An Electronic Provider Reimbursement Solution

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Medical payment strategies being utilized by payers to lower fulfillment expenses

“Bulk mailing” of provider payments from print vendors 835s with paper EOB Direct provider payments Default and continue to process one check/one

provider claim

All with the objective to achieve a lower expense ratio…

Challenge - Expense Reduction

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A “Virtual” Provider Payment Option

Rete-Pay provides a virtual Provider reimbursement process that incorporates a prepaid payment card & “paperless” explanation of benefits

Also includes the targeted recruitment of highly utilized providers to adopt the electronic payment process

This approach delivers an innovative solution that immediately reduces administrative expenses related to printing paper checks, postage, and fulfillment expenses.

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Rete-Pay’s Innovative Solution

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Rete-Pay’s Payment Features

Providers can choose to receive payments via fax, email, an on-line portal or a permanent Rete-Pay card.

Payment Security – Includes the ability to “lock-down” the card to each Providers Existing Merchant Terminal

Easiest & fastest payment delivery option – no need to obtain provider banking information

Payments are linked to an On-Line Claims Management Portal for easy access, Reconciliation, Payment History,

and New Provider Enrollments.

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“Virtual” Payment Advantages

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1.Provider submits Claim to Patient’s

Healthcare Carrier/TPA

7. Provider keys in Virtual Card Information into their Merchant Terminal to Complete Payment

Process

7. Provider keys in Virtual Card Information into their Merchant Terminal to Complete Payment

Process

6a. Provider Receives Payment Fax Containing Virtual Card Information

6a. Provider Receives Payment Fax Containing Virtual Card Information

6. Provider receives Payment Email and accesses Virtual

Card Information via Secure Link

6. Provider receives Payment Email and accesses Virtual

Card Information via Secure Link

2. Healthcare Carrier/TPA Sends Processed Claims /print file to RETE-PAY

2. Healthcare Carrier/TPA Sends Processed Claims /print file to RETE-PAY

3. Card Account is created for Each Provider to be Paid

3. Card Account is created for Each Provider to be Paid

4a. RETE-PAY sends extract file to append

provider email and fax

4a. RETE-PAY sends extract file to append

provider email and fax

4. Portal Subscriber? 4. Portal Subscriber? YES

5. RETE-PAY Sends email to Provider telling them their

Claim and Payment Information is

available online

5. RETE-PAY Sends email to Provider telling them their

Claim and Payment Information is

available online

NO

5a. RETE-PAY creates Fax Merge File Containing Claim and Provider Information , Card Number, CVV

5a. RETE-PAY creates Fax Merge File Containing Claim and Provider Information , Card Number, CVV

“Virtual” Payment Process

Rete-Pay’s “New Revenue” Opportunity: Generates a new revenue stream for the Payer Calculated off the monthly volume of medical claims

settled by Rete-Pay Continuous monthly payments for the life of the

contracted service agreement

“Shared Revenue” Opportunity Payer awarded 10 basis points $100 million in medical claim settlements through Rete-

Pay Annualized “shared revenue” payment of $100,000

New Revenue Stream

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New Revenue Stream Increased profitability through Rete-Pay’s Shared

Revenue Model Immediate Reduction in Fulfillment Expenses

By the dramatic reduction in print, postage, and fulfillment expenses from the first day of service

Improved internal efficiencies and provider office inquiries as providers utilize the self-service claims management portal

No implementation expenses or monthly service fees

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Carrier/TPA Benefits

New Revenue OpportunityClaims Processed Annually - $_________________*10 Basis Points (.1% )Revenue Opportunity - $_________________

Expense Savings OpportunityProvider Payments Processed Annually - #____________*Fulfillment Cost per Payment ($5.00)Savings Opportunity - $_____________

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Carrier/TPA Opportunity