Refund Policy

1. Purpose and Scope

This Refund Policy describes the circumstances under which Competant Global Solution Pvt. Ltd. (“Company”) will issue a refund, credit, or fee adjustment to a Client in connection with Revenue Cycle Management (RCM), medical billing, coding, or credentialing Services rendered under a signed Service Order or Master Service Agreement (“Agreement”).
This Policy applies to fees paid by the Client to the Company for the Services. It does not govern, and the Company has no control over, refunds owed by payers, insurance companies, or government programs to patients, nor does it govern patient-facing refund requests, which remain the sole responsibility of the Client as the treating healthcare provider.

2. General Principle: Fees for Services Rendered Are Non-Refundable

Because our fees compensate the Company for labor, infrastructure, and processing already performed (e.g., claims coded, submitted, or followed up on; reports generated; credentialing applications filed), fees for Services already rendered are generally non-refundable, except as expressly set out in this Policy or the applicable Service Order. This is consistent with standard industry practice for outsourced billing and RCM services.

3. Circumstances Eligible for Refund or Credit

The Company will issue a refund, credit, or fee adjustment in the following circumstances:

3.1 Billing Errors by the Company

If the Company has charged the Client in error — including duplicate invoicing, incorrect fee calculation, or charges for Services not actually performed — the Company will correct the error and issue a credit or refund of the overcharged amount once verified.

3.2 Company-Caused Processing Errors Affecting Collections

If a documented coding or submission error caused directly by the Company's negligence results in a claim denial, recoupment, or repayment demand from a payer, and the percentage-of-collections fee was already paid to the Company on that claim, the Company will credit back its fee attributable to that specific claim once the error is verified through the Company's internal quality review process. This credit applies only to the Company's fee on the affected claim(s) and does not extend to the underlying clinical reimbursement, which remains between the Client and the payer.

3.3 Service Outage or Non-Performance

If the Company fails to perform a material Service obligation specified in the Service Order (e.g., sustained failure to submit claims within agreed turnaround times due to causes within the Company's control), the Client may be entitled to a pro-rated credit for the affected billing period, subject to written notice and a thirty (30) day cure period as described in Section 11.3 of the Terms and Conditions.

3.4 Overpayment or Duplicate Payment by Client

If the Client inadvertently pays an invoice twice, or pays an amount greater than what is owed, the Company will refund or credit the excess amount upon verification, typically applied as a credit to the next invoice unless the Client requests a direct refund.

3.5 Early Termination Credits

If the Client has prepaid for a service period (e.g., an annual credentialing retainer) and terminates the Agreement before that period ends, any unearned, prepaid fees for Services not yet rendered will be refunded on a pro-rata basis, less any setup costs, third-party fees already incurred, and amounts owed for Services already performed, including the Wind-Down Period described in the Terms and Conditions.

4. Circumstances Not Eligible for Refund

Refunds will generally not be issued in the following circumstances, as these relate to outcomes outside the Company's control:
• Claim denials, underpayments, or delays caused by payer policy, payer system errors, or changes in reimbursement rates
• Claim denials caused by inaccurate, incomplete, illegible, or untimely clinical documentation, charge information, or authorization provided by the Client
• Non-payment or delayed payment by a patient or insurance company
• Loss of provider credentialing or network status due to the Client's own licensure, malpractice history, or compliance issues
• Fees for work already completed (e.g., claims already coded and submitted, credentialing applications already filed) even if the underlying claim is later denied for reasons unrelated to the Company's performance
• Dissatisfaction with collection results that are consistent with the performance benchmarks set out in the Service Order
• Set-up, onboarding, integration, or one-time implementation fees, once the corresponding work has been performed

5. Refund Request Procedure

To request a refund, fee adjustment, or credit, the Client must:
• Submit a written request to billing-support@[companydomain].com within thirty (30) days of the invoice date or the date the issue was identified, whichever is later;
• Include the invoice number(s), claim/account number(s) (if applicable), a description of the issue, and any supporting documentation;
• Allow the Company's billing and compliance team up to fifteen (15) business days to investigate and verify the request; and
• Receive a written determination from the Company specifying whether the request is approved (in whole or in part) and the resulting credit or refund amount.
Approved refunds will be issued, at the Company's discretion, as: (a) a credit applied to the Client's next invoice; or (b) a direct refund to the Client's account of record, typically processed within fifteen (15) business days of approval.

6. Billing Dispute Window

Consistent with Section 4.2 of our Terms and Conditions, any disputed invoice charge must be raised in writing within fifteen (10) days of the invoice date. Disputes raised after this window may still be reviewed at the Company's discretion but are not guaranteed a refund, as supporting documentation and system logs may no longer be reasonably retrievable.

7. Patient Refunds (Client Responsibility)

Where the Company processes patient payments or statements on the Client's behalf, any refund owed to a patient (e.g., due to overpayment, coordination-of-benefits adjustment, or a payer retraction) remains the financial and regulatory responsibility of the Client as the treating provider and Covered Entity. The Company will assist in identifying overpayments and preparing refund documentation as part of the agreed Services, but the determination to issue, and the actual disbursement of, a patient refund rests with the Client, in accordance with applicable state prompt-refund laws.

8. Chargebacks and Payment Disputes

If the Client initiates a chargeback or payment reversal with its bank or card provider for fees relating to Services already rendered, without first following the dispute procedure in Section 5, the Company reserves the right to suspend Services and pursue recovery of the disputed amount, including reasonable collection costs, in accordance with the Terms and Conditions.

9. Currency and Processing

Refunds and credits will be issued in the same currency in which the original payment was made, using the same payment method where reasonably possible. Any bank charges, wire fees, or currency conversion costs associated with processing a refund may be deducted from the refunded amount, except where the refund results from a verified error by the Company.

10. Changes to This Policy

The Company may update this Refund Policy from time to time. Changes will be posted on our website with a revised “Last Updated” date and will apply prospectively to invoices issued after the effective date of the change. Refund terms specifically negotiated in an existing Service Order will continue to govern that engagement unless amended in writing.

7. Contact Us

For refund-related questions, please contact us at:
Email: info@competantgs.com
Phone: +1 732-929-7270