Timberline Billing Service LLC

An electronic signature will be defined as an electronic symbol or process attached to or logically associated with a record executed or adopted by a person with the intent to authenticate and sign the record. The use of the distinctive username and the confidential password created by the User will serve as his/her electronic signature. This unique combination will ensure, for audit and confidentiality purposes, that all electronic submissions were prepared and submitted by the User and that all reported services were actually performed by the User.

The User hereby confirms and warrants the following:

1. I will keep my username and password secure and will not share this information with any other person.
2. I will deliver all services documented on Timberline’s website under my username.
3. I warrant that all information submitted (services and/or case notes) is true and accurate to the best of my knowledge and ability.
4. If I am a professional (Registered Nurse or Mental Health Professional), I attest that the services provided by staff are consistent with the student’s treatment plan or specific goals as described in the student’s IEP and IHP/BIP. This does not imply my supervision of the staff, nor have I necessarily observed the services provided.

I AcceptI DO NOT Accept