Terms governing your use of COSA Nexus.

By accessing or using COSA Nexus (the "Platform"), you agree to these Terms of Service. If you do not agree, you may not use the Platform. Continued use after a change to these Terms constitutes acceptance of the revised Terms.

• Authorized staff of chiropractic partner offices who have been provisioned by an administrator.
• Licensed medical evaluators contracted to conduct EMC and orthopedic evaluations.
• Internal COSA Nexus administrative and operations staff.

Accounts are created by administrators only. Sharing account credentials is prohibited. Each user is individually responsible for actions taken under their account.

• Use the Platform only for legitimate referral, evaluation, and documentation activities on behalf of your employer or contracting entity.
• Do not access, copy, or download PHI beyond the minimum necessary for your role.
• Do not attempt to bypass access controls, audit logging, or session limits.
• Do not upload malware, disable security features, or interfere with other users.
• Do not use the Platform to conduct research or clinical trials without written authorization.

Providers using the Platform for telehealth evaluations agree to:

• Verify they hold an active, unencumbered license in the patient's state of residence before conducting the evaluation.
• Present the applicable state consent form (California AB 3030, Texas §111, New York §2999-cc, or federal fallback) before starting a session.
• Review and edit AI-generated clinical notes before saving them to the record. The provider is the responsible clinician for all note content.
• Deliver final reports as PDF within the timeframe agreed with COSA Nexus administration.

Referring offices agree to:

• Provide accurate patient demographics, contact information, and clinical background.
• Upload only documents relevant to the referral (intake forms, imaging reports, prior notes).
• Respond promptly to Missing Info requests to avoid delayed patient care.
• Obtain any patient authorizations required by applicable state law before submitting the referral.

Administrators agree to:

• Provision, edit, deactivate, and audit user accounts according to organizational policy.
• Assign referrals only to providers licensed in the patient's state of residence.
• Review and act on all deletion requests within a reasonable timeframe.
• Maintain the state-specific consent template library in accordance with current law.

When the AI clinical scribe is available, it will be run only after the patient has acknowledged the applicable state-specific AI disclosure. California residents are subject to Assembly Bill 3030; other states may have their own requirements.

The AI produces a draft note structured per SOW §6.2 (Chief Complaint, HPI, Examination, Assessment, Plan, EMC Determination, and ICD-10 codes). The provider remains fully responsible for the clinical decisions and the final content of the note. The AI tool does not make medical decisions on its own.

The referring Covered Entity retains all rights, title, and interest in the PHI stored on the Platform. COSA Nexus processes PHI only as a Business Associate under the terms of the applicable BAA.

Providers retain professional ownership of the clinical notes they author, subject to the Covered Entity's records retention obligations.

COSA Nexus targets 99.5% monthly availability outside of scheduled maintenance. Planned downtime will be announced at least 24 hours in advance where feasible. Support requests should be directed to the internal COSA Nexus administration team.

The Platform is provided as a workflow and documentation tool. Nothing in the Platform substitutes for professional medical judgment. Providers using the AI scribe, the state consent library, or the ICD-10 code suggestions remain solely responsible for the accuracy and appropriateness of their clinical work.

The platform is provided "as is" without warranty of any kind. To the fullest extent permitted by law, COSA Nexus disclaims all warranties, express or implied, including merchantability, fitness for a particular purpose, and non-infringement.

In no event will COSA Nexus, its affiliates, officers, employees, or agents be liable for indirect, incidental, special, consequential, or punitive damages arising out of your use of the Platform, even if advised of the possibility of such damages.

COSA Nexus administration may suspend or terminate accounts that violate these Terms, fail to meet security requirements, or are no longer authorized by the associated Covered Entity. On termination, PHI belonging to the Covered Entity is retained under the applicable BAA and retention policy; account access is revoked.

We may update these Terms from time to time. When we do, the "Last updated" date at the top of this page will change. Material changes will be notified through the Platform.

These Terms are governed by the laws of the State of California, without regard to conflict-of-laws principles. Disputes will be resolved in the state or federal courts located in San Diego County, California.