Shoreline Medical Administration – Business Associate Agreement (Electronic Acceptance)

Effective Date: The date on which you check the acceptance box and submit documents through the Shoreline claims portal.

Parties:

  • Shoreline Medical Administration, LLC (“Business Associate”)

  • You/Your Organization (“Covered Entity” or “Submitting Party”)

1. Purpose

This Agreement is required under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the HITECH Act, and related regulations. It governs the use and disclosure of Protected Health Information (“PHI”) submitted to Shoreline.

2. Permitted Uses and Disclosures

  • You may upload PHI solely for the purpose of claim review, submission, and related administrative services provided by Shoreline.

  • Any other use or disclosure is prohibited unless required by law.

3. Responsibilities of the Submitting Party

By agreeing, you acknowledge that your organization will:

  • Use appropriate safeguards to protect PHI.

  • Report to Shoreline within 5 business days any unauthorized use, disclosure, or security incident involving PHI.

  • Cooperate with Shoreline if patients request access to or amendment of their PHI.

  • Limit PHI disclosure to the minimum necessary to perform services.

4. Responsibilities of Shoreline

Shoreline agrees to:

  • Use and disclose PHI only as permitted under this Agreement or required by law.

  • Maintain administrative, technical, and physical safeguards in compliance with HIPAA.

  • Report to you any unauthorized use or disclosure of PHI within 5 business days of discovery.

  • Provide access to PHI as required under HIPAA.

5. Term and Termination

  • This Agreement is effective upon your electronic acceptance and continues until terminated.

  • Either party may terminate if the other materially breaches this Agreement.

  • Upon termination, PHI will be returned or destroyed if feasible; if not feasible, it will remain protected under this Agreement.

6. Indemnification

You agree to indemnify and hold harmless Shoreline for losses arising from your unauthorized use or disclosure of PHI or other breach of this Agreement.

7. Miscellaneous

  • This Agreement automatically updates to reflect future changes in HIPAA and HITECH requirements.

  • No third-party beneficiaries are created by this Agreement.

  • Ambiguities shall be interpreted to comply with HIPAA.

Electronic Acceptance

By checking the box below and uploading documents, you:

  • Acknowledge that you have read and agree to this Business Associate Agreement;

  • Represent that you are authorized to bind your organization; and

  • Enter into a legally binding agreement with Shoreline Medical Administration, LLC.