Q. Is Coalition America a Preferred Provider Organization (PPO)?
A. Coalition America, Inc. provides comprehensive solutions for managing health
care costs. CAI/NPPN utilizes a suite of products and services including direct
provider contracts, PPO networks and provider negotiations to achieve industry
leading savings for its national client base of health insurance carriers, self insured
employers, Taft Hartley plans and third party administrators.

Q. Can CAI/NPPN provide access to a full range of providers?
A. Yes. CAI/NPPN has contracted with PPOs offering a full range of services
from physicians, ancillary providers, hospitals and hospice care. Additionally,
we have access to transplant facilities and Centers of Excellence through
multiple PPO partners.

Q. Does CAI/NPPN discount out-of-area and out-of-network medical bills?
A. Absolutely. CAI/NPPN is the leader in medical claim savings, specializing in
discounting out-of-area and out-of-network medical bills for group health
and workers' compensation plans. We utilize a unique four tiered approach
of wrap PPOs, supplemental PPOs, Continuous Discount Agreements
(CDAs) and negotiations on ALL size claims to generate the greatest
savings possible.

Q. Is CAI/NPPN a "silent" or "blind" PPO?
A. No. A "silent" or "blind" PPO or repricing organization provides discounts
on medical claims without meeting the requirements of their PPO partners
(example: the contract with a PPO requires that a minimum of 10% benefit
differentials must be in place to access a discount, however the vendor takes
the discount on a patient who is not proactively directed to the provider for
care). CAI/NPPN only uses those PPOs that BY CONTRACT authorize us to
access discounts when the patient is not directed to the provider for care or
otherwise meets the requirements of the provider. Typically, we can access
5-13 supplemental PPOs in each state.

There are some organizations that do engage in "blind discounting"
behavior and we caution companies to confirm their vendor's
contractual relationships with the PPOs or providers. Taking
discounts inappropriately can lead to provider disputes, lost
discounts and employee dissatisfaction.

Q. How do I determine if CAI/NPPN can provide savings for my company?
A. Easy. Let CAI/NPPN perform a detailed savings analysis. Using a proprietary
system called VIPER, CAI/NPPN analyzes specific provider information to provide
an "apples to apples" comparison of the savings we can generate compared
to your current solutions. We will provide realistic estimates of savings through
primary PPOs, as well as savings on out-of-area and out-of-network medical
bills all based on historical experience and not "guesstimated" savings percentages.

Q. Is CAI/NPPN HIPAA compliant?
A. Yes. CAI/NPPN has established HIPAA compliance programs for privacy.
Additionally, we have created several HIPAA compliant electronic data
interchange (EDI) mechanisms that can enable our clients to meet HIPAA
security standards with very little time and effort on their part.

Q. Does CAI/NPPN offer real-time claim repricing services?
A. Yes. CAI/NPPN led the market by offering the most user-friendly Internet
repricing system available, RepriceNow. This system provides claim
repricing in seconds without entering the complete HCFA or UB.
Additionally, we offer a state-of-the-art XML repricing solution that allows
our clients to receive real-time repricing through an automated solution.

Q. Does CAI/NPPN offer Electronic Data Interchange (EDI) solutions?
A. Yes. CAI/NPPN has several EDI options to meet the varying needs of its
clients. From HIPAA compliant direct 837 connections to more
sophisticated "paperless" solutions that reduce or eliminate mail room
and data entry costs we have what you need.

Q. What is the standard turnaround time (TAT) for claim repricings?
A. The standard TAT for PPO claim repricing is typically seconds for
claims discounted through RepriceNow for providers within our loaded PPOs.
For clean EDI claims the turnaround is typically one business day.
Complicated claims or claims requiring quality review can take an additional
business day to discount. These claims EXCLUDE those being directly
negotiated by CAI/NPPN. For negotiations, the claims will be returned within
the time frame determined by you.

Q. Is CAI/NPPN willing to guarantee savings?
A. Yes. CAI/NPPN continues to be a leading edge company and has created
a solution to protect savings for its clients. We have developed client-specific
programs to guarantee savings while also streamlining administration
of the repricing process.