Payments, Treatment Plan and Financial Features Addendum

Practice-facing addendum designed for acceptance during initial AiroDental onboarding.

This Addendum is incorporated into the AiroDental Master Services Agreement or Terms of Service (the “MSA”) between AiroDental LLC (“AiroDental”) and the dental practice or other customer identified in the applicable order, account, or enrollment record (“Practice”). Capitalized terms not defined here have the meanings in the MSA. The Business Associate Agreement (“BAA”) controls for HIPAA-specific obligations.

1. Purpose and Conditional Application

1.1 Advance acceptance

Practice agrees to this Addendum during initial AiroDental onboarding so AiroDental may make payment, treatment-plan, and financial features available later without requiring a completely new AiroDental master agreement each time a feature is activated.

1.2 Conditional applicability

Sections relating to a particular feature apply only when that feature is enabled or used. Accepting this Addendum does not guarantee processor approval, enable payment processing, authorize AiroDental to debit a bank account, or create a patient-specific payment authorization.

1.3 Activation conditions

AiroDental may require completion of processor onboarding, KYB/KYC, banking information, administrator certification, current pricing acknowledgement, hardware setup, or feature-specific terms before enabling a payment method or financial feature.

2. Roles

2.1 Practice is provider and merchant

Practice is solely responsible for its dental services and is the seller/provider for Patient transactions. Unless the applicable processor structure states otherwise, Practice is the merchant for Patient Payments and the recipient of settlement.

2.2 AiroDental is technology provider

AiroDental provides software, workflow, messaging, treatment-plan presentation, payment links, records, reconciliation surfaces, and integrations. AiroDental is not a dental provider and does not diagnose, determine clinical necessity, or provide professional dental advice.

2.3 Third-party payment providers

Payment functionality is provided through third-party payment infrastructure and financial providers, which may include AiroDental’s third-party payment processors, acquiring banks, payment networks, ACH providers, and hardware providers (collectively, “Payment Providers”). Practice’s use of payment services may be subject to separate Payment Provider terms.

2.4 No regulated-role assumption

Except where expressly stated in then-current Payment Provider terms, AiroDental is not the merchant of record, payment processor, payment facilitator, acquirer, bank, money transmitter, lender, creditor, servicer, or holder of Patient funds merely because the AiroDental interface initiates or displays a payment workflow.

3. Treatment Plans and Clinical Responsibility

3.1 Practice responsibility

Practice is solely responsible for diagnosis, treatment recommendations, clinical necessity, treatment alternatives, professional judgment, clinical records, procedure-specific consent, licensure requirements, and the accuracy and completeness of treatment-plan information entered into or transmitted through AiroDental.

3.2 Acknowledgement is not automatically informed consent

A Patient’s electronic review, acknowledgement, signature, selection, or acceptance of a treatment plan through AiroDental is evidence of the action captured by the workflow. It does not by itself establish legally sufficient clinical informed consent unless the Practice has configured and used a legally sufficient consent workflow for the applicable procedure and jurisdiction.

3.3 Pricing

Practice determines treatment prices, estimates, insurance assumptions, discounts, deposits, patient responsibility, and refund policies. AiroDental does not independently verify those amounts.

4. Payment Plans, Installments and Consumer Credit

4.1 Practice-defined terms

Practice is responsible for determining whether it may lawfully offer a payment schedule, installment arrangement, deferred-payment arrangement, interest, fee, or other extension of credit and for providing disclosures required by applicable federal and state law.

4.2 AiroDental does not underwrite

Unless AiroDental enters a separate written regulated-finance agreement, AiroDental does not determine creditworthiness, approve or deny a Patient for credit, set an APR, lend funds, purchase receivables, guarantee payment, collect debts for its own account, or act as a creditor or lender.

4.3 Feature restrictions

AiroDental may restrict the number of installments, interest, finance charges, late fees, deferred payment, required autopay, or other settings by state, processor, Practice type, or feature in order to reduce legal or payment-network risk. Practice will not circumvent those controls.

4.4 Separate financing

Third-party financing products are governed by the financing provider’s terms and disclosures. Practice will not describe an AiroDental payment schedule as “financing,” “credit,” or “interest-free financing” unless the underlying legal product and disclosures support that description.

5. Payment Provider Enrollment, Processor Terms and Eligibility

5.1 Separate acceptance

Practice must accept any Payment Provider terms required for its merchant or connected account. AiroDental may present or link to those terms, embed an approved onboarding flow, or redirect Practice to the Payment Provider.

5.2 KYB and underwriting

Practice will provide accurate, complete, and current business, ownership, identity, licensing, and banking information required by a Payment Provider. Payment activation and continued availability are subject to Payment Provider approval and monitoring.

5.3 No approval guarantee

AiroDental does not guarantee that a Payment Provider will approve, continue to serve, or maintain any particular payment method, processing rate, payout schedule, reserve level, or merchant account.

5.4 Processor actions

AiroDental may suspend, limit, or disable payment functionality when required or reasonably requested by a Payment Provider, bank, network, law, fraud/security risk, or compliance concern.

6. Patient Payment Authorizations

6.1 Practice obligation

Practice is responsible for ensuring that each Patient payment is authorized and for obtaining, preserving, and producing the payment authorization and related evidence required by applicable law, Payment Provider terms, and payment-network rules.

6.2 AiroDental workflow

AiroDental may provide templates, checkboxes, signatures, electronic records, and authorization workflows. Practice is responsible for using the correct workflow for the applicable transaction and jurisdiction and for not modifying required language in a way that makes the authorization deficient.

6.3 Stored card

Before saving a tokenized payment method for later use, Practice must obtain Patient consent for storage and future use consistent with the applicable Payment Provider and card-network requirements.

6.4 Recurring card

Before initiating recurring or scheduled card charges without a new Patient action for each charge, Practice must obtain an authorization describing the payment schedule or the method for determining amount and timing, as applicable, and must honor revocation or cancellation rights required by law and Payment Provider rules.

6.5 ACH

Before initiating recurring consumer ACH debits, Practice must obtain a written or similarly authenticated authorization satisfying applicable requirements, provide the consumer a copy where required, and follow applicable notice, revocation, stop-payment, account-validation, and Nacha requirements. AiroDental may disable ACH functionality unless the approved workflow is used.

7. Card Data, PCI and Payment Security

7.1 Approved channels only

Practice will enter card or bank credentials only through payment fields, hosted pages, terminals, or other components designated by AiroDental or the applicable Payment Provider for that purpose.

7.2 Prohibited storage

Practice will not enter, upload, paste, transmit, or store full card numbers, CVV/CVC, track data, PIN/PIN blocks, or other prohibited payment credentials in AiroDental notes, messages, treatment-plan fields, attachments, forms not designated for card capture, support tickets, screenshots, or free-text fields.

7.3 Practice environment

Practice is responsible for the security of its users, devices, browsers, local network, physical terminals, passwords, MFA devices, and employee access. Practice will promptly disable departed users and report suspected compromise.

7.4 Terminal security

If card-present hardware is used, Practice will follow then-current device security, inspection, location, tamper, loss/theft, software, and return requirements published by AiroDental or the applicable Payment Provider.

8. Banking Information and Administrator Authority

8.1 Settlement account

Practice represents that each settlement bank account it supplies is owned or lawfully controlled by Practice and may be used for payouts, reversals, offsets, refunds, chargebacks, or other debits expressly authorized by the applicable Payment Provider terms.

8.2 Authorized administrators

Practice is responsible for designating administrators with authority to activate payment features, provide or change bank information, issue refunds, manage users, and accept Payment Provider terms.

8.3 Bank changes

Practice will use only the approved authenticated workflow to change settlement-bank information. AiroDental may require MFA, reauthentication, additional verification, or a temporary security hold before a bank change becomes effective.

9. Refunds, Chargebacks, Disputes, Returns and Negative Balances

9.1 Underlying transaction

Practice is responsible for the Patient’s underlying obligation and for disputes concerning dental treatment, service quality, treatment cancellation, services not rendered, deposits, refunds, and Patient dissatisfaction.

9.2 Refund decisions and Practice refund policy

Practice makes refund decisions subject to law and Payment Provider rules. AiroDental may transmit or facilitate a refund instruction but does not assume liability for the underlying refund decision. Practice is responsible for setting, disclosing, and honoring its own refund, cancellation, and deposit policy with its Patients. AiroDental does not set refund eligibility, refund amounts, or refund timing, and does not decide whether a Patient is entitled to a refund.

9.3 How refunds are processed

A refund is initiated through AiroDental Pay and is carried out by the applicable Payment Provider. A refund is generally returned to the original payment method used for the transaction, subject to Payment Provider and card network rules. AiroDental does not hold Practice or Patient funds, so the time for a refund to reach the Patient is controlled by the Payment Provider, the card networks, and the issuing or receiving bank, not by AiroDental. Processing fees on the original transaction may or may not be returned on a refund, as determined by the Payment Provider’s terms.

9.4 Partial refunds, deposits, and cancellations

Practice may issue a full or partial refund where its refund policy and applicable law allow. Practice is responsible for handling deposits, treatment cancellations, services not rendered, and any related credits in accordance with its own policy and applicable law. AiroDental provides the workflow to record and transmit these actions but does not determine the underlying entitlement.

9.5 Chargebacks and returns

Practice is responsible for chargebacks, ACH returns, retrieval requests, dispute fees, and related losses to the extent imposed on Practice by the applicable Payment Provider or arising from the underlying transaction, authorization failure, Practice conduct, or Practice evidence failure.

9.6 Negative balances

Refunds, chargebacks, ACH returns, reversals, and fees may exceed a Practice’s available or pending settlement, creating a negative balance. Practice is responsible for any negative balance arising from its transactions. The Payment Provider may recover a negative balance from current or future settlement, from a reserve, from the Practice’s designated bank account, or by other means permitted under its terms. Practice will promptly fund any negative balance that cannot be recovered from settlement.

9.7 Processor records

AiroDental records may be used for operational reconciliation, but Payment Provider, acquirer, and banking records control actual settlement, payout, reserve, and network outcomes where they differ, subject to correction of verified AiroDental software errors.

10. HIPAA, Privacy and Payment Data

10.1 BAA

The BAA governs AiroDental’s use and disclosure of PHI on behalf of Practice. Payment and treatment-plan functionality may cause payment status, treatment-plan records, Patient identity, authorization evidence, or other information to become PHI in the AiroDental environment.

10.2 Minimum necessary

Practice will not place unnecessary diagnoses, tooth numbers, clinical narratives, or other sensitive treatment detail into payment descriptions, processor metadata, statement descriptors, or other fields intended only to facilitate payment.

10.3 Payment Providers

AiroDental may disclose or transmit information to Payment Providers as reasonably necessary to provide payment functionality, subject to the BAA, applicable law, and AiroDental’s Payment Provider arrangements. AiroDental will use data-minimized identifiers where reasonably feasible.

11. Records and Electronic Evidence

11.1 Electronic contracting

Practice agrees that electronic signatures, clickwrap acceptance, electronic records, and electronic notices may be used to form and evidence agreements to the extent permitted by law.

11.2 AiroDental evidence

AiroDental may retain evidence of Practice and Patient actions, including account identity, authorized administrator, version of terms or form, timestamp, signature or checkbox evidence, relevant IP/device data, transaction IDs, and audit logs, subject to applicable retention and privacy requirements.

11.3 Practice retention

Practice remains responsible for retaining treatment, consent, financial, credit, and Patient authorization records for the period required by law, payer requirements, Payment Provider rules, and Practice policy.

12. Fees, Payment Economics and Surcharges

12.1 Practice fees

Practice will pay the payment-processing and platform charges shown in its Order Form, activation screen, pricing schedule, or then-current Payment Pricing Page incorporated under Section 15.

12.2 Patient surcharges or convenience fees

Practice may not impose a surcharge, convenience fee, service fee, cash-discount differential, or similar amount through AiroDental unless the feature is enabled and configured in accordance with applicable law and Payment Provider/card-network requirements. Practice is responsible for state-specific legality and required disclosures unless AiroDental expressly provides a compliant managed program.

13. Practice Representations, Warranties and Covenants

• Practice is duly organized, properly licensed, and authorized to provide the services for which it accepts payment.
• The person accepting these terms has authority to bind Practice.
• All merchant, ownership, identity, and bank information supplied for payment activation is accurate and current.
• Practice will comply with law applicable to its dental services, Patient financial arrangements, credit terms, refunds, and Patient communications.
• Practice will obtain required Patient payment authorizations and preserve evidence.
• Practice will comply with Payment Provider terms and payment-network rules applicable to Practice.
• Practice will not submit fraudulent, sham, money-transfer, unrelated, or prohibited transactions through AiroDental Pay.
• Practice will not use AiroDental Pay to collect for services or businesses not disclosed to and approved by the applicable Payment Provider.
• Practice will protect administrator credentials and immediately report suspected misuse, compromised terminals, fraudulent refunds, or bank-account substitution attempts.
• Practice will reasonably cooperate with AiroDental and Payment Providers concerning disputes, fraud, audits, regulatory inquiries, and security incidents.

14. AiroDental Rights, Disclaimers, Indemnity and Liability

14.1 Suspension

AiroDental may suspend or restrict payment functionality for fraud, security, legal, Processor, network, excessive-dispute, inaccurate-KYB, nonpayment, or material breach concerns without terminating Practice’s other AiroDental services where practical.

14.2 Third-party services

Payment Providers are third-party services. AiroDental does not guarantee their availability, underwriting decisions, payout timing, reserves, risk actions, payment success, dispute outcomes, or continued support of any payment method.

14.3 No guarantee of collection

AiroDental does not guarantee that Patients will pay, that a payment will remain final, or that a transaction will not be reversed, returned, refunded, or charged back.

14.4 Practice indemnity

Practice will defend, indemnify, and hold harmless AiroDental and its affiliates from third-party claims and losses arising from Practice’s dental services, clinical decisions, treatment-plan content, informed-consent failures, pricing, refund obligations, payment-plan or credit terms, Patient authorization failures, employee fraud, security failures within Practice’s environment, Practice violation of Payment Provider terms, or violation of law by Practice, except to the extent caused by AiroDental’s breach or misconduct.

14.5 MSA controls

The warranty disclaimers, limitations of liability, dispute-resolution provisions, governing law, and other general risk-allocation provisions in the MSA apply to this Addendum unless this Addendum expressly states otherwise.

15. Online Policies, Updates and Reacceptance

15.1 Incorporated Online Policies

Practice agrees that the then-current versions of the Payment Services Policy and the Payment Pricing Page are incorporated into this Addendum by reference. The Payment Services Policy covers the payment providers and processors AiroDental uses, supported payment methods, stored-card, recurring, and ACH authorizations, payment security and PCI rules, and the terms for card-present hardware and terminals. The Payment Pricing Page sets out the fees for AiroDental Pay.

15.2 Operational and compliance updates

AiroDental may update the Online Policies from time to time to reflect Payment Provider changes, security requirements, technical changes, fraud controls, supported payment methods, operational requirements, or changes in law. Nonmaterial, technical, security, or compliance changes may become effective upon posting or on the effective date stated in the updated policy.

15.3 Material changes

For a material change that increases Practice fees, materially increases Practice financial liability, or materially changes a contractual right unrelated to an urgent security, legal, or Payment Provider requirement, AiroDental will provide reasonable notice by email, in-app notice, account notice, or another reasonable electronic method before the change takes effect where practicable. Continued use of the affected feature after the stated effective date constitutes acceptance to the extent permitted by law.

15.4 Reacceptance only when required

AiroDental may require affirmative reacceptance when required by law, a Payment Provider, a new payment method, a new regulated feature, or AiroDental’s reasonable compliance determination. Nothing in this Section eliminates a Patient-specific authorization or direct Processor acceptance that must be obtained at the time of use.

15.5 BAA exception

The BAA is governed by its own amendment and legal requirements. AiroDental will not rely solely on an Online Policy update to eliminate or materially reduce obligations that HIPAA requires to be included in a written business associate agreement.

16. Order of Precedence and Survival

16.1 Order

For HIPAA-specific matters, the BAA controls. For Payment Provider obligations, direct Payment Provider terms control as between Practice and that Payment Provider. This Addendum controls over inconsistent general MSA language on the specific payment and treatment-plan features addressed here.

16.2 Survival

Payment obligations, refunds, chargebacks, returns, authorization evidence, audit records, indemnification, and other provisions that by their nature apply after termination survive termination of the affected feature or MSA.

Suggested Initial Onboarding Acceptance

Checkbox copy:

“I certify that I am authorized to bind the Practice. I have reviewed and agree to the AiroDental Master Services Agreement, Business Associate Agreement, and Payments, Treatment Plan and Financial Features Addendum, including the incorporated Online Policies. I understand that payment features remain subject to separate processor onboarding, eligibility, and any patient-specific authorizations required when the features are used.”

Suggested Payment Activation Acknowledgement

Activation copy:

“Activate AiroDental Pay. I certify that the Practice information and settlement information I provide are accurate, that I am authorized to activate payment services for the Practice, and that I will complete and accept any required Payment Provider onboarding and terms. I acknowledge the current payment pricing and understand that Payment Provider approval is required before processing begins.”