Terms & Use
Welcome to the HPS Online Access!
Restrictions on use of this website
- not to use this website or Content in any way not explicitly permitted by these Terms or the text of the website itself
- not to copy, modify or create derivative works involving the Content, except you may print a reasonable number of copies for your personal use, provided that you reproduce all proprietary copyright and trademark notices
- not to misrepresent your identity or provide us with any false information in any information-collection portion of this website, such as a registration or application page
- not to take any action intended to interfere with the operation of this website
- not to access or attempt to access any portion of this website to which you have not been explicitly granted access
- not to share any password assigned to or created by you with any third parties or use any password granted to or created by a third party
- not to directly or indirectly authorize anyone else to take actions prohibited in this section
Changes to website content
We may change, add or remove some or all of the Content on this website at any time. In addition, please note that although our goal is to provide accurate information, certain features that may be offered through this website, such as Accumulators or other Content, may not be accurate or up to date.
Any payment made through this site is subject to the terms and conditions of the participant agreement. Payments made through this site can take up to 24-72 hours to process and therefore may not be reflected on your next SuperEOB®. Payments to your account will be credited to the oldest outstanding balance.
When making an electronic payment through this site you are agreeing to make a payment using the payment information you have provided and you authorize Health Payment Systems to withdraw the funds in the specified amount.
If payment is made by check or ACH transaction and the payment is dishonored or returned for any reason, HPS will charge a NSF (non-sufficient funds) fee of $30.00.
You may submit and store credit card information via this website for payment. You must submit the necessary card information before your payment will be processed. If the card information that you submit is incorrect or invalid, your payment will not be processed.
Payments are subject to the approval of the financial institution issuing the card or holding the account. HPS assumes no responsibility or liability if the financial institution refuses to accept or honor your card for any reason.
Your Health Payment Systems, Inc. Single Payment System℠ Participant Agreement
WHAT THIS DOCUMENT IS. This is a copy of Your Agreement with Us covering the use of your Account. Please read this Agreement and keep it for your records.
MEANING OF CERTAIN WORDS. When the words listed below are used in this agreement, they have the meanings shown below.
“Account” means your Single Payment System℠ Claim payment account with Us.
“Benefit Program” means the contract, policy or other document(s) evidencing the health care plan provided to You by your Employer, under which Your Employer is obligated to provide healthcare benefits on Your behalf.
“Claim” means a claim for payment of healthcare good or services provided to You by a Provider, which is paid to the Provider through the Single Payment System℠.
“Participant Claim Payment” means the amount of liability that You have, arising from a Claim, as the result of deductible, co-payment and co-insurance requirements under Your Benefit Program.
“Payment Due Date” means that the date thirty (30) days after the date of your monthly Account statement.
“Single Payment System℠” means Our system for paying claims, including Participant Claim Payment amounts, to a Provider, within approximately twenty (20) days after We receive a properly prepared Claim.
“Provider” means those healthcare providers, physicians, and other healthcare professionals and facilities that contract with Us to participate in the Single Payment System℠.
“You”, “Your”, and “Yours” means yourself, your spouse, and any dependent of yours who is covered by Your Benefit Program and who receives healthcare goods or services, the Claims for which are paid through the Single Payment System℠.
“We”, “Us”, and “Our” means Health Payment Systems, Inc. (“HPS”), its agents and assigns.
YOUR PROMISE TO PAY. You promise to pay Us, in the manner called for by this Agreement, the full amount of all Participant Claim Payments that are paid to Providers on behalf of You, Your spouse and any dependent of Yours who is covered by Your Benefit Program through the Single Payment System℠. All payments must be in U.S. Dollars and must be made in full and as directed by Us, no later than the Payment Due Date shown on Your monthly Account statement. If you object to the payment of a Claim as erroneous, your obligation to pay the disputed Claim will be suspended pending a Claim audit and dispute resolution as provided in this Agreement.
PAYMENT BY CHECK. When you pay Us by check, you expressly authorize Us, if your check is dishonored or returned for any reason, to electronically debit Your checking account for the amount of the check plus a processing fee of $30 (or legal limit, if less). The use of a check for payment is Your acknowledgement and acceptance of this policy and its terms.
PAYMENT OF CLAIMS. You agree to be responsible for the payment of all Participant Claim Payment amounts, subject to your right to dispute such amounts as provided in this Agreement.
NOTICE OF ASSIGNMENT. The receivable from Participant Claim Payment amounts paid to Providers through the Single Payment System℠ are automatically assigned by the Provider to HPS for collection from You, and You acknowledge and agree to such assignment and to any modification to the payment terms of such receivable that may be necessary to reflect the terms set forth in this Agreement.
COOPERATION IN COORDINATION OF BENEFITS. You agree to complete and submit Coordination of Benefit forms identifying and Benefit Program, insurance or other party (“Alternate Payors”) that may be responsible for the payment of all or any portion of any of Your Participant Claim Payment amounts and to provide such information as my be reasonably necessary to enable HPS if it deems appropriate to bill any Alternate Payor in order to appropriately coordinate benefits. You also agree to notify Your Employer of the existence of any Alternate Payors that may be responsible for the payment of all or any portion of any of Your Participant claim Payment amounts in the event that You suffer an injury or condition requiring medical attention as the result of any accident (either in the workplace or otherwise).
REIMBURSEMENT OF HPS. You agree to reimburse Us for any Participant Claim Payment amounts paid to Providers. In the event it is ultimately determined that an Alternative Payor is responsible for the payment of all or any portion of any of Your Participant claim Payment amounts HPS will assist You in efforts to pursue Coordination of Benefit claims against any such Alternate Payor for any Participant Claim Payment amounts.
WAIVER OF OBJECTION RIGHTS. You agree that all objections and defenses to the payment of any of Your Participant Claim Payment amounts shall be waived in the event that You have not provided Us with a written objection within one hungered eighty (180) days after the provider has received such payment.
DISPUTE OF CLAIM PAYMENT AMOUNTS. With respect to any Claim payment made to a Provider on Your behalf, You, Your employer, or the Provider may object to the amount of such payment as erroneous, provider such objection is made within one hundred eighty (180) days after the Provider has received such payment. No party shall have a right to dispute the correctness of the amount of any Claim payment or Participant Claim Payment if such objection is not raised within one hundred eight (180) days after the Provider receives the disputed payment.
CLAIM AUDIT AND DISPUTE RESOLUTION. You and each Provider shall have the right to object to the amount of the payment of a Claim and to audit such Claim as erroneous subject to the time limitations set forth in the preceding paragraph. You agree to cooperate with Providers and with HPS in connection with any Claim audit. In the event of a Claim payment dispute between You and a Provider, HPS, Your employer, and the Provider shall make good faith best efforts to facilitate resolution of the dispute, and shall provide access to records and personnel reasonably necessary to support resolution of the dispute.
CLAIM PAYMENTADJUSTMENTS AFTER DISPUTE RESOLUTION. Upon resolution of a Claim payment dispute: (i) in the event that it is determined that such Claim has been underpaid, You shall make payment to HPS of the underpaid Participant Claim Payment portion of such Claim amount within ten (10) Business Days after such dispute resolution; and (ii) in the event that it is determined that such Claim has been overpaid, HPS shall authorize a credit or refund of such overpaid Participant Claim Payment portion of such Claim amount from the Provider to You within ten (10) Business Days after such dispute resolution.
CONSENT TO DISCLOSURE OF HEALTH INFORMATION. You consent to the release and disclosure of Your medical and health information to Us.
APPLICATION LAW. This Agreement shall be interpreted under the laws of the State of Wisconsin. In the event that any provision of this Agreement is deemed unenforceable by any court of competent jurisdiction, the remaining provisions shall remain in full force and effect.
To contact us regarding this policy and our related privacy practices, please contact us at: firstname.lastname@example.org or call our representatives at: 888.477.7968
7 a.m. - 8 p.m. (Monday-Thursday)
7 a.m. - 5 p.m. (Friday)
9 a.m. - 1 p.m. (Saturday) CT.