Service Terms and Conditions Agreement

Client certifies they are authorized to enter into and agrees to the following service terms and
conditions Agreement in their entirety between Client and Patient Payment Solutions, LLC,
hereafter referred to as PPS.

PPS offers multiple financial software service solutions for healthcare providers and patients.
Unless otherwise requested specifically, Client will automatically be signed up for
Prefunding and Direct Pay only and must request to be signed up for Auto-debit plans.
Client hereby acknowledges that PPS is NOT a debt collection agency. It is a software
company contracted by Client to facilitate financial transactions entered into PPS software in
conjunction with other third-party financial vendors. PPS credit card software and services,
although proprietary in nature, in no way guarantees credit card payments from accounts put
into system. Validation of credit worthiness of patient(s) is the sole responsibility of the
Client for payment plans.

Application fee to participate is $299 per clinic and is non-refundable. A Monthly $99
hosting fee per clinic will be charged on the first day of the month following the application
of the Client. For Clients that choose to utilize in-house payment plans, there is an 8%
transaction fee on collected payments only. The initial services term is 6 months and is
thereafter month to month. A 30-day written notice is required by either party in order to
terminate this Agreement. Without written notice this contract will continue uninterrupted
and the stated fee will continue to be debited. Termination of Agreement with PPS does not
terminate the Agreement with other third-party vendors. PPS will facilitate cancellation with
those vendors upon request by Client.

Client understands Patient Payment Solutions software works in conjunction with other third-
party vendors. When becoming a Client under Patient Payment Solutions, Client also becomes a
Client under other third-party vendors. Those vendors may have certain contract requirements as
well as PCI (payment card industry) and DSS (data security standards) compliance requirements.
Client accepts full responsibility for adhering to and fulfilling those third-party vendor contract

Both parties agree any disputes shall be settled by way of binding arbitration in the state of
Alaska and its jurisdiction according to the rules of the American Arbitration Association.