Last updated: March 8, 2026
Please read these Terms of Service ("Terms") carefully before using Kestrel (the "Service"), operated by Cai Systems LLC ("Company," "we," "us," or "our"). By accessing or using the Service, you agree to be bound by these Terms. If you do not agree to these Terms, do not use the Service.
Kestrel is a web-based application that analyzes clinical documentation against payer-specific prior authorization requirements and produces gap analysis reports. The Service identifies potential documentation deficiencies before prior authorization submission. The Service is designed for use by healthcare professionals, prior authorization coordinators, billing specialists, and revenue cycle management staff.
a. Not Medical Advice. The Service provides documentation analysis and administrative decision support only. It does not provide medical advice, clinical recommendations, diagnosis, or treatment suggestions. All clinical decisions remain the sole responsibility of licensed healthcare providers.
b. No Guarantee of Authorization. The Service does not guarantee that any prior authorization request will be approved or denied. Gap analysis results are advisory and based on the Service's interpretation of published payer requirements, which may be incomplete, outdated, or subject to payer discretion. Payers retain sole authority over authorization decisions.
c. AI-Powered Analysis. The Service uses artificial intelligence technology to analyze clinical documentation. AI analysis may contain errors, miss relevant information, or misinterpret clinical context. Users must exercise independent professional judgment when reviewing results and should not rely solely on the Service's output for prior authorization decisions.
d. Payer Requirements Currency. Payer prior authorization requirements change without notice. While we make reasonable efforts to maintain current requirements, there may be delays between payer policy updates and corresponding updates to our database. Users should verify critical requirements against current payer publications.
a. You must provide accurate and complete information when creating an account. You are responsible for maintaining the confidentiality of your account credentials and for all activities that occur under your account.
b. You must be at least 18 years old and authorized to act on behalf of the healthcare organization or business entity you represent. By creating an account, you represent that you have the authority to bind your organization to these Terms.
c. We reserve the right to suspend or terminate your account at any time for violation of these Terms, non-payment, or any other reason at our sole discretion with reasonable notice.
You agree to use the Service only for its intended purpose of prior authorization documentation analysis. You shall not:
a. Use the Service for any purpose other than healthcare prior authorization documentation analysis and related administrative functions.
b. Attempt to reverse-engineer, decompile, or extract the underlying algorithms, payer rules database, or AI models used by the Service.
c. Resell, sublicense, or redistribute access to the Service or its output without prior written consent.
d. Submit clinical documentation for patients who have not consented to electronic processing of their health information as required by applicable law.
e. Use the Service to submit false, fabricated, or misleading clinical documentation to payers.
f. Attempt to circumvent any access controls, rate limits, or security measures of the Service.
a. Business Associate Agreement Required. Use of the Service with Protected Health Information (PHI) requires a separately executed Business Associate Agreement (BAA) between your organization and the Company. The BAA governs the handling of PHI and is incorporated by reference into these Terms. You must not submit PHI through the Service until a BAA has been executed.
b. PHI Processing. Clinical note text submitted through the Service is processed in-memory only and is not stored, logged, or retained by the Company. The gap analysis output returned to you does not contain or reproduce the clinical note text. De-identified metadata (payer name, procedure code, analysis result categories) may be retained for service improvement.
c. Your Responsibilities. You are responsible for ensuring that you have obtained all necessary consents and authorizations from patients before submitting their clinical documentation to the Service, and that your use of the Service complies with all applicable federal and state privacy laws.
a. Fees for the Service are as set forth in the applicable service agreement or pricing page. All fees are quoted in U.S. dollars and are due in accordance with the billing cycle specified in your subscription.
b. We reserve the right to change pricing with thirty (30) days' prior written notice. Continued use of the Service after a pricing change constitutes acceptance of the new pricing.
c. Failure to pay fees when due may result in suspension or termination of your access to the Service.
d. All fees are non-refundable except as expressly provided in these Terms or as required by applicable law.
a. The Service, including its software, algorithms, payer rules database, user interface, and documentation, is the property of the Company and is protected by intellectual property laws. These Terms do not grant you any ownership interest in the Service.
b. You retain all rights to clinical documentation submitted through the Service. The Company claims no ownership interest in your clinical notes or patient data.
c. De-identified, aggregated analysis metadata (not including PHI) generated through use of the Service may be used by the Company for service improvement, benchmarking, and product development.
a. TO THE MAXIMUM EXTENT PERMITTED BY LAW, THE COMPANY SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO DAMAGES FOR LOST PROFITS, LOST REVENUE, DENIAL OF PRIOR AUTHORIZATION REQUESTS, DELAYED PATIENT CARE, OR LOSS OF DATA, REGARDLESS OF WHETHER SUCH DAMAGES WERE FORESEEABLE OR WHETHER THE COMPANY WAS ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
b. THE COMPANY'S TOTAL AGGREGATE LIABILITY ARISING OUT OF OR RELATED TO THESE TERMS SHALL NOT EXCEED THE TOTAL FEES PAID BY YOU TO THE COMPANY IN THE TWELVE (12) MONTHS PRECEDING THE EVENT GIVING RISE TO THE CLAIM.
c. The Service is provided "as is" and "as available" without warranties of any kind, either express or implied, including but not limited to implied warranties of merchantability, fitness for a particular purpose, accuracy, or non-infringement.
You agree to indemnify, defend, and hold harmless the Company and its officers, directors, employees, and agents from and against any claims, liabilities, damages, losses, costs, and expenses (including reasonable attorneys' fees) arising out of or related to: (a) your use of the Service; (b) your violation of these Terms; (c) your submission of false or misleading clinical documentation; or (d) your violation of any applicable law or regulation, including HIPAA.
a. You may terminate your account at any time by providing written notice to the Company. Termination does not entitle you to a refund of prepaid fees.
b. We may terminate or suspend your access to the Service immediately, without prior notice, for conduct that we determine, in our sole discretion, violates these Terms, is harmful to other users or the Company, or is otherwise objectionable.
c. Upon termination, your right to use the Service will immediately cease. Given our in-memory-only processing architecture, no PHI is retained after your session ends. De-identified metadata may be retained as described in these Terms.
We reserve the right to modify these Terms at any time. We will provide notice of material changes by posting the updated Terms on the Service and updating the "Last Updated" date. Your continued use of the Service after such changes constitutes acceptance of the modified Terms. If you do not agree to the modified Terms, you must discontinue use of the Service.
a. These Terms shall be governed by and construed in accordance with the laws of the State of Rhode Island, without regard to its conflict of law provisions.
b. Any dispute arising out of or relating to these Terms shall be resolved through binding arbitration administered by the American Arbitration Association in accordance with its Commercial Arbitration Rules, conducted in Providence, Rhode Island.
c. Nothing in this section shall prevent either party from seeking injunctive or other equitable relief in a court of competent jurisdiction.
a. These Terms, together with the BAA and any applicable service agreement, constitute the entire agreement between you and the Company regarding the Service.
b. The Company's failure to enforce any right or provision of these Terms shall not be deemed a waiver of such right or provision.
c. If any provision of these Terms is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.
d. You may not assign or transfer these Terms without the Company's prior written consent. The Company may assign these Terms without restriction.
e. The headings in these Terms are for convenience only and do not affect interpretation.
For questions about these Terms, please contact:
Cai Systems LLC Email: support@caisystems.dev