PAYER +

Business management consulting and advisory services for the healthcare industry; Business services, namely, independent medical management services for self-funded major medical health plans; Collection and analysis of quality metric data for a network of health care providers for business purposes; Consulting services in the cost management of health care; Cost management for the health care benefit plans of others; Data compiling and analyzing in the field of insurance; Health care utilization and review services; Managed care services, namely, electronic processing of health care information; Management and compilation of computerised databases; Medical billing support services; Medical claims management services, namely, receiving, data entering, and re-pricing of transactions that are originated by physicians, hospitals, and ancillary medical care providers

Administration of pre-paid health care plans; Claims administration services in the field of health insurance; Electronic processing of insurance claims and payment data; Insurance services, namely, insurance eligibility review and verification and consultation in the fields of managed healthcare for health insurance claims administration, health insurance claims payment and health insurance claims utilization review and management in the health insurance industry; Medical insurance case and utilization review and insurance claims adjustment services for healthcare purchasers and payors and providers and Medicare beneficiaries; Financial consultation relating to the management of reimbursement payments for others in the health care industry

Electronic data interchange services in the field of healthcare transactions such as claims, eligibility, claim status, electronic remittance advice, prior authorizations, attachments and referrals that allow direct transaction and payment communications between healthcare providers and payers

Application service provider (ASP) featuring software for use in hosting, managing, developing, analyzing and maintaining computer software for use in connection with the processing and administration of insurance claims; Application service provider (ASP) featuring software for use in hosting, managing, developing, analyzing, and maintaining computer software for verifying patient eligibility, payment processing, and estimating patient payment responsibility; Application service provider (ASP) featuring software for use in hosting, managing, developing, analyzing and maintaining computer software for medical cost management and medical cost comparison; Design, development, and implementation of software for use in connection with the processing and administration of insurance claims; Providing a website featuring resources, namely, non-downloadable software for patients to access information, namely, health insurance claims and coverage information, payment information, prescription and pharmacy information, information on health and wellness and information on healthcare providers and locations ; Software as a service (SAAS) services featuring software for medical and healthcare cost review and cost management, payment for insurance claims, and managing insurance claims and settlements; Software as a service (SAAS) services featuring software for verifying patient eligibility, payment processing and estimating patient payment responsibility; Software as a service (SAAS) services featuring software for payment processing and accounting in the field of healthcare and insurance; Software as a service (SAAS) services featuring software for healthcare plan management and administration; Software as a service (SAAS) services featuring software for submission of health insurance claims and electronic processing of insurance claims and payments; Software as a service (SAAS) services featuring software for use in medical claims processing and management; Software as a service (SAAS) services featuring software for the retrieval and transmission of electronic health records for tracking and managing patient summary, healthcare plan coverage and healthcare plan claims, healthcare plan reimbursements, healthcare plan quality initiatives and outcomes; Software as a service (SAAS) services featuring software for health insurance claims administration, health insurance claims payment and health insurance claims utilization review and management; Software as a service (SAAS) services featuring software for medical cost management and medical cost comparison; Software as a service (SAAS) services featuring software for use in collecting, aggregating, reviewing, storing, organization, reporting, managing and analyzing healthcare and insurance data, namely, computer software platforms for creating, integrating, analyzing, storing and managing health records, for reviewing bills, fee schedules, claims management utilization review and case management, and for creating reports in connection therewith

Compiling and analyzing statistical health data in order to uncover and identify health care fraud and claims errors