Terms of Service

These Terms apply to everyone who accesses or uses the Services, including organisations that subscribe to the Services (Customers), the individuals they authorise (Authorised Users), and individuals such as doctors, coders and members of the public who download or sign up to our mobile or web applications directly.

Age requirement

You must be at least 18 years old to create an account or use the Services. The Services are not intended for children, and we do not knowingly allow anyone under 18 to register. If we learn that a user is under 18, we will close the account.

If you use the Services on behalf of an organisation, you confirm that you are authorised to accept these Terms for that organisation, and "you" refers to both you and the organisation.

Where a signed agreement, quotation or Order Form with Casemix Solutions conflicts with these Terms, the signed agreement prevails for that Customer.

The Services include, as made available to you from time to time:

• Casemix software: the Casemix Web Grouper, Batch Grouper, Case Cost Module, MY-DRG® and UNU-CBG® groupers, data and analytics tools.
• Casemix CodeAssist: our mobile and web application for AI-assisted clinical coding.
• Grouper API: programmatic access that lets your own systems, such as a hospital information system (HIS), use our grouper.
• Professional services: consultancy, implementation, training and support, which may also be governed by a separate proposal or agreement.

Relify, our clinic management system, is governed by its own terms at relify.com.my.

You must provide accurate information when creating an account and keep it up to date. You are responsible for all activity under your account and for keeping your login details confidential.

• Accounts are personal. Do not share passwords, one-time codes or devices used to sign in.
• If you sign in with Google, your use of your Google account is also subject to Google's terms. See our Privacy Policy for what we receive from Google.
• You can delete your account at any time in the app or on our account deletion page.
• Customers are responsible for granting, reviewing and removing their Authorised Users' access, including when staff leave.
• Tell us promptly at info@casemix.com.my if you suspect unauthorised access.

We may require additional verification, or suspend access, to protect an account or the Services.

Our mobile applications, including Casemix CodeAssist, are licensed to you, not sold, for use on devices you own or control, in line with these Terms.

App stores

If you download an app from the Google Play Store, Apple App Store or another store, you must also comply with that store's terms. The store operator is not responsible for the app or for providing support, and is not a party to these Terms.

Device security

• Sign-in may be linked to your device. Keep your device protected with a screen lock and current operating-system updates.
• If a device is lost, stolen or transferred, sign out remotely if available, or contact us so we can revoke its access.
• Do not use the app on rooted, jail-broken or otherwise compromised devices.

Updates

We may release updates that fix issues, improve security or change features. Some updates may be required to continue using the app.

The Grouper API lets your systems group episodes without using our web application. API access is provided only to approved Customers.

API keys

• API keys are confidential credentials issued to your organisation. Store them securely on your servers and never place them in public code, mobile apps or web pages.
• You are responsible for all requests made with your keys. Tell us immediately if a key may have been exposed, so we can revoke and replace it.
• We may rotate, limit or revoke keys to protect the Services or where these Terms are breached.

Fair use

• Use the API only for your own organisation's grouping, coding, costing and reporting.
• Do not resell, sublicense or expose the API to third parties without our written agreement.
• Respect any rate limits, quotas and technical documentation we provide, and do not attempt to reverse-engineer the grouper logic.

You are responsible for your own systems, integrations and the accuracy of the data you send. We are not responsible for errors caused by your HIS or third-party software.

Some Services include artificial-intelligence features, such as suggesting ICD-10, ICD-11 and procedure codes, explaining grouping results, or answering DRG questions (AI Features).

Acceptance

Before using AI Features for the first time, you will be asked to confirm that you understand and accept this section. By using AI Features you agree that:

• AI outputs are suggestions. They may be incomplete, outdated or wrong, even when they appear confident.
• A qualified person must review every suggestion before it is accepted, recorded, submitted for payment or used for any decision.
• You will not rely on AI Features as the sole basis for clinical, coding, billing or funding decisions.
• We may change, limit or withdraw AI Features, including usage limits, at any time.

Not medical advice

AI Features, including the DRG assistant, give information about coding and Casemix only. They are not medical advice and must not be used to diagnose, treat or make decisions about anyone's health, including your own. If you have a health concern, see a doctor.

Acceptable use of AI

• Do not use AI Features to create harmful, offensive, misleading or unlawful content, or to try to get around their safeguards.
• Do not submit patient identifiers, or anyone else's personal data, in prompts or clinical text.

Reporting AI answers

If an AI answer is wrong, offensive or unsafe, use the Report option next to the answer in the app, or email info@casemix.com.my. We review reports and use them to improve our safeguards.

We designed our AI Features so that patient demographics and identifiers are never sent to AI. Only the clinical content needed to suggest codes is processed.

Your part

Because AI Features work on the clinical text you provide, you must not type or paste patient identifiers (such as names, IC numbers or contact details) into clinical text fields. Remove any identifiers that appear inside a discharge summary before submitting it.

How AI providers use the data

AI processing is performed by OpenAI (United States) through its API, acting on our instructions. Under OpenAI's API data terms, your content is not used to train OpenAI's models. The app asks for your permission before any clinical content is sent to OpenAI. We do not sell your data. See our Privacy Policy for details.

The Services support Casemix grouping, costing and clinical coding. They do not provide medical advice, diagnosis or treatment, and they do not replace professional judgment.

• Customers and their coders remain responsible for the accuracy and completeness of clinical documentation, codes and claims.
• Grouping and costing results depend on the data entered. Incorrect or incomplete input will produce incorrect results.
• Customers are responsible for complying with the coding standards, payer rules and regulations that apply to them.

You keep ownership of the data you submit to the Services (Customer Data). You give us permission to host, process and transmit Customer Data only to provide, secure, support and improve the Services, and as described in these Terms.

We process personal data in line with Malaysia's Personal Data Protection Act 2010 (PDPA). For healthcare data you submit, the Customer is generally the data controller and we act on its instructions. See our Privacy Policy and PDPA Policy for details.

You confirm that you have the rights, notices and consents needed to submit Customer Data to the Services.

We use reasonable technical and organisational measures to protect the Services and Customer Data, including access controls, encryption in transit and device-bound authentication for mobile apps.

No system is perfectly secure. You are responsible for securing your own devices, networks, accounts and API keys. If we become aware of a security incident affecting your Customer Data, we will notify you without undue delay and as required by law.

You must not:

• use the Services in breach of any law, including healthcare, privacy and anti-fraud laws;
• submit false information or use the Services to support fraudulent claims;
• access accounts, data or systems you are not authorised to access;
• copy, scrape, reverse-engineer or attempt to extract our grouper logic, source code or models;
• interfere with or overload the Services, or bypass security or usage limits;
• upload malware, or use the Services to harass or harm others.

Paid Services, including software subscriptions, API access, consultancy and training, are arranged directly with Casemix Solutions. We do not sell subscriptions through in-app purchases or app stores.

• After a consultation, we will send you a quotation or invoice setting out the Services, fees and payment terms.
• Payment is made directly to Casemix Solutions Sdn. Bhd. by bank transfer, using the bank details on our official invoice.
• Access to paid Services begins once payment is received, unless we agree otherwise in writing.
• Unless stated otherwise, fees exclude applicable taxes.

Some features may be offered free of charge. We may change or end free features at any time. If payment is overdue, we may suspend access after giving notice.

The Services, including our software, groupers, classification logic, documentation, training materials and brand, belong to Casemix Solutions or its licensors. MY-DRG® and UNU-CBG® are registered marks of their respective owners.

We grant you a limited, non-exclusive, non-transferable right to use the Services during your subscription, for your internal purposes, in line with these Terms. If you send us feedback, we may use it without obligation to you.

We aim to keep the Services available and reliable, but we do not guarantee uninterrupted or error-free operation. We may carry out maintenance, and we will try to give notice of planned downtime.

We may update, improve or discontinue features. If we discontinue a paid Service you rely on, we will give reasonable notice.

You may stop using the Services at any time. Subscriptions end as set out in your agreement.

We may suspend or terminate access if you breach these Terms, fail to pay, create a security risk, or if required by law. Where reasonable, we will give notice first.

After termination, we will make Customer Data available for export for a reasonable period on request, after which it may be deleted, subject to legal retention requirements.

Except as expressly stated in these Terms, the Services are provided "as is" and "as available". To the extent permitted by law, we disclaim implied warranties, including fitness for a particular purpose.

To the extent permitted by law, we are not liable for indirect or consequential losses, lost profits, lost revenue or claims rejected by payers. Our total liability for any claim relating to the Services is limited to the fees you paid us for the relevant Service in the 12 months before the claim.

Nothing in these Terms limits liability that cannot be limited under applicable law.

These Terms are governed by the laws of Malaysia. The courts of Malaysia have exclusive jurisdiction over any dispute, unless otherwise agreed in writing.

If any part of these Terms is found unenforceable, the rest remains in effect. Our failure to enforce a term is not a waiver of it.

We may update these Terms from time to time. We will update the "Last updated" date and, for material changes, notify Customers by email or within the Services. Continued use after changes take effect means you accept the updated Terms.

Casemix Solutions Sdn. Bhd.
Lot 1-15 MKH Boulevard, Jalan Changkat, Bandar Kajang, 43000 Kajang, Selangor Darul Ehsan, Malaysia
info@casemix.com.my · +60 10-354 6921