patient finance

Creating Financial Solutions to Meet Capital Needs

OMNI-MEDOPTION-PAY

Revenue Alternative Enhancement to

Patient Financing

OMNI-MED SERVICES Omni-Med, a division of Omni Funding that has over 15 years serving health care

and wellness providers in many fields including: Audiology, Dental, Chiropractic, Optometry, and others.

We have created the Option-Pay program to give more of your patients/clients the ability to say YES to elective and recommended care. Thus increasing Case Acceptance!

This turnkey program has no set up cost, no equipment to purchase, and can be implemented into your office setting within 48 hours.

Years of experience and research have gone into the development of the Option-Pay model and process. Our program is designed to work with, and enhance, your current offerings, by making your products/services attainable to a broader base of prospective patients/clients.

The user friendly Option-Pay Program allows your practice to provide financing with convenient terms and flexible options that you control at the point of sale. Web-based efficiency allows you instant credit decisions, the ability to monitor your financing status 24/7/365, and state of the art reporting that offers various data reports and downloads.

The Option-Pay team is an Advisory, or group of consultants, that will guide you through the implementation of a program that will enable you to take control of your practice’s financial wellness, and have a sound and effective contingency system in place to help insure the continued success of your business; no matter what the future credit markets have in store for our economy.

REAL QUESTIONS OF CONCERN!

Are you experiencing any of the following trends in your practice?

*Increasing Decline Ratios

*Increasing Partial Approval Ratios

*Patient Insurance Payment Gaps

*Patients With No Insurance

*Patients Not Getting A Fair Alternative To Accept Treatment

*No Contingency Plan For Economic Trends

**If you said yes to any of these questions, then Omni-Med can help you bridge the gap to more patients saying YES for treatment!

STATE OF PATIENT FINANCING

Did you know these interesting statistics?

*The median credit score has dropped from 725 to 675 in the US

*Average credit score required to gain approval from other financial sources is 720

*Revolving healthcare credit cards seem to be the norm to bridge gaps

*40% of no interest, same-as-cash (SAC) offers are not paid within promo

*40% of patients that accept SAC are now paying 25%+ rates

*Credit lines and available overall healthcare financing dollars have been greatly reduced

WHAT ARE YOU DOING ABOUT IT?

Are You Loosing Patients & Revenue Based On Statistics?

1. What are you doing when a patient is declined credit?2. What are you doing when a patient is partially approved for credit?3. What are you doing when a patient has an insurance payment gap?4. What are you doing when a patient has no insurance at all?

Solution: Have A Contingency Plan For Case Acceptance

1. Provide alternative credit decisions in your office for flexibility!2. Process partial approval balances with contingency alternative!3. Process insurance payment gaps with contingency alternative!

OMNI-MED A DIVISION OF OMNI FUNDING

Omni-Med maximizes your business with reduced fees, higher approval ratio’s, patient satisfaction, and providing an alternative profit center. Our services include helping you understand the different types of patient financing available, and how that financing impacts your business, patients, and clients.

• Minimize your monthly finance fees • Increase case acceptance• Create another profit center• Increase patient/client finance awareness• Enhance your business with turnkey

results

Welcome To Your Patient Finance Enhancement

Points of Consideration!

1. Simple NO DISCOUNT patient finance program!

2. Option to control terms and % interest charged… (creates affordable patient financing alternative)

3. No Pre-Payment Penalties

4. Easy application process!

5. Easy documentation!

6. Provider is ALLWAYS in control!

7. Virtually 92% patient/client approval ratio!

WHO SHOULD APPLY AND USE PROGRAM?

Patients/Clients that may have been declined or partially approved by one or more of your existing finance sources.

Patients/Clients that have high insurance deductibles, or no insurance coverage.

Providers not satisfied with current patient finance options.

Providers that want to build an additional profit center with the most cost effective/turnkey method in the patient finance market place!

APPLICATION & DOCUMENTATION

Quick, Simple Application Process

Quick Credit Decisions (no partials)

Quick, Simple Documents

Quick, Simple Learning Curve

Web Based Efficiency (24/7/365)

Flexible For Your Practice & Patients

FAQ’SQ. How long does it take to get set up for this program?A. 24 to 48 hours

Q. How long does it take for a patient to be approved?A. In minutes at your office location.

Q. Do you need original documents to complete transaction?A. Electronic Signature is available for instant confirmation or for wet signatures Faxed or Emailed documents are acceptable.

Q. Do you run my credit to be accepted on this program? A. NO! We do an initial consultation with your health care or wellness practice and

make a determination if a mutual relationship would be beneficial.

Q. Will there be information for patients/customers?A. Yes… PDF flyers will be provided to your office location(s) The objective is to make

the program very user friendly for your staff and patients/clients.

Q. What type of training can our office(s) expect regarding your ongoing revenue program?A. You will be provided initial and ongoing training so that your patient finance enhancement continues to run smoothly and efficiently. Our commitment is to assist you in creating the best individual program for your practice.

Q. Is this program provided on a national basis if we have multiple locations?A. Of course… we can accommodate healthcare and wellness providers in all 50 states!

FAQ’S CONT’D

Q: How do I submit accounts for approval? A: Our online instant credit decision platform makes submitting credit requests easy and

enables you to simply prepare contracts for your patients’ signature.

Q: What are the definitions of commonly used finance terms? A: Term is the number of months over which payments will be made. Down Payment

is the amount the patient pays directly to you prior to receiving their service. An Interest Rate is the fee paid by a patient on borrowed assets. Documentation Fees/Admin Fees (optional) are fees associated with the establishment of the financing. Amount Financed is the cost of the procedure less the Down Payment and Doc/Admin.

Q: Can I change the Credit Profile of the patients I wish to approve? A: Certainly. We can adjust our credit profile matrix to meet the needs of your practice

(i.e. tighten or loosen credit standards).

Q: What response will I receive after submitting an application for credit? A: Within seconds, you will receive a response indicating whether the patient is Approved

or Declined. With an Approval, you will be notified of the patient’s Credit Grade (i.e. A, B, C, etc.). We encourage internal provider language to be Tier 1 =A Tier 2=B Tier 3=C Tier 4=D

Q: Will your online instant credit decision platform tell me the patient’s credit score?

A: No, the credit bureaus restrict the sharing of credit scores. We provide you with the Credit Grade so you have a good understanding of the patients’ credit worthiness and can make individual decisions related to your willingness to amend the underwriting guidelines for a particular patient.

FAQ’S CONT’D

Q: Why is the optional $10 monthly loan administration fee included in the calculation of the patients’ APR?

A: Any fees a consumer pays related to financing should be included in the APR calculation. Since the patient would otherwise not pay this monthly fee, it is considered a finance charge. However, your practice may elect to cover these nominal fees by using an extra ongoing revenue method that would cover the servicing fees. Your Omni-Med Advisor can show you how this is accomplished!

Q: How do I know if a patient’s state limits the amount I can charge a patient (i.e. finance charges)?

A: The APR is limited in many states. If your state has such a restriction, our payment calculator will automatically reduce the Interest Rate until the APR complies with state law. Remember that maximizing finance charges can bring a better price should you decide to liquidate a portion or your entire ongoing revenue stream for cash in the future.

Q: How do I review/manage my loan portfolio? A: We provide you online access to view all activity associated with your account; from

new accounts submitted to your ability to drill down and read our billing service representatives notes on an individual account. In addition to monthly reports, we provide dashboards that enable you to quickly and easily monitor key indicators associated with your portfolio’s performance 24/7-365.

Q: If a patient is declined for financing, do I have any obligation to notify them of the reason?

A: Under the Fair Credit Reporting Act, a consumer is entitled to a free credit report within 60 days of any adverse action as a result of their credit rating. While you are not required to provide them the reason for being declined, we will provide the declination letter to meet the FCRA requirements.

PROGRAM FEES

Provider Pricing

Per Month Facility Web Portal $59 unlimited access Per Credit Recommendation/Credit Report $22 Per Month Client Processing $10 option*

Patient/Client Pricing

Provider Down Payment $ varies & optional Provider Administrative $19 optional Per Month Client Processing $10 option*

*Provider has option to pass $10 per month processing cost on to patient/client that will be collected with patient/clients normal monthly payment. Provider may choose to pay processing out of earned income from Option-Pay Program. Processing cost is optional depending on state usury laws and particular need of provider.

GET STARTED!

Schedule a free no obligation consultation and analysis

Authorize our enrollment process

Schedule training for staff and management

Start using program for instant results!!!

THANK YOU. I LOOK FORWARD TO WORKING WITH YOU!

Thank you for your time!

Please contact Brett Harrel at 888 268-OMNI (6664) ext. 304 with any questions or concerns. I will be glad to help you.

Omni – Med will strive to get you enrolled in the most cost effective patient finance program in the Healthcare and Wellness marketplace!

You deserve it!

Use this form to determine your credit parameters, Standard Set-Up or customize your preferences. Check the appropriate box.

Omni-Med Standard Set Up - Here is an overview of our standard program utilized:

Underwriting/Pricing Guideline Proposed Terms Credit Grade1

Minimum Credit Score2

Anticipated Default Rate3

Minimum Down Payment

Interest Rate4 5

Amount Financed

Term (months)

A 720 8-14% 10% 9.99% $500 - $2,000 12 B 680 12-18% 15% 12.99% $2,001 - $4,000 24 C 620 18-24% 20% 14.99% $4,001 - $6,000 36 D 560 30%+ 25% 17.99% $6,001 - $10,000+ 48

1Generally, if you decide to sell your agreements in the future, your patient will need to have a credit grade of C or better. 2Credit scores are continually evaluated and may change. 3Default rates vary based on a number of factors, including credit, loan term, procedure type, geographic region, etc. 4Patients’ actual APR will reflect the $10 monthly servicing fee unless your practice decides to cover cost with ongoing reven ue earned. 5Patients’ APRs may be limited in certain states. Our online platform will restrict excessive consumer finance costs.

This guide is intended to help you, as the Provider, determine the patients for whom you wish to extend financing, and under what terms. While the recommendations in this document are based on our experience, and historical performance data reported by Credit Reporting Agencies and Fair Isaac, this information provided should not be considered a guarantee of your portfolio’s future performance.

Customized Set Up - To customize your credit parameter preferences please fill in the appropriate boxes below:

Proposed Terms Amount Financed Term (months)

12 24 36

48

Underwriting/Pricing Guideline Grade - Tier A - 1 B - 2 C - 3 D - 4 Credit Score

Down Payment % Interest Rate

No BK in last X Years No Public Records (e.g. liens, judgments) in past X years

No Open Delinquent Accounts ( Y or N) No more than X 30dpd within last 12 months No more than X 30dpd within last 24 months No more than X 30dpd within last 36 months No more than X 60dpd within last 12 months No more than X 60dpd within last 24 months No more than X 60dpd within last 36 months

Current employer for X+ years ^OR Previous employer for X+ years^

Print Name: ____________________________ Signature: _________________________________ Date: ________

Option-Pay Credit Decision Set-Up Form

TechTimes

Option-Pay Program Omni-Med provides a systematic approach tailored exclusively to meet the needs of health care & wellness providers. We help you grow your practice by making it easy to give patients financing options to pay for recommended and elective procedures or equipment. Build an additional profit center without the dedicated office resources (overhead) required to manage the majority of its function. Omni-Med’s Option-Pay Program makes it simple, and enables you to increase profits by providing flexible payment programs to broaden your patient base.

Provider Benefits

Online instant credit decisions enable you to schedule procedures immediately Create a new profit center Documents are quick and easy to prepare with our online platform Lock-in treatment plans and schedules today Increase revenues by making your services more affordable Ongoing program and marketing training Option-Pay works in conjunction with other patient financing programs that

approve only prime credits, or provide approvals that meet only a portion of the patient’s financing needs

Patient Benefits

Fast, easy and secure instant credit decisions Affordable payment plans up to 48 months Multiple payment method options Online access to accounts for patient No pre-payment penalties

About Omni-Med

With over 15 years meeting the financing needs of health care and wellness providers, Omni-Med understands how recent changes in the availability of patient financing options have impacted your control and choices. Omni-Med’s comprehensive Option-Pay Program is a cost effective solution designed to maximize profitability, give you confidence that your patients are receiving a superior level of service, and free you up to focus on meeting the health care needs of your patients/clients. Set-up is quick and easy…Contact us today to get started!

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Call Today! (888) 268-OMNI (6664)

omnimedservices.com

Brett Harrel Ext. 304

[email protected]

First Name Initial Last Name

Other Names Used For Credit

Date of Birth Social Security Number Home Number

( )

Street Address Appartment Number

City State ZIP

No. Dependents Residence Type Mo. Amount Time at Residence

Own / Rent / Board $ Yrs. Mos

Mortgage Holder Landlord Name Phone Number

Previous Address How Long?

Yrs Mos

City State ZIP

Year & Make of Autos Drivers License No.

Name of Bank City/State Checking Acct No. Savings Acct No.

Employer Name Occupation

Employer Phone Time Employed Monthly Income

( ) Y rs. Mos. $

Employment Address

City State Zip

Previous Employer Occupation

Previous Employment Phone Time Employed

( ) Y rs. Mos.

Other Income (Please Specify) Source:

INCOME NOTICE: You need not disclose alimony, child support or separate maintenance income if you do not wish to have it considered as a basis for repaying this obligation.

NAME ADDRESS PHONE NUMBER RELATIONSHIP




CO-SIGNATURE ______________________________________________________

DATED: ______-______-______

Credit Application

APPLICANT INFORMATION

I HEREBY ACKNOWLEDGE that I am over the age of eighteen (18) years, and that all of the information set forth in this credit statement is true, accurate and full and complete disclosure

EMPLOYMENT INFORMATION

PLEASE PROVIDE 3 PERSONAL REFERENCES

thereof. I HEREBY authorize any holder of the Retail Installment Contract or any person, firm or corporation requested to extend credit thereunder, (including any employee or agent of any

of them,) to communicate with any person, firm or corporation including my employer in respect of my creditworthiness. IN THE EVENT that credit is extended to me in respect of my Retail

Installment Contract, I hereby authorize any holder thereof, the creditor, any attorney, debt collector or collection agency, (their agents or employees), to communicate with any person, firm

or corporation, (including my employer), in respect of such debt. I FURTHER AUTHORIZE any holder of the Retail Installment Contract, the creditor thereof, any attorney, debt collector or

collection agency communicating any and all information concerning this application or debt to any credit reporting agency or other creditor. I FURTHER ACKNOWLEDGE AND AGREE,

that I will notify the creditor or prospective creditor in writing of any change in my name, address or employment within a reasonable time thereafter.

Electronic Funds Transfer (EFT) Authorization Form

THE UNDERSIGNED, hereby authorizes Duvera Billing Services, LLC, hereafter called the “Company” to initiate debit entries to my (our) checking account and the Depository named below, hereinafter called the “Depository” and to debit the same to such account. THIS AUTHORITY is to remain in full force and effect until Company and Depository have received written notice from the undersigned of its termination in such time and such manner as to afford Company and Depository a reasonable opportunity to act on it.

Checking Account

Name (as it appears on check): ______________________________ Bank Name: ________________ City/State: _________________ Bank Routing: ___________________________________________ Account Number: _________________________________________

Please attach a voided check here

Credit Card

Card Number: __________-__________-__________-__________ Expiration Date: ____-____-____

Debit Card

Card Number: __________-__________-__________-__________ Expiration Date: ____-____-____

Signature Date

1 Number of Locations5 New Patients Added Each Month (each location)

500 Cost of Goods/Service Sold2,500 Average Procedure Cost

15% Average Down Payment (provider optional) Single Cost Tota l Cost

13% Interest Rate (provider optional) Provider Fee $59.00 $59.00

12 Term (provider optional) Credit Rec/Rept $22.00 $110.00

189.80 Average Patient Payment No. of Patients 1 5

22 Credit Tier Recommendation Fee (per each credit evaluation)Avg Cost p/Patient $81.00 $33.80

29 Patient Aministrative Fee (provider optional)59 Provider Fee (per month, per location)

- Processing Fees (Per Patient/Per Month)

Month: 1 2 3 4 5 6 7 8 9 10 11 12 13Beg. No. Loans: - 5 10 15 20 25 30 35 40 45 50 55 60 New Loans: 5 5 5 5 5 5 5 5 5 5 5 5 5 Ending No. Loans: 5 10 15 20 25 30 35 40 45 50 55 60 60

PORTFOLIO LOAN BALANCEBeginning A/R: - 10,625 20,365 29,219 37,188 44,271 50,469 55,781 60,208 63,750 66,406 68,177 69,063 Principal Pmts Rec'd: - (885) (1,771) (2,656) (3,542) (4,427) (5,313) (6,198) (7,083) (7,969) (8,854) (9,740) (10,625) New Loans Added: 10,625 10,625 10,625 10,625 10,625 10,625 10,625 10,625 10,625 10,625 10,625 10,625 10,625 Ending A/R: 10,625 20,365 29,219 37,188 44,271 50,469 55,781 60,208 63,750 66,406 68,177 69,063 69,063

PROJECTED REVENUEDown Payment: 1,875 1,875 1,875 1,875 1,875 1,875 1,875 1,875 1,875 1,875 1,875 1,875 1,875 plus Administrative Fee 145 145 145 145 145 145 145 145 145 145 145 145 145 plus Principal Pmts: 0 885 1,771 2,656 3,542 4,427 5,313 6,198 7,083 7,969 8,854 9,740 10,625 plus Interest Rev: 0 64 127 191 254 318 381 445 509 572 636 699 763 less Provider Fee: (59) (59) (59) (59) (59) (59) (59) (59) (59) (59) (59) (59) (59) less Processing Fees: - - - - - - - - - - - - - less Credit Recomendation Fee: (110) (110) (110) (110) (110) (110) (110) (110) (110) (110) (110) (110) (110) Projected Revenue*: 1,851 2,800 3,749 4,698 5,647 6,596 7,545 8,494 9,443 10,392 11,341 12,290 13,239 Cumulative Revenue: 1,851 4,651 8,400 13,098 18,745 25,341 32,886 41,380 50,823 61,215 72,556 84,846 98,085

Revenue Recognized 2,020 2,969 3,918 4,867 5,816 6,765 7,714 8,663 9,612 10,561 11,510 12,459 13,408 Cost of Goods/Services Sold 2,500 2,500 2,500 2,500 2,500 2,500 2,500 2,500 2,500 2,500 2,500 2,500 2,500 Overall Net Loss/Profit (480) 469 1,418 2,367 3,316 4,265 5,214 6,163 7,112 8,061 9,010 9,959 10,908

*Projections do not account for early payoffs, delinquencies, or defaults.

Average fees to Provider per Patient













Revenue Recognized 2,020 2,969 3,918 4,867 5,816 6,765 7,714 8,663 9,612 10,561 11,510 12,459 13,408 Cost of Goods/Services Sold 3,125 3,125 3,125 3,125 3,125 3,125 3,125 3,125 3,125 3,125 3,125 3,125 3,125 Overall Net Loss/Profit (1,105) (156) 793 1,742 2,691 3,640 4,589 5,538 6,487 7,436 8,385 9,334 10,283















Revenue Recognized 2,020 2,969 3,918 4,867 5,816 6,765 7,714 8,663 9,612 10,561 11,510 12,459 13,408 Cost of Goods/Services Sold 3,750 3,750 3,750 3,750 3,750 3,750 3,750 3,750 3,750 3,750 3,750 3,750 3,750 Overall Net Loss/Profit (1,730) (781) 168 1,117 2,066 3,015 3,964 4,913 5,862 6,811 7,760 8,709 9,658



patient finance

Health & Medicine