PHYSICIAN VISIT

• With the Physician Visit Network, you and your family can save 10% to 30% or more at over 336,000 participating physician offices nationwide.
• The Network includes both primary care physicians and specialists.
• Members can also access savings at over 40,000 ancillary facilities, which includes medical clinics, labs, diagnostics, out-patient surgery centers and more…
• Anyone can receive the negotiated savings.

The Galaxy Health Network Physician Visit program is valid at participating network providers,including but not limited to:

PRIMARY CARE PHYSICIANS	CHIROPRACTIC	COUNSELING
SPECIALISTS	LABS/DIAGNOSTICS	RADIOLOGY
PEDIATRICS	ALTERNATIVE MEDICINE	REHAB
OB/GYN	SKILLED NURSING	HOME HEALTH
OUT-PATIENT SURGERY CENTERS	MEDICAL CLINICS	And more…

How it works…

1. Members select a local participating provider by calling 800-975-3322 Option 4 and asking for the "Medical Savings Card" department, or by accessing online at www.galaxyhealth.net
2. Members must show ID card at the time of their visit in order to receive a discount.
3. Provider will follow instructions on the back of the card to "re-price" the bill by applying the predetermined savings according to the negotiated contract.
4. Member is responsible for paying remaining balance due to provider at the time of service. If member has any additional medical coverage, that amount will be applied to the bill according to the medical plan or policy in place.

HOSPITAL

• Members have access to almost 2,700 acute-care hospitals nationwide for in-patient confinement, with savings of 5% - 30% or more.

How it works…

1. Pre-Planned Services: members call 800-975-3322 Option 4 to receive savings for pre-planned/nonemergency services; available only with the required pre-certification and referral number. The negotiated estimate payment portion amount needs to be secured prior to member receiving any services. Network will confirm payment ability and provide a referral number.
2. Emergency Visits: members must notify network and receive a referral number within fortyeight (48) hours of an Emergency Visit by calling 800-975-3322 Option 4.

PATIENT ADVOCACY
To ensure members have a positive experience when using their medical savings card, network representatives are ready to help. Network will confirm that provider is in network and accepting new patients, confirm provider is aware of how the medical savings card works, and verify the discount will be honored at the time of service.

Members simply need to contact a Patient Advocacy representative at 800-975-3322 Option 4 prior to making their appointment to take advantage of these services. *Patient Advocacy is not available in California.

With over 336,000 doctors and over 2,700 hospitals in the United States participating in this Referral program, you could save from 5% - 30% on your medical bills. As a minimum, you will receive a 20% savings on your actual bill from the doctor's office. Additionally, our Patient Advocacy Program will help you select a participating provider.

Saving are available on the following type of services:

Inpatient: Hospital Room Operating Room X-Rays Lab Services Electrocardiograms Surgeon's Fees Many Others

Outpatient: Office Visits Pathology X-Rays Sonograms Chemotherapy Many Others

Physicians
Our patient advocacy representatives will work with members to locate specific providers, confirm the provider's acceptance of new patients and provide the member with a listing of several different providers in their immediate area that will meet the member's specific needs.

Hospitals
For assistance with hospitals, patient advocacy representatives will work with members to locate a participating hospital. The member will be responsible for any applicable financial guarantees required by the hospital, prior to admission.

This is a discount program only. Galaxy Health Network (GHN) has no liability for providing or guaranteeing service or for the quality of service rendered.

How to use your Physician And Facility Patient Advocacy Benefit
This service is included with purchase of physician/facility discount access network.
*Patient Advocacy is not available in California.

Galaxy Health Network (GHN) offers a Patient Advocacy Service for all Physician/Facility service visits through participating providers in the Galaxy Medical Savings Network.

How the Galaxy Health Network Patient Advocacy Department works:

1. Members call Galaxy Health Network Medical Savings Card (MSC) Department at 1-800-975-3322 option 4 to locate a participating provider in your area.
2. Member identifies their location, zip code and the type of doctors or facility being requested, and provides a telephone number, fax number or e-mail address so that the a Patient Advocacy representative can provide specific information back to the member.
3. The GHN Patient Advocacy Department will contact providers specific to the member’s zip code and specialty, verify that the provider is accepting new patients, precertify that the physician/facility understands that they are part of Galaxy Health Network and that they will accept the Medical Savings Card product, confirms the provider’s office understands how to re-price the bill, and perform any unique pre-certification that may be required.
4. The Patient Advocacy Department contacts the member via telephone, fax or e-mail and provides member with 2 to 3 different provider options for the member’s selection purposes.
5. Member will make their own appointment and visit one of the 336,000 physicians or 40,000 facilities within Galaxy Health Network.
6. Provider will utilize the IVR repricing line or web-based system for immediate repricing of the procedure. Members will receive 5 to 30% savings or more, and the provider will receive payment for the services provided (based on their contract with Galaxy Health Network) at the time of service.

How to use the Hospital Patient Advocacy Program
This service is included with purchase of Hospital discount access network.
*Patient Advocacy is not available in California.

Members have access to the Galaxy Health Network (GHN) Patient Advocacy representatives to pre-certify and obtain a referral number for all hospital/facility needs.

MSC representatives will coordinate hospital in-patient as well as out-patient needs. Members call 1-800-975-3322 to receive assistance in and let us initiate the process of negotiating their hospital services on their behalf. To make it simple members only need to make one point of contact, as our patient advocacy representatives will do the rest.

Members will be asked to provide the following information:

Patient Name Member Name Card Number or Group ID Number Illness or Injury Treatment required or requested

Referring Physicians and Phone Number Facility Requested Insurance Carrier (if applicable) Medical Savings Account Sponsor Name

After making the necessary arrangements we will contact the member with the details regarding their procedure. We will obtain a good faith estimate of the cost involved for treatment, contact the insurance carrier if applicable to verify benefits and eligibility, apply the GHN network discount to the total billed charges, and then apply the insurance benefit amounts. We will inform the member of the estimate amount they will be responsible for payment. *This amount needs to be secured prior to the member receiving any services as providers will expect the remaining balance due at the time of service.

Members have the option to secure payment using the following methods or any combination thereof: Cash, Check, Credit Card, Insurance Payment or Medical Savings Account Funds or other Certified Funds. The FACILITY and/or PROVIDER, in advance of services being performed, must agree upon any needed payment arrangement. If payment arrangements are not pre-approved or payment is not made in a timely manner, the contracted SAVINGS could be in jeopardy. If members need assistance negotiating such a payment arrangement, member can contact GHN Patient Advocacy department at 1-800-975-3322.

Members will receive 5% - 30% savings or more, and the provider will receive payment for the services provided (based on their contract with Galaxy Health Network) at the time of service.

MEMBERS must process their Hospital service through the GHN Patient Advocacy department in order to guarantee the network savings. MEMBERS ARE NOT ELIGIBLE FOR SAVINGS THROUGH GHN IF THEY ASK A PROVIDER/FACILITY TO FILE AN INSURANCE CLAIM FOR THEM and do not contact GHN first, as the provider will then balance bill the patient for any payment portions not covered by insurance. If a member fails to obtain precertification or referral number from GHN and a bill is received, the bill will be returned to the member as "SELF-PAY" resulting in the member being responsible for billed services in full. In the event of an "Emergency Room Visit", members must notify GHNH at 1-800-975-3322 and receive a referral number within forty-eight (48) hours of said visit or GHNH is not responsible to negotiate discounts.

If a member selects an Out-Of-Network Provider, savings are more difficult, and possibly unavailable. However, GHN will utilize its resources to coordinate negotiations with the Facility and/or Physician to obtain the best possible savings – even if a provider is not participating with Galaxy Health Network.

GALAXY HEALTH NETWORK MEDICAL SAVINGS CARD HOSPITAL TERMS AND CONDITIONS

Participating Galaxy Health Network Hospitals (GHNH) and Physicians are available to provide MEMBERs services at less than RETAIL PRICE. Amount saved may vary. By utilizing the GHNH program, MEMBER agrees to the terms and conditions of this Membership Agreement and acknowledges and consents to the release of medical information to Galaxy Health Network as necessary to provide Eligible Services.

DEFINITIONS
A) MEMBER shall mean the person who has purchased the membership, including all tax-deductible/ legal dependent family members of the MEMBER who has been accepted by the GHNH program. GHNH has the right to decline or renew any membership. B) ADMINISTRATOR shall mean the Galaxy Health Network Hospital (GHNH) program. C) ELIGIBLE SERVICES shall mean access to medical SAVINGS, which is capable of being provided by GHNH through participating FACILITIES and PROVIDERs. D) FACILITY shall mean any ancillary or hospital that provides eligible services to MEMBERs. E) PROVIDER shall mean any physician or healthcare professional that provides eligible services to MEMBERs. F) RETAIL PRICE shall mean the usual fees charged by a participating FACILITY and/or PROVIDER. G) SAVINGS shall mean any amount less than the RETAIL PRICE charged by a FACILITY or PROVIDER. Amount saved may vary.

GENERAL PROVISIONS
The General Provisions of the GHNH program are as follows: A) BEST EFFORT. GHNH shall use its best efforts to enlist an adequate number of PROVIDERs who will agree to provide Services to its MEMBERs. However, GHNH does not assume any obligation if the PROVIDER Network is not sufficient to serve MEMBERs' needs. B) OUT-OF-NETWORK PROVIDER. If a MEMBER selects an OUT-OF-NETWORK PROVIDER, SAVINGS ARE MORE DIFFICULT, AND POSSIBLY UNAVAILABLE THROUGH THIS AGREEMENT. However, GHNH will utilize its resources to coordinate negotiations with the FACILITY and/or PROVIDER to obtain the best possible SAVINGS. C) MEMBERSHIP CARD. MEMBER will be provided with a membership card. The MEMBER should present the membership card to provide proof of the right to services under this agreement. By using the GHNH membership card or services, MEMBER agrees to the terms of membership. D) RELATED SERVICES. On occasion, additional charges may be received by GHNH relating to Services received by a MEMBER, such as lab or radiology services provided at the request of the selected PROVIDER. If such related charges are sent to GHNH, MEMBER authorizes GHNH to process the charges as a part of the original Services. Notification of any additional charges of such services shall be sent to the MEMBER in the customary manner. E) PRECERTIFICATION/ REFERRAL NUMBER. The GHNH program requires pre-certification and a referral number prior to services being rendered which GHNH Medical Savings Card (MSC) Representatives coordinate. For pre-planned services, SAVINGS ARE NOT AVAILABLE WITHOUT THE REQUIRED REFERRAL NUMBER. In the event of an "Emergency Room Visit", MEMBERs must notify GHNH and receive a referral number within forty-eight (48) hours of said visit OR GHNH IS NOT RESPONSIBLE TO NEGOTIATE DISCOUNTS. IF A MEMBER FAILS TO OBTAIN PRE-CERTIFICATION OR REFERRAL NUMBER AND A MEDICAL BILL IS RECEIVED, THE MEDICAL BILL WILL BE RETURNED TO THE MEMBER AS "SELF-PAY" RESULTING IN THE MEMBER BEING RESPONSIBLE FOR ALL BILLED SERVICES IN FULL. MEMBERS MUST CALL 1-800-975-3322 TO PRE-CERTIFY AND RECEIVE A REFERRAL NUMBER. F) PAYMENT. (1) MEMBERs will be responsible for any payment after either insurance and/or contracted discount is applied. This payment will be made directly to the FACILITY and/or PROVIDER of services. This payment will be coordinated by the GHNH MSC Department with the PROVIDER, patient, and insurance company (if provided). (2) MEMBERs have the option to secure payment using the following methods or any combination thereof as pre-approved by the FACILITY and/or PROVIDER: Cash, Check, Credit Card, Insurance Payment, Medical Savings Account Funds, or other Certified Funds. The FACILITY and/or PROVIDER, in advance of services being performed, must agree upon any needed payment arrangement. If payment arrangements are not pre-approved or payment made in a timely manner, the contracted SAVINGS could be in jeopardy. (3) MEMBERs will receive an itemized statement listing services rendered, the contracted discount taken, and all applicable payments (i.e. insurance company), if information is provided. G) MEDICAL BILL PROCESSING. MEMBERs must process their medical bill through GHNH before submitting the medical bill to an insurance carrier. MEMBERS ARE NOT ELIGIBLE FOR SAVINGS THROUGH GHNH IF THEY ASK A PROVIDER/FACILITY TO SUBMIT THEIR MEDICAL BILLS TO AN INSURANCE CARRIER FOR THEM. H) CANCELLATION BY THE ADMINISTRATOR (GHNH). GHNH reserves the right to decline or renew the membership of any MEMBER. Failure to pay regular membership fees will result in immediate cancellation of Services rendered by GHNH until the debt is resolved. I) ENTIRE AGREEMENT. All provisions under this Agreement constitute the entire Agreement between GHNH and the MEMBER. If any provision is declared void under the law, that provision is severable and the remainder of this Agreement shall remain in full force and effect. J) LEGAL ACTION. If either party brings any legal action to this Membership Agreement it is expressly agreed that the party in whose favor final judgment is rendered shall be entitled to recover from the other party reasonable attorney's fees in addition to any other relief that may be awarded. Venue of any action to enforce this Agreement shall be Tarrant County, Texas and this Agreement shall be construed in accordance with the laws of the State of Texas. K) LIABILITY. GHNH only provides reduced fees with FACILITIES and/or PROVIDERs through which MEMBERs may receive SAVINGS. GHNH does not provide any medical treatment, medical services, products, product liability, or guarantees of any kind for any MEMBER. FACILITIES and/or PROVIDERs are independent contractors and are not employees or agents of GHNH. The final selection of the FACILITY and/or PROVIDER and the approval or disapproval of medical treatment is the MEMBER's choice alone. It is the MEMBER's responsibility alone to perform due diligence (investigation) of any FACILITY and/or PROVIDER the MEMBER chooses to use. GHNH shall not interfere with the PROVIDER-MEMBER /Doctor-Patient relationship and assumes no responsibility for any medical advice given by any participating FACILITY and/or PROVIDER. GHNH shall not be liable for the negligence or other wrongful acts or omissions of any FACILITY and/or PROVIDER providing services pursuant to this Agreement. The MEMBER shall have no recourse against GHNH by reason of its availability for referral to FACILITIES and/or PROVIDERS. Upon occasion a FACILITY and/or PROVIDER may offer special pricing for services, or MEMBERs may be eligible for SAVINGS through other plans. MEMBERs have the option of choosing to pay the FACILITY AND /OR PROVIDER directly or utilizing an alternate plan instead of the GHNH program. If the GHNH program is not used, and the fees charged are greater than the amount quoted by the FACILITY and/or PROVIDER or through an alternate plan, GHNH shall not be liable to the MEMBER for the difference and no refunds will be issued. L) ARBITRATION. In the event either MEMBER or GHNH brings an action against the other to enforce the provisions of this Agreement, such action shall be resolved by arbitration in Arlington, Texas, USA. Under the rules of the American Arbitration Association, with each party hereto appointing one arbitrator and the two appointed arbitrators appointing a third arbitrator. The arbitrators will have no authority to award any punitive or exemplary damages, or to vary or ignore the terms of this Agreement, and will be bound by controlling law. The parties acknowledge because this Agreement affects interstate commerce the Federal Arbitration Act applies. The majority decision of the three arbitrators shall be binding upon the parties here to. The hospital product works with insurance, but also works as a point-of-service stand alone product. MEMBERs must provide information about the product they purchased when calling the Galaxy Health Network Hospital (GHNH) program Medical Savings Card (MSC) department. The Galaxy Health Network Hospital (GHNH) program is NOT insurance, but will coordinate services with insurance products if MEMBERs have purchased this service. The GHNH program is not intended to take the place of insurance.