Authorized Federal Supply Schedule Price List



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U.S. GENERAL SERVICES ADMINISTRATION FEDERAL SUPPLY SERVICE Authorized Federal Supply Schedule Price List CONTRACTOR: TIONWIDE PROVIDER SOLUTIONS, LLC 2031 CLARKSVILLE ST PARIS, TX 754606243 Contract Number: GS23F0050X Schedule Title : Financial and Business Solutions (FABS) Product Service Code : R704 DUNS# : 011847008 Contract Period : March 16, 2011 - March 15, 2016 Business Size : Small Contract Administrator : EARLINE LAHMAN Phone Number : 903-783-0864 Fax Number : 903-783-1603 Web Site : http://www.nationwideprovidersolutions.com Online access to contract ordering information, terms and conditions, up-to-date pricing, and the option to create an electronic delivery order are available through GSA Advantage!, a menu-driven database system. http://www.gsaadvantage.gov For more information on ordering from Federal Supply Schedules, visit http://www.gsa.gov/portal/content/197989

CONTRACTOR: TIONWIDE PROVIDER SOLUTIONS, LLC 2031 CLARKSVILLE ST PARIS, TX 754606243 Schedule Title : Financial and Business Solutions (FABS) Product Service Code : R704 DUNS# : 011847008 Contract Period : March 16, 2011 - March 15, 2016 Business Size : Small Awarded service information listed by Special Item Numbers (SINS): SIN:520 15 - Outsourcing Recurring Commercial Activities for Financial Management Services Family Med/Occ Med Billing Services Percentage Per Transaction 03/16/2012 03/15/2013: 8.55% 03/16/2013 03/15/2014: 8.73% 03/16/2014 03/15/2015: 8.90% 03/16/2015 03/15/2016: 9.07% Orthopedic Billing Services Percentage Per Transaction 03/16/2012 03/15/2013: 8.55% 03/16/2013 03/15/2014: 8.73% 03/16/2014 03/15/2015: 8.90% 03/16/2015 03/15/2016: 9.07% Pain Management Billing Services Percentage Per Transaction 03/16/2012 03/15/2013: 8.55% 03/16/2013 03/15/2014: 8.73% 03/16/2014 03/15/2015: 8.90% 03/16/2015 03/15/2016: 9.07% Physiartry/Physical Med/Rehab Billing Percentage Per Transaction 03/16/2012 03/15/2013: 8.06% 03/16/2013 03/15/2014: 8.22% 03/16/2014 03/15/2015: 8.38% 03/16/2015 03/15/2016: 8.55% Psychiatry Billing Services Administrative Support and Clerical Occupations. Greater of 2000.00 or 10 percent of total collections Percentage Per Transaction 03/16/2012 03/15/2013: 8.02% 03/16/2013 03/15/2014: 8.18% 03/16/2014 03/15/2015: 8.34% TIONWIDE PROVIDER SOLUTIONS, LLC Contract GS23F0050X 1

03/16/2015 03/15/2016: 8.50% Miscellaneous Services Authorizations Administrative Support and Clerical Occupations. 65.00 per Hour (1) hour Minimum Per Provider Per Hour 03/16/2012 03/15/2013: $65.46 03/16/2013 03/15/2014: $66.77 03/16/2014 03/15/2015: $68.11 03/16/2015 03/15/2016: $69.47 Clearing House Chgs Electr Billing Administrative Support and Clerical Occupations. 110.00 per Month Per Individual Provider Per Month 03/16/2012 03/15/2013: $112.20 03/16/2013 03/15/2014: $114.44 03/16/2014 03/15/2015: $116.73 03/16/2015 03/15/2016: $119.07 Patient Statements Administrative Support and Clerical Occupations. 1.25 Per Patient Statement per Provider per Month Per Transaction 03/16/2012 03/15/2013: $1.28 03/16/2013 03/15/2014: $1.31 03/16/2014 03/15/2015: $1.33 03/16/2015 03/15/2016: $1.36 Reports on Demand Administrative Support and Clerical Occupations. 125.00 per Hour (1) Hour Minimum per Provider Per Hour 03/16/2012 03/15/2013: $125.89 03/16/2013 03/15/2014: $128.41 03/16/2014 03/15/2015: $130.97 03/16/2015 03/15/2016: $133.59 Software Set UP Administrative Support and Clerical Occupations. 5000.00 per Group NPI/Tax ID to include 1 provider Per Set Up 03/16/2012 03/15/2013: $5,035.49 03/16/2013 03/15/2014: $5,136.20 03/16/2014 03/15/2015: $5,238.92 03/16/2015 03/15/2016: $5,343.70 TIONWIDE PROVIDER SOLUTIONS, LLC Contract GS23F0050X 2

Software Set UP 2 Administrative Support and Clerical Occupations. 5000.00 per individual NPI/Tax Individual Practice Per Set Up 03/16/2012 03/15/2013: $5,035.49 03/16/2013 03/15/2014: $5,136.20 03/16/2014 03/15/2015: $5,238.92 03/16/2015 03/15/2016: $5,343.70 Software Set UP 3 Administrative Support and Clerical Occupations. 2000.00 Each Additional Provider to be added to each Group and/or individual Practice Per Set Up 03/16/2012 03/15/2013: $2,014.19 03/16/2013 03/15/2014: $2,054.47 03/16/2014 03/15/2015: $2,095.79 03/16/2015 03/15/2016: $2,137.70 Superbill Encounter Form Administrative Support and Clerical Occupations. 75.00 per Hour (1) Hour Minimum per Provider Per Hour 03/16/2012 03/15/2013: $75.53 03/16/2013 03/15/2014: $77.04 03/16/2014 03/15/2015: $78.58 03/16/2015 03/15/2016: $80.15 TIONWIDE PROVIDER SOLUTIONS, LLC Contract GS23F0050X 3

Terms and Conditions: 1. Table of awarded special item number(s) with appropriate cross reference to item descriptions and awarded price(s): SIN Description 520 15 Outsourcing Recurring Commercial Activities for Financial Management Services 2. Maximum order per SIN: SIN Maximum Order 520 15 $1,000,000.00 3. Minimum order: $100.00 4. Geographic Coverage: 48 States,DC 5. Point(s) of production (city, county, and State or foreign country): North America 6. Quantity Discounts: 7. Prompt payment terms: 0%-0 0%-0 NET 30 8. Government purchase cards accepted above the micro-purchase threshold: Yes 9. Government purchase cards are accepted at or below the micro-purchase threshold: Yes 10. Foreign Items: 11. Time of Delivery: 3 Days Delivered (after receipt of order) 12. Expedited Delivery: 13. Overnight and 2-Day Delivery: 14. Urgent requirements: TIONWIDE PROVIDER SOLUTIONS, LLC Contract GS23F0050X 4

15. F.O.B. points: Alaska : D - Destination Continental US : D - Destination Hawaii : D - Destination Puerto Rico : D - Destination 16. Ordering Addresses: 1 NPS Earline Lahman 2031 Clarksville Street Paris, Texas 75460 United States Ph:903-783-0864 Fax:903-783-1603 earline1@suddenlinkmail.com 17. Ordering Procedures: 18. Payment Addresses: 1 NPS Earline Lahman 2031 Clarksville Street Paris, Texas 75460 United States Ph:903-783-0864 Fax:903-783-1603 earline1@suddenlinkmail.com 19. Warranty Provision: 20. Terms and conditions of Government purchase card acceptance (any thresholds above the micro-purchase level): 21. Terms and conditions of repair parts: 22. Terms and conditions for any other services: 23. Terms and conditions of rental, maintenance, and repair: 24. Terms and conditions of installation: 25. List of service and distribution points: 26. List of participating dealers: TIONWIDE PROVIDER SOLUTIONS, LLC Contract GS23F0050X 5

27. Preventative maintenance: 28. Special attributes such as environmental attributes: Not Applicable 29. Section 508 compliance information: Not Applicable 30. Data Universal Number System (DUNS) number: 011847008 TIONWIDE PROVIDER SOLUTIONS, LLC Contract GS23F0050X 6