive, non-transferable license to use generated appeal letters solely for the purpose of submitting insurance appeals on behalf of your patients.

4.2 Customer Data

You retain all rights to PHI and other data you upload to the Platform. By uploading data, you grant ClaimWon a limited license to process such data solely as necessary to provide the services described in these Terms and the Business Associate Agreement.

4.3 Aggregate Data

ClaimWon may use de-identified, aggregated data derived from Platform usage (including denial outcomes, appeal success rates, and payer behavior patterns) for any lawful purpose, including improving the Platform and building its payer intelligence database. De-identification shall comply with 45 C.F.R. § 164.514.

5. Acceptable Use

You agree not to:

  • Use the Platform for any purpose other than generating insurance denial appeals for ABA therapy services;
  • Upload data containing PHI of individuals who have not authorized such disclosure for appeal purposes;
  • Attempt to reverse-engineer, decompile, or derive source code from the Platform;
  • Scrape, harvest, or systematically extract data from the Platform;
  • Share account credentials or allow unauthorized third parties to access the Platform;
  • Submit fraudulent, fabricated, or misleading information through the Platform;
  • Use the Platform in any manner that violates applicable law, including HIPAA, state insurance regulations, or anti-fraud statutes.

6. HIPAA Compliance

The parties acknowledge that the Platform involves the creation, receipt, maintenance, and transmission of PHI as defined by HIPAA. The Business Associate Agreement ("BAA") executed between the parties is incorporated into these Terms by reference. In the event of a conflict between these Terms and the BAA regarding the handling of PHI, the BAA shall control.

You shall not upload PHI to the Platform until a BAA has been fully executed between you and ClaimWon.

7. Disclaimers

THE PLATFORM IS PROVIDED "AS IS" AND "AS AVAILABLE." TO THE FULLEST EXTENT PERMITTED BY LAW, CLAIMWON DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT.

Without limiting the foregoing, ClaimWon does not warrant that:

  • Appeal letters generated by the Platform will result in successful appeal outcomes;
  • The Platform will be uninterrupted, error-free, or secure;
  • The payer intelligence database or clinical citations will be complete, current, or accurate for every payer or jurisdiction;
  • The Platform constitutes legal, medical, or billing advice.

8. Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT SHALL CLAIMWON'S TOTAL AGGREGATE LIABILITY ARISING OUT OF OR RELATED TO THESE TERMS EXCEED THE AMOUNTS ACTUALLY PAID BY YOU TO CLAIMWON IN THE TWELVE (12) MONTHS IMMEDIATELY PRECEDING THE EVENT GIVING RISE TO THE CLAIM.

IN NO EVENT SHALL CLAIMWON BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO LOSS OF REVENUE, LOSS OF PROFITS, LOSS OF DATA, OR DENIAL OF INSURANCE CLAIMS, REGARDLESS OF WHETHER SUCH DAMAGES WERE FORESEEABLE OR WHETHER CLAIMWON WAS ADVISED OF THE POSSIBILITY THEREOF.

The limitations in this section do not apply to liability arising from (a) a Breach of the BAA caused by ClaimWon's gross negligence or willful misconduct, or (b) ClaimWon's indemnification obligations under the BAA.

9. Indemnification

You agree to indemnify, defend, and hold harmless ClaimWon and its officers, directors, employees, and agents from and against any claims, liabilities, damages, losses, and expenses (including reasonable attorneys' fees) arising out of or relating to:

  • Your use of the Platform in violation of these Terms;
  • Your submission of fraudulent, inaccurate, or unauthorized data;
  • Your failure to review and verify appeal letters before submission;
  • Any allegation that your use of the Platform infringes or violates the rights of a third party.

10. Term and Termination

These Terms take effect when you create an account and remain in effect until terminated. Either party may terminate by providing thirty (30) days' written notice.

ClaimWon may suspend or terminate your access immediately if:

  • You breach any material provision of these Terms or the BAA;
  • Your payment is past due by more than fifteen (15) days;
  • Continued use poses a security risk or legal liability.

Upon termination, your right to use the Platform ceases immediately. PHI data handling upon termination is governed by the BAA. ClaimWon will retain de-identified aggregate data indefinitely.

11. Governing Law and Dispute Resolution

These Terms shall be governed by the laws of the State of Arizona, without regard to conflict of laws principles.

Any dispute arising under these Terms shall first be submitted to good-faith mediation. If mediation fails within sixty (60) days, the dispute shall be resolved by binding arbitration in Maricopa County, Arizona, under the rules of the American Arbitration Association. Each party shall bear its own costs of mediation and arbitration unless the arbitrator awards costs to the prevailing party.

12. General Provisions

12.1 Entire Agreement

These Terms, together with the BAA and the Privacy Policy, constitute the entire agreement between you and ClaimWon regarding the Platform.

12.2 Severability

If any provision of these Terms is held to be unenforceable, the remaining provisions shall continue in full force and effect.

12.3 Waiver

The failure of ClaimWon to enforce any right or provision of these Terms shall not be deemed a waiver of such right or provision.

12.4 Assignment

You may not assign or transfer these Terms without ClaimWon's prior written consent. ClaimWon may assign these Terms in connection with a merger, acquisition, or sale of all or substantially all of its assets.

12.5 Force Majeure

ClaimWon shall not be liable for any delay or failure to perform resulting from causes outside its reasonable control, including acts of God, natural disasters, pandemics, government actions, or failures of third-party service providers.

12.6 Amendments

ClaimWon may update these Terms at any time by posting the revised version at claimwon.ai/terms and notifying you by email at least thirty (30) days before the changes take effect. Your continued use of the Platform after the effective date constitutes acceptance of the revised Terms.

12.7 Contact

If you have questions about these Terms, contact us at:

FoundryNX LLC d/b/a ClaimWon
Phoenix, Arizona
Email: legal@claimwon.ai
Website: claimwon.ai