DenaliHealth is a Medicare claims intelligence application that provides AI-powered coverage guidance, appeal letter generation, diabetes management coaching, and weight management guidance. The Service uses artificial intelligence (Claude via AWS Bedrock) to help you understand Medicare coverage rules, identify potential denial risks, and generate appeal letters when claims are denied.
The Service is coverage guidance only — not medical advice, legal advice, or billing services. All AI-generated content is clearly marked and should not be used as a substitute for professional medical or legal counsel.
2. Acceptance of Terms
By creating an account, you actively acknowledge that you have read, understood, and agree to be bound by these Terms of Service and our Privacy Policy. Account creation requires an affirmative action (entering your email and verifying a one-time passcode) — we do not assume acceptance through passive use.
If you do not agree with any part of these Terms, do not create an account. If you have already created an account and no longer agree, you may delete your account at any time through Settings > Danger Zone.
3. Eligibility
The Service is designed for Medicare beneficiaries — both Original Medicare and Medicare Advantage — (generally age 65 and older) and their authorized caregivers. You must be at least 18 years of age to create an account. By using the Service, you represent that you meet these eligibility requirements.
4. Account Terms
Account creation requires a valid email address, verified via one-time passcode (OTP)
You may optionally enable TOTP-based multi-factor authentication for additional security
You are responsible for maintaining the security of your account credentials and devices
You must promptly notify us if you suspect unauthorized access to your account
One account per individual — sharing accounts is not permitted
5. Medicare Data Connection
The Service offers an optional connection to your Medicare claims data through the official Medicare API. This connection:
Requires your explicit authorization through a secure OAuth process on the official Medicare website
Provides read-only access — we never modify your Medicare records
Can be revoked at any time through your Settings page
Is subject to your consent preferences for AI use, local caching, and analytics
Accesses only Patient, Coverage, and Explanation of Benefits (EOB) data
We never request, access, use, or share your Medicare.gov login credentials — authorization is handled entirely by CMS through secure OAuth
Clinical insights such as conditions, medications, and screening history are extracted from your claims data — they are not provided as separate data from Medicare. Your Medicare data is used solely for: (1) displaying your health information to you; (2) providing AI-powered coverage guidance and appeal assistance; and (3) with your explicit consent, personalizing AI conversations. It is not used for any other purpose and is never sold.
6. AI Disclaimer
All responses are generated by artificial intelligence (Claude via AWS Bedrock). While our AI references real Medicare policies (LCD/NCD), clinical evidence (PubMed), and standardized medical codes, it is not a substitute for professional medical, legal, or financial advice.
AI-generated appeal letters should be reviewed by you and your healthcare provider before submission
Coverage guidance is based on Original Medicare rules — Medicare Advantage plans have their own rules
We do not guarantee that any appeal will be approved or that any claim will be covered
Always verify coverage guidance with your healthcare provider and Medicare
7. Payment Terms
Free Trial
Sign up with your email to start a 14-day free trial — 10 messages per day, 1 chat day per week
The free trial does not include appeal letter generation
After the trial period, chat access is locked until you subscribe to a plan
Plus: $20 per month (2 appeal credits, 20 messages/day, every day)
Unlimited: $60 per month (unlimited appeal letters and messages)
Billing
Payments are processed by Stripe — we never see or store your credit card number
All subscriptions renew automatically on a monthly basis and can be cancelled at any time
Appeal credits are non-refundable once used to generate an appeal letter
Unused appeal credits do not roll over between monthly billing periods
8. Acceptable Use
When using the Service, you agree not to:
Use automated tools to scrape, crawl, or extract data from the Service
Harvest or collect medical codes, policy references, or other structured data for redistribution
Redistribute, resell, or sublicense appeal letters or coverage guidance for commercial purposes
Impersonate another person or misrepresent your identity to access Medicare data
Use the Service to commit fraud or submit false claims to Medicare
Interfere with or disrupt the Service or its infrastructure
Attempt to circumvent rate limits, paywalls, or access controls
9. Intellectual Property
Appeal letters generated by the Service are owned by you, the user, and may be freely used for their intended purpose (filing Medicare appeals)
AI-generated content may not be eligible for copyright protection under current law
The DenaliHealth brand, logo, and original software are the intellectual property of Qash Solutions Inc
Medicare policy data, medical codes, and clinical evidence referenced by the Service are from public sources and are not our intellectual property
10. Limitation of Liability
DenaliHealth provides Medicare coverage guidance only. To the maximum extent permitted by law:
We are not responsible for the outcome of any Medicare claim or appeal
We are not liable for decisions made based on our AI-generated guidance
We do not guarantee the accuracy, completeness, or timeliness of coverage information
Our total liability for any claim arising from use of the Service is limited to the amount you paid us in the 12 months preceding the claim
We are not liable for indirect, incidental, consequential, or punitive damages
11. Termination
You may delete your account at any time through Settings — all your data will be permanently deleted (except audit logs, which are subject to a minimum 6-year HIPAA retention requirement)
We may suspend or terminate accounts that violate these Terms, engage in fraudulent activity, or abuse the Service
Upon termination, your right to use the Service ceases immediately
Sections on limitation of liability, intellectual property, and dispute resolution survive termination
12. Changes to These Terms
We may update these Terms from time to time. For material changes, we will notify registered users via email at least 30 days before the new terms take effect, with a summary of what changed. If you disagree with the changes, you may delete your account before the effective date. Continued use of the Service after the effective date constitutes acceptance of the updated Terms.
In the event of a merger, acquisition, or sale of assets, your data may be transferred to a successor entity. We will notify you via email at least 30 days before your data is transferred and becomes subject to different terms. As a holder of CMS Blue Button API production credentials, we will also notify CMS at the earliest practicable time, as production credentials are issued to a specific approved application and entity and a change of ownership requires CMS re-review. You may delete your account and all associated data before the transfer takes effect.
13. Your Medicare Data Rights
As a Medicare beneficiary using the Blue Button APIs through our Service, you have the following rights with respect to your data:
Access: You may view all Medicare data we have stored about you at any time through the Health section of the app
Correction: If you believe data displayed is inaccurate or incomplete, you can refresh your connection to re-sync from the official Medicare source or contact us to flag discrepancies
Deletion: You may delete your account at any time through Settings > Danger Zone — all Medicare data, conversations, appeal letters, and diabetes tracking data are permanently deleted immediately (audit logs recording data access events are retained for a minimum of 6 years per HIPAA requirements)
Revocation: You may disconnect your Medicare connection at any time through Settings — this immediately deletes all cached health data
Consent withdrawal: You may withdraw consent for AI use of your health data at any time through Settings > Privacy & Data
Data portability: You may request a copy of your stored data by contacting us
14. CMS Non-Endorsement Disclaimer
This product is not endorsed or certified by the Centers for Medicare & Medicaid Services (CMS) or the U.S. Department of Health and Human Services (HHS). DenaliHealth is an independent application that accesses Medicare data through publicly available APIs. References to Medicare, CMS, or government programs do not imply any official affiliation, endorsement, or certification.
15. Contact Information
If you have questions about these Terms of Service:
