Legal

Clinical Use & AI Limitations

What Resova iQ’s outputs are, what they are not, and the professional review every one of them requires.

1. Purpose and Intended Use

Resova iQ is a business-to-business clinical documentation, clinical decision-support, billing, credentialing, and healthcare-operations platform operated by Resova AI.

Resova iQ is intended for licensed healthcare practices and their authorized professional users, including clinicians, coding and billing personnel, credentialing teams, administrators, and practice-operations staff.

Resova iQ may support:

  • Clinical documentation, decision-support, administrative, billing, credentialing, and healthcare-operations workflows.

Resova iQ is not a healthcare provider or medical practice. It does not directly provide medical care or medical advice to patients, and it is not intended for patients to use to obtain care.

Resova iQ does not replace professional judgment or independently provide professional services.

2. Types of Resova iQ Outputs

Resova iQ may provide several different types of outputs. Users should understand the distinction between those outputs before relying on them.

Output typeDescriptionRequired review
Drafts and suggestionsDrafts, suggestions, calculations, references, and workflow supportReview, edit, and approve before clinical, coding, billing, or operational use
Calculations and other system-generated resultsCalculations and other system-generated resultsVerify the calculation, inputs, applicable rules, and patient-specific circumstances before use
Reference contentReference and research materialsConfirm currency, relevance, jurisdiction, and completeness against authoritative sources
Administrative, operational, and compliance-related supportAdministrative, operational, and compliance-related supportIndependently confirm the output against the applicable records, primary sources, current requirements, and professional judgment

An output that is deterministic or based on a programmed rule is not necessarily clinically appropriate for every patient or situation. An output that includes a source or reference is not necessarily complete, current, or applicable to the user’s circumstances.

3. General Limitations

Resova iQ outputs may be inaccurate, incomplete, outdated, inconsistent, or inappropriate for a particular patient, practice, payer, jurisdiction, or situation.

Outputs may be affected by:

  • Limitations in the information and systems used to provide the outputs.

Users are responsible for reviewing the information submitted to Resova iQ and for determining whether it is sufficiently accurate, complete, and current for the intended use.

Resova iQ does not guarantee that any output will be accurate, complete, current, suitable for a particular purpose, or appropriate for a particular patient, claim, payer, practice, or jurisdiction.

4. Clinical Review and Approval

Clinical outputs must be reviewed, edited as appropriate, and approved by an appropriately licensed clinician before they are:

  • Used in patient care;
  • Included in a medical record;
  • Signed or exported to an electronic medical record or other clinical system;
  • Used to support a diagnosis or treatment decision; or
  • Used in prescribing or other medication-related decisions.

The reviewing clinician is responsible for determining whether an output is accurate, complete, clinically appropriate, and supported by the patient’s actual circumstances.

Resova iQ does not independently approve, sign, or assume responsibility for a clinical decision. The customer and its authorized professionals remain responsible for the clinical care they provide and for the content of the records they create, approve, sign, or export.

5. Medication-Related Information

Medication-related outputs may include information, calculations, and references that require independent professional verification.

Before using a medication-related output, the responsible professional must independently verify it against:

  • Current prescribing information and product labeling;
  • Current primary medical and pharmaceutical sources;
  • Applicable clinical guidance and institutional protocols;
  • The patient’s diagnosis and treatment plan;
  • Age, weight, allergies, contraindications, and drug interactions;
  • Kidney, liver, and other relevant organ function;
  • Current medications and relevant treatment history; and
  • Any other patient-specific facts that may affect the decision.

A medication-related output is not a prescription, medication order, or authorization to administer or dispense medication. The treating or prescribing professional remains responsible for the final medication-related decision.

6. Administrative and Operational Information

Coding, billing, claim-validation, claim-submission, and revenue-cycle outputs are workflow-support tools. They do not establish that a claim, code, billing determination, or reimbursement position is correct.

Qualified personnel must review applicable outputs against:

  • The complete and accurate clinical record;
  • The services actually provided;
  • Current code-set guidance;
  • Payer requirements and billing policies;
  • Applicable laws and regulations;
  • Contractual requirements; and
  • Any other information necessary to support the submission or determination.

Resova iQ does not guarantee:

  • Coding accuracy;
  • Claim acceptance;
  • Reimbursement;
  • Payment amount or timing;
  • Compliance with a particular payer’s requirements;
  • The absence of an audit, denial, recoupment, or repayment obligation; or
  • Any particular financial or operational result.

Customers must review and approve billing activity in accordance with their configured permissions and procedures. The customer remains responsible for reviewing and approving claims and related billing activity before submission.

7. Credentialing, Licensure, Payer, and Contract Information

Credentialing evidence, provider-licensure information, payer information, contract analyses, and related outputs must be independently verified against the relevant issuing authority, payer, agreement, or other primary source.

Resova iQ does not guarantee:

  • That a provider is currently licensed or authorized to practice;
  • That a provider is credentialed or enrolled with a payer;
  • That a provider participates in a particular network;
  • That a payer will accept a credentialing or enrollment submission;
  • That a contract analysis captures every applicable term or obligation; or
  • That any output reflects a later change to a license, payer policy, contract, law, regulation, or agency requirement.

Users remain responsible for confirming the applicable status, deadline, requirement, or contractual obligation before relying on the information.

8. Telehealth and Prescribing-Law References

Telehealth and prescribing-law information is provided for research and reference purposes only. Requirements may vary based on the patient’s location, the clinician’s location, the practice’s location, the type of service, the medication involved, licensure status, payer requirements, and other facts.

Laws, regulations, agency guidance, professional requirements, and payer policies may change. Users must verify applicable requirements against current primary authority before relying on the information or taking action.

Legal and regulatory reference content is not a substitute for review by qualified legal or compliance counsel when such review is appropriate.

9. Independent Review of Sources and Recommendations

Before relying on a recommendation or other output, users are responsible for independently reviewing:

  • The information used to generate the output;

Where Resova iQ displays supporting sources or explanatory information, users must determine whether those materials are current, authoritative, relevant, and complete.

10. Automation Controls and Professional Responsibility

Customers are responsible for maintaining appropriate review, authorization, and access controls for their organization.

Workflow actions remain subject to customer-configured permissions and required review or approval. Users must review outputs before relying on them, and customers are responsible for configuring appropriate permissions, approval steps, and access controls for their organization.

The customer remains solely responsible for:

  • Clinical decisions;
  • Coding and billing decisions;
  • Claim review and submission;
  • Medication-related decisions;
  • Credentialing and licensure determinations;
  • Compliance with payer requirements;
  • Compliance with applicable law and professional standards; and
  • The accuracy and completeness of information entered into or exported from Resova iQ.

11. Reporting Potentially Inaccurate or Unsafe Outputs

If you identify an output that may be inaccurate, misleading, incomplete, or unsafe, do not rely on it without appropriate professional review. Report the issue to inquire@resovaiq.com.

When reporting an issue, include, if available:

  • The general area of the platform involved;
  • The date and approximate time;
  • The output or a description of the issue;
  • The relevant inputs or assumptions;
  • The source or reference displayed by the platform;
  • The reason you believe the output may be inaccurate or unsafe; and
  • Any action taken to prevent reliance on the output.

Do not include unnecessary patient information or other sensitive information in a report. If a situation presents an immediate risk to a patient, follow the applicable clinical, organizational, and emergency procedures rather than waiting for a response from Resova AI.

13. No Guarantee of Results

Resova iQ is intended to support professional users; it does not guarantee any particular clinical, coding, billing, reimbursement, credentialing, legal, regulatory, financial, or operational result.

Use of Resova iQ does not guarantee:

  • A particular patient outcome;
  • Clinical accuracy or appropriateness;
  • Coding or billing accuracy;
  • Claim acceptance or reimbursement;
  • Credentialing or payer participation;
  • Licensure status;
  • Compliance with a particular law, regulation, payer rule, or professional requirement; or
  • A particular financial or operational improvement.

Professional users must apply their own training, judgment, verification procedures, and organizational policies before relying on any output.

14. Updates to This Page

We may update this page from time to time.

Users should review this page periodically for updates.

15. Contact

Questions about this page or reports concerning potentially inaccurate or unsafe outputs may be directed to:

Resova AI

4017 Williamsburg Ct., Suite 300

Fairfax, Virginia 22032

Email: inquire@resovaiq.com

Phone: (386) 280-7470