Effective Date: October 2022
The Provider Portal is provided on behalf of TriCore and our employees, managers, officers, directors, agents and representatives, and is powered by Rhodes Group, Inc. and its employees, affiliates and agents (“Rhodes Group”) (collectively, “Portal Operators”). The Portal Operators are either parties or intended third-party beneficiaries of this agreement and are entitled to enforce all terms and conditions of this agreement.
Provider Portal Service
We are pleased to offer you access to the Service, which enables you to order laboratory tests and easily and securely access laboratory test results and related information.
The Service is offered for free to individuals or entities that meet the definitions of a “health care provider” and a “covered entity” under 45 C.F.R. § 160.103, and to authorized personnel who have been provided a unique User ID by TriCore or Rhodes Group (also known as “Authorized Users”).
Provider Portal Account
In order to access the Provider Portal, you must complete the Outreach User Access form, which can be obtained by sending a request to email@example.com. This form will be used toset up a unique user account (“User Account”). In setting up a User Account, you must state whether you are an ordering provider, a member of the nursing staff or another member of the provider’s staff.
By setting up a User Account, you acknowledge that you are at least 18 years of age and that you are requesting access to the Service as a health care provider or on behalf of a health care provider exclusively for purposes of:
- Treatment: The provision, coordination, or management of health care and related services by one or more health care providers, including the coordination or management of health care by a health care provider with a third party; consultation between health care providers relating to a patient; or the referral of a patient for health care from one health care provider to another.
- Payment: To obtain or provide reimbursement for the provision of health care to an individual, including but not limited to determinations of eligibility or coverage, claims management and collection activities.
- Limited Health Care Operations: (1) Conducting quality assessment and improvement activities, including outcomes evaluation and development of clinical guidelines, provided that the obtaining of generalizable knowledge is not the primary purpose of any studies resulting from such activities; patient safety activities (as defined in 42 CFR 3.20); population-based activities relating to improving health or reducing health care costs, protocol development, case management and care coordination, contacting of health care providers and patients with information about treatment alternatives; and related functions that do not include treatment; and (2) Reviewing the competence or qualifications of health care professionals, evaluating practitioner and provider performance, health plan performance, conducting training programs in which students, trainees, or practitioners in areas of health care learn under supervision to practice or improve their skills as health care providers, training of non-health care professionals, accreditation, certification, licensing, or credentialing activities; or (3) Health care fraud and abuse detection or compliance.
Use of the Service for any other purpose (other than Treatment, Payment or Limited Health Care Operations, as those terms are defined above), is strictly prohibited.
Provider Portal Access
The Portal Operators hereby grant you a limited revocable, non-exclusive, non-assignable and non-transferable right to create a User Account to order laboratory tests and access, exchange and use Electronic Health Information (“EHI”) in accordance with the laws that apply to you, the Provider and TriCore.
Password and Security
You are responsible for maintaining the confidentiality of your User ID, password and User Account details, if any, and are fully responsible for any and all activities that occur under your User ID or User Account. You agree to (i) not share your User ID or password with anyone including any employee or person acting on your behalf; (ii) immediately notify the Portal Operators at firstname.lastname@example.org of any unauthorized use of your User ID or User Account or any other breach of security or unauthorized access to information in the Provider Portal; and (iii) ensure that you exit from your User Account and close your browser at the end of each session when accessing the Service. The Portal Operators are not liable for any loss or damage arising from your failure to comply with this section of the agreement.
Provider Portal Content
You understand and acknowledge that what is available through the User Account (“Provider Portal Content”) may not be a complete record of all health information that is maintained by or for TriCore or the Provider for a specific patient. Nor is it a complete record of all health information that is maintained by other health care providers, health plans or others for a specific patient.
Due to our obligations to comply with a complex set of state and federal health information laws, as well as limits on our technical and administrative capabilities to segment data, there may be instances where we must delay immediate access to certain EHI.
You understand and agree that:
- The EHI available through the Provider Portal may include health information that neither TriCore nor the Portal Operators created, and that neither TriCore nor the Portal Operators are responsible for verifying the accuracy of third-party information. All third-party information is provided “AS IS” with all faults. Neither TriCore nor the Portal Operators guarantee that third-party information in the Provider Portal will be accurate, complete, timely (real-time), error free, or without interruptions.
- In addition to Historical Data and Unsupported Data (discussed above), the Provider Portal may not contain: (i) health information that is subject to more restricted federal or state laws, such as information protected by 42 C.F.R. Part 2 , because it is infeasible under the circumstances to make that information available in a way that complies with applicable law; (ii) health information that is not maintained by TriCore in a designated record set, as that term is defined under HIPAA; (iii) non-final clinical information (e.g., information is not reliable for purposes of clinical decision making); (iv) Information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding; (v) health information that an individual has requested, and TriCore has agreed, to not share through the Provider Portal; (vi) health information created or obtained during research that includes treatment; (vii) health information protected by the federal Privacy Act (5 U.S.C. § 522a); (viii) information provided by a non-health care provider pursuant to promises of confidentiality if the information would reveal the confidential source; and (ix) health information for which a licensed health care professional—who has a current or prior clinical-patient relationship with the patient whose health information is at issue—has determined on an individualized basis in the exercise of professional judgment that denying or delaying the access, exchange or use of EHI will substantially reduce a risk of a harm to the patient or other natural person. Depending on the circumstances, it may not be feasible for TriCore to segment this health information from other EHI in the Provider Portal. In such instances, TriCore may suspend, disable or terminate use of the Service.
To request health information that is not accessible through the Provider Portal, and/or to request access to health information (including EHI) in a manner other than through the Provider Portal, please contact us at 505.938.8922 or 1.800.245.3296, and select Option 1 for Client Engagement.
- The Services does not make clinical, medical or other decisions. Your use of the Service is not a substitute for your professional medical judgment. You are solely responsible for confirming the accuracy of all data and making all medical and diagnostic decisions.
Rhodes Group Not Provider
Rhodes Group operates the Provider Portal under a contract with TriCore. Rhodes Group and its employees are not health care professionals and assume no responsibility for the Provider Portal Content or any consequence relating directly or indirectly to any action or inaction you take based on the Provider Portal Content or use of the Service. Rhodes Group and its agents shall not be liable for any false positive results, false negative results, inconclusive results, missing or incomplete results, course treatment, diagnosis or any other information, Service or products received from TriCore or any other health care professionals.
Health Information Privacy
If you set up a User Account, you may provide only information that you own or have the right to use/disclose. You and/or Provider are responsible for obtaining and maintaining any consents, authorizations or legally necessary permissions from patients, as may be required by law to disclose, access or use the Provider Portal Content. You acknowledge and agree that certain types of health information may be subject to re-disclosure restrictions and state or federal law that are more stringent than HIPAA, such categories of data are prohibited from being disclosed through the Provider Portal or are subject to additional disclosure restrictions (“Protected Data”).
Modification, Suspension and Termination of The User Account
Unavailability and Performance Degradation
In order to ensure the confidentiality, integrity, availability and good-working order of the Service, as well as to make improvements and upgrades to the Service, your User Account and/or the Service may be temporarily unavailable, or the performance degraded, from time to time. You acknowledge and agree that the Portal Operators may make your User Account and/or the Service temporarily unavailable, or otherwise degrade their performance, under any of the following circumstances:
- Regularly scheduled or unscheduled system maintenance and/or upgrades;
- Backup procedures or other system outages;
- Data corruption issues, such as if the Portal Operators reasonably suspects there is misidentified, mismatched or corrupt data due to a technical failure or other reason that is reasonably likely to endanger the life or physical safety of a person;
- In response to a privacy or security event or risk; and/or
- An uncontrollable event, such as a natural or human-made disaster, public health emergency, public safety incident, war, terrorist attack, civil insurrection, strike or other labor unrest, telecommunication or internet Service interruption, or act of military, civil or regulatory authority. If there is an uncontrollable event, we will take reasonable steps to notify you that the Provider Portal is unavailable, such as by posting a notice on our website or communicating with you through any of the contact information you have provided to the Portal Operators.
When the Provider Portal is unavailable, please use other communication methods (such as the telephone) to contact us.
You agree to not use the Service or permit the Service to be used to:
- Email, upload or otherwise transmit any content that: (i) infringes any intellectual property or other proprietary rights of any party; (ii) contains malware, software viruses or any other computer code, files or programs designed to interrupt, disable, destroy or limit the functionality of any computer software or hardware or telecommunications equipment or corrupt, restrict destroy any data; or (iii) poses or creates a privacy or security risk to any person;
- interfere with, disrupt or attempt to interfere with or disrupt the integrity or performance of the Service, Provider Portal Content or servers or networks connected to the Service, or disobey any requirements, procedures, policies, or regulations of networks connected to the Service;
- attempt to alter or destroy data on the Provider Portal;
- use the Service in a manner that interferes with other individuals' or entities' use of the Service;
- violate any applicable local, state, national, or international law, or any regulations having the force of law;
- impersonate any person or entity, or falsely state or otherwise misrepresent your affiliation with a person or entity;
- hack, manipulate or otherwise attempt to gain unauthorized access to the Service or any person’s account for which you do not have written authorization;
- buy, sell, trade, exchange or transfer login credentials or passwords to any third party;
- solicit personal information from anyone under the age of 18;
- harvest or collect other users’ email addresses or other contact information from the Service for the purposes of sending unsolicited emails or other unsolicited communications;
- further or promote any criminal activity or enterprise;
- obtain or attempt to access or otherwise obtain any content or information through any means not intentionally made available or provided for through the Service;
- circumvent, remove, alter, deactivate, degrade, or thwart any of the content protections in or geographic restrictions on any content (including Service Content (as defined below)) available on or through the Service, including through the use of virtual private networks; or
- engage in or use any data mining, robots, scraping, or similar data gathering or extraction methods; display, distribute, license, perform, publish, reproduce, duplicate, copy, create derivative works from, reverse engineer, modify, sell, resell, exploit, transfer, or upload for any commercial purposes, any portion of the Service, use of the Service, or access to the Service; or
If you are blocked by the Portal Operators from accessing the Service (including by blocking your IP address), you agree not to implement any measures to circumvent such blocking (e.g., by masking your IP address or using a proxy IP address or virtual private network).
The Service is for your professional use only. This section does not limit your proper use of EHI.
The Service may be available via a mobile device, including (i) the ability to upload content to the Service via a mobile device, and (ii) the ability to browse the Service from a mobile device (collectively, the “Mobile Service”). To the extent you access the Service through a mobile device, your wireless service carrier’s standard charges, data rates, and other fees may apply. In addition, downloading, installing, or using certain Mobile Services may be prohibited or restricted by your carrier, and not all Mobile Services may work with all carriers or devices. By using the Mobile Service, you agree that we may communicate with you regarding the Provider Portal by SMS, MMS, text message, or other electronic means to your mobile device and that certain information about your usage of the Mobile Service may be communicated to us. Message frequency varies. You understand and agree that these forms of communications are inherently unsecure and may present additional privacy and security risks. By using the Mobile Service, you accept those risks. The Portal Operators will not be liable for any unauthorized access or disclosure by third parties caused by use of mobile devices to access the Service.
You can cancel the SMS service at any time. Just text "STOP" to the short code you receive. After you send the SMS message "STOP" to us, we will send you an SMS message to confirm that you have been unsubscribed. After this, you will no longer receive SMS messages from us. If you are experiencing issues with the messaging program, you can reply with the keyword “HELP” for more assistance, or you can get help directly at email@example.com. If you want to join again, just sign up as you did the first time and we will start sending SMS messages to you again. In the event you change or deactivate your mobile telephone number, you agree to promptly update the User Account information to ensure that your messages are not sent to the person that acquires your old number.
The technology and software underlying the Service or distributed in connection therewith are the property of Rhodes Group, Inc. and its licensors (the “Software”). You agree not to copy, modify, create a derivative work of, reverse engineer, reverse assemble, decompile or otherwise attempt to discover any source code, object code or underlying structure, ideas or algorithms of the Software or sell, assign, sublicense, or otherwise transfer any right in the Software. Any rights not expressly granted herein are reserved by Rhodes Group.
Access Outside the U.S.
The Portal Operators are headquartered in the United States. If you access or use the Service from outside of the United States, you do so at your own risk. Whether inside or outside of the United States, you are solely responsible for ensuring compliance with the laws of your specific jurisdiction. Software available in connection with the Service and the transmission of applicable data, if any, is subject to United States export controls. No Software may be downloaded from the Service or otherwise exported or re-exported in violation of U.S. export laws. Downloading or using the Software is at your sole risk.
Intellectual Property Rights
Service Content: You acknowledge and agree that the Service may contain content or features (“Service Content”) that are protected by copyright, patent, trademark, trade secret, or other proprietary rights and laws. Except as expressly authorized by the Portal Operators, you agree not to modify, copy, frame, scrape, rent, lease, loan, sell, distribute, reverse-engineer or create derivative works based on the Service or the Service Content, in whole or in part, except that the foregoing does not apply to your own User Content (as defined below). Any use of the Service or the Service Content other than as specifically authorized herein is strictly prohibited.
Trademarks: TriCore name and logos are trademarks and service marks of TriCore (collectively “TriCore Trademarks”). Rhodes Group name and logos are trademarks and service marks of Rhodes Group (collectively “Rhodes Group Trademarks”). Other company, product, and service names and logos used and displayed via the Service may be trademarks or service marks of their respective owners who may or may not endorse or be affiliated with or connected to TriCore or Rhodes Group. Nothing in these Terms of Service or the Service should be construed as granting, by implication, estoppel, or otherwise, any license or right to use any of TriCore Trademarks or Rhodes Group Trademarks displayed on the Service, without prior written permission in each instance. All goodwill generated from the use of TriCore Trademarks or Rhodes Group Trademarks will inure to our exclusive benefit, respectively.
Third-Party Material: Under no circumstances will the Portal Operators be liable to you in any way for any content or materials of any third parties (including users) (“Third-Party Content”), including for any errors or omissions in any Third-Party Content, or for any loss or damage of any kind incurred as a result of the use of any such Third-Party Content. You acknowledge that the Portal Operators do not pre-screen Third-Party Content, but that the Portal Operators will have the right (but not the obligation) in their sole discretion to refuse or remove any Third-Party Content that is available via the Service. You agree that you must evaluate, and bear all risk associated with, the use of any Third-Party Content, including any reliance on the accuracy, completeness, or usefulness of such Third-Party Content.
User Content: You represent and warrant that you own all right, title and interest in and to all code, images, information, data, text and other materials that you make available to the Portal Operators, including via the Service or by email (“User Content”), including all copyrights and rights of publicity contained therein. You assume all risk associated with your User Content and the transmission of your User Content, and you have sole responsibility for the accuracy, quality, legality and appropriateness of your User Content.
Usage Data: You hereby authorize the Portal Operators to derive statistical and usage data relating to your use of the Service (“Usage Data”). We may use Usage Data for any purpose in accordance with applicable law, our privacy policies and our contractual obligations.
YOUR USE OF THE SERVICE IS AT YOUR SOLE RISK. THE SERVICE IS PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS. THE PORTAL OPERATORS AND THEIR LICENSORS EXPRESSLY DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS, IMPLIED OR STATUTORY, INCLUDING THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE AND NON-INFRINGEMENT.
THE PORTAL OPERATORS MAKE NO WARRANTY THAT (A) THE SERVICE WILL MEET YOUR REQUIREMENTS; (B) THE SERVICE WILL BE UNINTERRUPTED, TIMELY, SECURE, OR ERROR-FREE; (C) THE RESULTS THAT MAY BE OBTAINED FROM THE USE OF THE SERVICE WILL BE ACCURATE OR RELIABLE; OR (D) THE QUALITY OF ANY PRODUCTS, SERVICES, INFORMATION, OR OTHER MATERIAL PURCHASED OR OBTAINED BY YOU THROUGH THE SERVICE WILL MEET YOUR EXPECTATIONS.
YOU ACKNOWLEDGE THAT ACCESS TO THE SERVICE IS PROVIDED OVER VARIOUS FACILITIES, COMMUNICATIONS LINES, ROUTERS, SWITCHES, AND OTHER DEVICES OWNED, MAINTAINED, AND SERVICED BY THIRD-PARTY CARRIERS, UTILITIES, INTERNET SERVICE PROVIDERS, AND OTHER SERVICE PROVIDERS (“CARRIER LINES”), ALL OF WHICH ARE BEYOND THE PORTAL OPERATORS’ CONTROL. THE PORTAL OPERATORS ARE NOT LIABLE FOR ANY DELAY, FAILURE, INTERRUPTION, INTERCEPTION, LOSS, TRANSMISSION, OR CORRUPTION OF ANY DATA OR OTHER INFORMATION TRANSMITTED ON THE CARRIER LINES THAT ARE BEYOND THE PORTAL OPERATORS’ CONTROL. USE OF THE CARRIER LINES IS SOLELY AT YOUR RISK AND IS SUBJECT TO ALL APPLICABLE LAW.
Limitation of Liability
YOU EXPRESSLY UNDERSTAND AND AGREE THAT NEITHER THE PORTAL OPERATORS NOR THEIR LICENSORS WILL BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY DAMAGES, OR DAMAGES FOR LOSS OF PROFITS INCLUDING DAMAGES FOR LOSS OF GOODWILL, USE, OR DATA OR OTHER INTANGIBLE LOSSES (EVEN IF THE PORTAL OPERATORS OR THEIR LICENSORS HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES), WHETHER BASED ON CONTRACT, TORT, NEGLIGENCE, STRICT LIABILITY, OR OTHERWISE, RESULTING FROM: (A) THE USE OR THE INABILITY TO USE THE SERVICE; (B) THE COST OF PROCUREMENT OF SUBSTITUTE GOODS AND SERVICES RESULTING FROM ANY GOODS, DATA, INFORMATION, OR SERVICES PURCHASED OR OBTAINED OR MESSAGES RECEIVED OR TRANSACTIONS ENTERED INTO THROUGH OR FROM THE SERVICE; (C) UNAUTHORIZED ACCESS TO OR ALTERATION OF YOUR TRANSMISSIONS OR DATA; (D) STATEMENTS OR CONDUCT OF ANY THIRD PARTY ON THE SERVICE; OR (E) ANY OTHER MATTER RELATING TO THE SERVICE. IN NO EVENT WILL THE PORTAL OPERATORS OR THEIR LICENSORS INDIVIDUAL LIABILITY TO YOU FOR ALL DAMAGES, LOSSES, OR CAUSES OF ACTION EXCEED ONE HUNDRED DOLLARS ($100).
SOME JURISDICTIONS DO NOT ALLOW THE DISCLAIMER OR EXCLUSION OF CERTAIN WARRANTIES OR THE LIMITATION OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES. ACCORDINGLY, SOME OF THE ABOVE LIMITATIONS SET FORTH ABOVE MAY NOT APPLY TO YOU OR BE ENFORCEABLE WITH RESPECT TO YOU. IF YOU ARE DISSATISFIED WITH ANY PORTION OF THE SERVICE OR WITH THESE TERMS OF SERVICE, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USE OF THE SERVICE.