CaseWhy Appeals — Privacy Policy

1. What this covers. This policy describes what CaseWhy LLC collects when you use CaseWhy Appeals at appeals.casewhy.com, why, who sees it, how long we keep it, and your choices. It does not cover CaseWhy's USCIS case-tracking service, which has its own policy.

2. The short version. You upload a denial notice, a premium determination, or a bill. We read it to explain it and calculate your deadlines. We do not keep the text of your documents. We keep a small set of structured facts about the denial or determination (what kind of notice, which plan or agency, what service or drug category, the dates, which appeal level), and never the details you type into a letter when you download it. Medicare numbers and Social Security numbers are fully redacted before anything is stored — we do not retain any part of them, not even the last few digits. For a Medicare Part D case, the same is true of the drug's name: we keep only a coarse category of what was denied (for example, "not on the formulary" or "prior authorization"), never the specific brand or generic drug name — you (or your prescriber) enter the drug name only at the moment you download a form or letter that needs it, and that name is not stored. For a Medicare premiums case, the same is true of dollar amounts: any income figure, tax-year amount, premium surcharge tier, or penalty amount you type is automatically detected and removed before anything is saved — we never store what your income was. For a complaint or grievance, the same is true of the narrative: we keep only the kind of complaint, which program it's against, and its dates — the description of what happened is entered only at the moment you download a letter, and is never stored. The Medigap page collects nothing at all: it has no account, no case, and no server request beyond loading the page — the state you pick only changes what's shown to you in your browser. You tell your cases apart by a name you give the case or the date it was created. You can delete any case at any time, and deletion is permanent.

3. What we collect. - *Account:* your email address and a password (or a sign-in provider), and the state you select for local contacts. - *Documents you upload:* images or PDFs of denial notices, decision letters, pharmacy notices, facility or pharmacy bills, and — for an Original Medicare case — Medicare Summary Notices (MSNs), Advance Beneficiary Notices (ABNs), provider bills, the fast-track notices (a Notice of Medicare Non-Coverage, Important Message from Medicare, Medicare Outpatient Observation Notice, Medicare Change of Status Notice, Detailed Explanation of Non-Coverage, or Detailed Notice of Discharge), and Medicare Secondary Payer documents (a conditional-payment letter or notice, a recovery demand letter, or a waiver decision); for a PACE case, a service determination denial, a PACE organization appeal decision, an Independent Review Entity decision, or a state fair hearing notice; and for a Medicare enrollment and entitlement case, a Social Security determination or reconsideration decision about an application, entitlement date, enrollment period, or premium Part A. These contain health information — the name of the person the notice concerns, the service or drug category denied, and the plan's, agency's, or contractor's reason. We process them to provide the Service (see §4). We treat this as sensitive information under the state privacy laws that define it that way. - *Facts extracted from your documents:* the notice type, plan or agency name, denied service or drug category, the dates on the notice, the appeal level, and a short reason category from a fixed list. We do not store the extracted text of the document, and for a Medicare Part D case, that fixed list of categories never includes the specific drug's brand or generic name — only a coarse category such as "not on the formulary" or "quantity limit." For an Original Medicare case built on an MSN, ABN, or provider bill, we store only the amount in controversy for a denied claim line — we never store the provider's name, a claim number, or any other billed amount from the document. For a fast-track case, the same is true of the hospital or facility's name: we keep only the contested-item category (for example, "skilled nursing services ending" or "changed to observation status") and the notice's own dates — never the hospital's or facility's name, which stays in the original document only. The original file itself is kept — in private, encrypted-at-rest storage, with its filename separately encrypted — for your own reference, until you delete the case or the account. - *Medicare numbers and Social Security numbers:* redacted before storage; we do not retain any portion of either number. - *Dollar amounts, for a Medicare premiums or Medicare enrollment and entitlement case:* any income figure, MAGI, tax-year amount, IRMAA tier, or penalty amount is automatically detected and redacted before storage — we do not retain the figure. - *Answers you give:* the situation questions (for example, whether there was a prior hospital stay, or whether a life-changing event applies) and the flags you set (for example, that a bill was sent to collections, or that the person also has Medicaid). - *Letter and form details:* the names, addresses, Medicare number, drug name (for a Medicare Part D coverage-determination or redetermination form), income or plan information (for a Medicare premiums form), a financial statement of income, expenses, and assets (for a Medicare Secondary Payer waiver or compromise request), and dates you enter when you download or copy a letter or form are used to fill it in at that moment and are not stored. - *Complaints and grievances:* the kind of complaint (plan grievance, QIO complaint, or Ombudsman request), which program it's against, whether it concerns quality of care, and its dates. The description of what happened, and the names/addresses used to fill in a letter, are entered only when you download that letter and are not stored. The Medigap page stores nothing — it has no account and makes no request beyond loading the page. - *Payments:* Stripe collects your card details; we receive a payment confirmation, the amount, and Stripe's own identifiers for the transaction. We never see or store full card numbers. - *Email activity:* whether reminders were delivered or bounced, and whether you paused them. - *Technical data:* IP address, browser type, and pages viewed, used for security and to run the Service. When a document is in Spanish, we record that a Spanish-language document was seen, in an aggregate daily count by page — never tied to your account or the document itself.

4. How we use it. To read and explain your documents, calculate deadlines, send reminders you asked for, prepare letters and forms you purchase, process payments, answer support requests, secure the Service, and understand which situations users face (in aggregate — counts of notice types, denied services, and referrals, never case content). We do not sell your information, do not share it for advertising, and do not use your documents to train AI models.

5. Who receives it. Service providers that process data on our behalf under contract: Vercel (hosting; and the AI gateway through which Anthropic's Claude models read your documents to produce explanations and letter drafts — Anthropic's commercial API terms state this data is not used to train its models), Neon (database), Vercel Blob (encrypted file storage), Postmark (email delivery — reminder and account emails never contain health details, and for a Medicare Part D case never contain a drug name, and for a Medicare premiums case never contain a dollar amount; they refer to your case by a label you can recognize), and Stripe (payments; Stripe's own privacy policy governs card data). We disclose information if the law requires it, to protect the Service or its users, or in a merger or sale of CaseWhy LLC, in which case we tell you first and you may delete your cases beforehand. We do not share your information with Medicare, CMS, the Social Security Administration, any health plan or drug plan, or any provider; you send your own appeal.

6. Security. Data is encrypted in transit (TLS) and at rest. Uploaded files are stored in private storage with an encrypted filename; Medicare and Social Security numbers, and dollar amounts on a Medicare premiums case, are redacted before anything is stored; document text is not retained; passwords are hashed. No system is perfectly secure. If a breach affects your information we will notify you and any regulator the law requires, including under the FTC Health Breach Notification Rule and Florida's Information Protection Act, without undue delay.

7. Retention and deletion. Case data is kept while the case exists and your account is active. Deleting a case — from that case's own page, at any time — permanently removes its file, its extracted facts, its deadlines, its letters, and its reminders immediately; we keep only a minimal record that a deletion happened (an identifier and a date) and the payment records the law requires us to keep for bookkeeping (amounts, dates, Stripe identifiers — no case content). Deleting your account — Settings → Delete my account — permanently deletes every case on your account the same way, your account preferences, and your sign-in itself, right away; we keep the same minimal deletion record and payment bookkeeping described above, no longer linked to you. Reminder emails stop when you pause them, when the case closes, or when you delete it.

8. Your rights and choices. Wherever you live, you can view and correct your account information, delete any case at any time, pause reminders from any reminder email, and ask us what we hold about you. Residents of California, Colorado, Connecticut, Virginia, Utah, Texas, Oregon, Montana, and other states with consumer privacy laws have rights to access, correct, delete, and obtain a copy of their personal information, to opt out of sale or targeted advertising (we do none), and to not be discriminated against for exercising these rights. Some of those laws require your consent before we process sensitive data such as health information; you give that consent when you create an account and upload a document, and you withdraw it by deleting the case. To exercise any right, email info@casewhy.com; we verify requests through your account email and respond within the time the law allows (usually 45 days). You may appeal a decision by replying to our response.

9. Children. The Service is for adults 18 and over. Notices you upload may concern a person of any age; we do not knowingly collect information directly from anyone under 18.

10. Not a HIPAA covered entity. CaseWhy LLC is not a health plan, health care provider, or clearinghouse, and is not a business associate of one, so HIPAA does not apply to the Service. We say this so you know which law protects your information here: this policy, the FTC Act and Health Breach Notification Rule, and your state's privacy law.

11. Changes. We will post changes here and update the date above; material changes are announced by email 14 days in advance.

12. Contact. appeals@casewhy.com · CaseWhy LLC, 7901 4th St N, Ste 300, St. Petersburg, FL 33702, US.