Cotiviti, LLC (“Cotiviti”) provides this portal (the “Portal”) for the convenience of certain providers (each, a “User” or “you”) subject to audit by Cotiviti and its customers. These Terms of Use (the “Terms of Use”) state the terms and conditions upon which this Portal is offered to Users. By clicking ‘SUBMIT’, you accept these Terms of Use. NO USER SHALL ACQUIRE ANY RIGHT AGAINST COTIVITI BY VIRTUE OF THESE TERMS OF USE OR THE USER'S USE OF THIS PORTAL. Any use of the Portal not expressly permitted by these Terms of Use is a breach of these Terms of Use. If any User violates these Terms of Use, access to the Portal may be terminated immediately.

Cotiviti owns all rights, title and interest in and to the Portal. Users shall not copy, modify, disassemble, reverse engineer or decompile any portion of the Portal and any intellectual property therein. Cotiviti reserves the right to modify the Portal in its sole discretion without notice. Cotiviti will not be responsible or liable to any User if the Portal is unavailable or not functioning at any time. Cotiviti may restrict access to the Portal at its discretion, including for scheduled maintenance or for other purposes.

You have been provided with a unique identifier in order to use the Portal to provide requested information, such as medical charts. You must treat such identifier as confidential and must not provide third parties with, or permit third parties to use the identifier provided to you by Cotiviti. You agree to notify Cotiviti immediately of any unauthorized use of the Portal or your identifier or any other breach of security with respect to the Portal involving your account. Cotiviti shall have the right to disable any identifier at any time in our sole discretion for any or no reason, including if, in our opinion, any User has violated any provision of these Terms of Use.

You may use the Portal only for lawful purposes and in accordance with these Terms of Use and any applicable laws, including, but not limited to the Health Insurance Portability and Accountability Act (HIPAA), the HIPAA regulations, and any similar state laws and regulations. You shall not use the Portal in any way that violates any applicable federal, state, local or international law or regulation (including, without limitation, any laws regarding the export of data or software to and from the US or other countries). You shall not engage in any conduct that may compromise the Portal. Prohibited activities include, but are not limited to:

• use of anything, including any device or software, that interferes with the proper working of the Portal;
• uploading any files that contain viruses, trojan horses, worms, logic bombs or other material which is malicious or technologically harmful;
• attempting to gain unauthorized access to, interfere with, damage or disrupt the Portal, or any server, computer or database connected to the Portal;
• interfering, or attempting to interfere with the proper working of the Portal.

YOUR USE OF THE PORTAL IS PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS, WITHOUT ANY WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED. NEITHER COTIVITI NOR ANY PERSON ASSOCIATED WITH COTIVITI MAKES ANY WARRANTY OR REPRESENTATION TO ANY USER WITH RESPECT TO THE COMPLETENESS, SECURITY, RELIABILITY, QUALITY, FUNCTIONALITY OR AVAILABILITY OF THE PORTAL. WITHOUT LIMITING THE FOREGOING, NEITHER COTIVITI NOR ANYONE ASSOCIATED WITH COTIVITI REPRESENTS OR WARRANTS THAT THE SERVICE WILL BE RELIABLE, ERROR-FREE OR UNINTERRUPTED, THAT DEFECTS WILL BE CORRECTED, FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS OR THAT THE SERVICES WILL OTHERWISE MEET THE NEEDS OR EXPECTATIONS OF ANY USER.

COTIVITI HEREBY DISCLAIMS ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO ANY WARRANTIES OF MERCHANTABILITY, NON-INFRINGEMENT AND FITNESS FOR PARTICULAR PURPOSE.

THE FOREGOING DOES NOT AFFECT ANY WARRANTIES WHICH CANNOT BE EXCLUDED OR LIMITED UNDER APPLICABLE LAW.

IN NO EVENT WILL COTIVITI, ITS AFFILIATES, EMPLOYEES, AGENTS, OFFICERS OR DIRECTORS BE LIABLE FOR DAMAGES OF ANY KIND, UNDER ANY LEGAL THEORY, ARISING OUT OF OR IN CONNECTION WITH YOUR USE, OR INABILITY TO USE, THE PORTAL, INCLUDING ANY DIRECT, INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO, PERSONAL INJURY, PAIN AND SUFFERING, EMOTIONAL DISTRESS, LOSS OF REVENUE, LOSS OF PROFITS, LOSS OF BUSINESS OR ANTICIPATED SAVINGS, LOSS OF USE, LOSS OF GOODWILL, LOSS OF DATA, AND WHETHER CAUSED BY TORT (INCLUDING NEGLIGENCE), BREACH OF CONTRACT OR OTHERWISE, EVEN IF FORESEEABLE.

THE FOREGOING DOES NOT AFFECT ANY LIABILITY WHICH CANNOT BE EXCLUDED OR LIMITED UNDER APPLICABLE LAW.

All matters relating to the Portal and these Terms of Use and all disputes or non-contractual obligation arising out of or in connection with it will be governed by and construed in accordance with the laws of the State of New York, without reference to the principles of conflicts of law that would apply the substantive laws of another jurisdiction. User hereby submits to the exclusive jurisdiction of the courts, state or federal, sitting in New York County, New York State over any dispute arising out of or in connection with the Portal and waives the right to object to such venue or make a claim of forum non conveniens.

Overview

The purpose of the Cotiviti Provider Connection Portal is to provide an efficient and secure way for Providers to upload documents for complex record review. Providers will be sent letters with details about the information being requested.

Each letter will contain the following information:

• URL to the portal.
• Unique Request Code that is associated with one medical claim.
• Portal verification information.
• Details about the requested information.

Security

To maximize privacy and security, the portal is designed to be one-way. This means it will accept information like medical records, but it will not allow for the download or viewing of protected information via the portal.

Important points:

• Each request code is tied to one medical claim. All uploaded documents are separated by request code.
• All data is encrypted in motion and at rest (AES256 an industry encryption standard).
• No Protected Health Information (PHI) or Personally Identifiable Information (PII) will be presented in any of the portal pages or made available for download.

Accessing the portal

The portal can be accessed by a web browser that access to the internet (Google Chrome, Firefox and Internet Explorer are supported).

https://providerconnection.cotiviti.com

Important: If you have trouble accessing the portal from your network, please contact your IT Department and have them whitelist the following URLs:

• https://cotiviti.com
• https://providerconnection.cotiviti.com
• https://cotiviti-providerconnection-prod-filestore.s3.amazonaws.com/

To upload documents to the portal, you will need (2) pieces of information:

1. Request code on the letter you received from Cotiviti.
2. Verification item (1 of the following list):
   1. Member Date of Birth
   2. Claim Number
   3. Member Admit Date
   4. Member ID

Select a verification type from the Dropdown Option then enter the corresponding value. Please note that it must match the value on the letter you received and/or our internal systems. If you are not able to validate successfully, you can try a different verification type.

Submitting Documents

You will see the screen below after successfully entering a valid request code and verification item. If you are using this request code for the first time, there will not be any previously uploaded files shown. If you are returning to this request code you may see a list of documents that were previously uploaded. Click the “Add Document” button to upload a document.

Supported File Types

The portal supports uploading documents with the following file types/extensions:

File Type	File Extension
Portable Document Format (PDF)	*.PDF
Tagged Image File Format (TIFF)	*.TIF or *.TIFF

Note: The portal allows for files up to 5GB to be uploaded.

Uploading Files

IMPORTANT: Please note that any files that you upload should only be related to one medical claim that is indicated on the letter you received.

There are 3 steps to uploading a file to the portal.

1. Click the “Choose File” button and browse for the file you want to upload. Please make sure the file is NOT password protected so that it can be processed.
2. Select the “Document Type” of the file you are uploading. Please be careful to select the correct Document Type so the file is routed properly.
   1. Medical Record – Any medical documents associated with initial Medical Record request.
   2. Other document types to be added soon.
3. Click “Add” button to upload.

You will see that the file was successfully uploaded in the file list once the upload is complete. All the file details except for the name are shown in the list. The file names are not shown in case the file name contains PHI. You can upload as many documents as necessary to fulfil the request on the letter.

If you upload a file in error, please contact a Cotiviti Provider Services Representative with the details to remove it from our systems.

When you have completed uploading documents, click the link which reads “Enter a new request Code / exit” to exit the portal or begin uploading documents related to a different medical claim.

Cotiviti Provider Support Contact Information

Please direct all portal related questions to 203-202-6107 and choose option 3 for technical support.