Passport Health Communications, Inc. - Patient Eligibility, Claims Verification, and Demographics

<body topmargin="0" leftmargin="0" link="#000000"> <div align="left"> <table width="772" border=0 cellpadding=0 cellspacing=0 bordercolorlight="#000000" bordercolordark="#FFFFFF" bgcolor="#FFFFFF" height="61" style="border-collapse: collapse" bordercolor="#111111"> <tr> <td width="772" colspan="2"> <font style="font-size: 4pt"> </font></td> </tr> <tr> <td width="232" valign="top"> <p align="left"> <img border="0" src="logotitlebar1.jpg" width="200" height="60"> </td> <td valign="top" width="540"> <table border="0" cellspacing="1" width="100" height="6"> <tr> <td><font size="1"> </font></td> </tr> </table> <table border="0" width="540" background="../../www_phc_new/01-Images/topbar4.jpg" cellpadding="0" height="20" cellspacing="0" bordercolor="#FFFFFF"> <tr> <td width="534"> <p align="right"> <b><font face="Tahoma" size="1" color="#000080"> <a href="../04-News/05-2006Events.htm" style="text-decoration: none"> <font color="#000080">Visit Booth #622 at ANI-HFMA National, June 28-July 1, 2004 - Nashville, Tennessee</font></a> </font></b></td> <td width="6">  </td> </tr> </table> <table border="0" cellspacing="0" width="534" style="border-collapse: collapse" bordercolor="#111111" cellpadding="0"> <tr> <td width="534" align="right"> <p style="margin-top: 2; margin-bottom: 5"><b> <font face="Tahoma" style="font-size: 8pt; text-decoration:underline" color="#6000BF"> <a href="../../www_phc_new/00-PressReleases/00-pr033104.htm"> <font color="#59118E">Passport Health Communications - Acquires United Wisconsin Proservices</font></a></font></b></td> </tr> </table> </td></tr> </table> </div> <table border="0" cellspacing="0" width="771" background="../../www_phc_new/01-Images/phc_titlepx0.jpg" cellpadding="0" style="border-collapse: collapse" bordercolor="#111111" height="17"> <tr> <td width="10"><font face="Tahoma" style="font-size: 8pt"> </font></td> <td width="84"><b> <font color="#FFFFFF" style="font-size: 8pt; text-decoration:none" face="Tahoma"> </font><font 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href="../../www_phc_new/00-Support/00-csupport.htm"> <font face="Tahoma" color="#FFFFFF">Support</font></a></b></font></td> <td width="75"><font face="Tahoma" style="font-size: 8pt"> <b><font color="#FFFFFF"><a href="../00-hipaa.htm" style="text-decoration: none"><font color="#FFFFFF">HIPAA</font></a></font></b></font></td> <td width="105"> <p align="right"> <a style="text-decoration: none" target="pright" href="../../www_phc_new/00-Forms/00-contactsnew.htm"> <font face="Tahoma" style="font-size: 8pt"> </font><font color="#FFFFFF" style="font-size: 8pt" face="Tahoma"><b>Contact Us</b></font></a></td> <td width="18"><font face="Tahoma" style="font-size: 8pt"> </font></td> </tr> </table> <table border="0" cellspacing="0" width="771" cellpadding="0" height="8" background="../../www_phc_new/01-Images/phc_titlepx00.jpg" style="border-collapse: collapse" bordercolor="#111111"> <tr> <td><font style="font-size: 5pt"> </font></td> </tr> </table> <table border="0" cellspacing="0" width="771" cellpadding="0" height="8" style="border-collapse: collapse" bordercolor="#111111" bgcolor="#FFFFFF"> <tr> <td><font style="font-size: 5pt"> </font></td> </tr> </table> <table border="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="523" height="310"> <tr> <td valign="top" align="left" width="150"> <table border="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="155"> <tr> <td valign="top" align="left"> <table border="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="150"> <tr> <td width="15" align="center" height="20" valign="top"> <img border="0" src="../../www_phc_new/01-Images/phctri2.jpg" width="12" height="12"></td> <td align="left" height="20" valign="top" width="131"> <b><font face="Tahoma" color="#006486"> <a target="pright" href="../00-whoweare.htm"> <font color="#006486" style="font-size: 8pt">Who is Passport?</font></a></font></b></td> </tr> <tr> <td width="15" align="center" height="20" valign="top"> <img border="0" src="../../www_phc_new/01-Images/phctri2.jpg" width="12" height="12"></td> <td align="left" height="20" valign="top" width="131"> <b><font face="Tahoma" color="#006486"> <a target="pright" href="../00-howwehelpyou.htm"> <font color="#006486" style="font-size: 8pt">How we can help...</font></a></font></b></td> </tr> <tr> <td width="15" align="center" height="20" valign="top"> <img border="0" src="../../www_phc_new/01-Images/phctri2.jpg" width="12" height="12"></td> <td align="left" height="20" valign="top" width="131"> <span style="font-weight: 700"> <a target="pright" href="../../www_phc_new/00-PayerCoverage/00-paycover.htm"> <font face="Tahoma" style="font-size: 8pt" color="#006486"> Payers you need...</font></a></span></td> </tr> <tr> <td width="15" align="center" height="20" valign="top"> <img border="0" src="../../www_phc_new/01-Images/phctri2.jpg" width="12" height="12"></td> <td align="left" height="20" valign="top" width="131"> <span style="font-weight: 700"> <a target="pright" href="../00-gettingstarted.htm"> <font face="Tahoma" style="font-size: 8pt" color="#006486"> Getting started...</font></a></span></td> </tr> <tr> <td width="15" align="center" height="20" valign="top"> <img border="0" src="../../www_phc_new/01-Images/phctri2.jpg" width="12" height="12"></td> <td align="left" height="20" valign="top" width="131"> <span style="font-weight: 700"> <font face="Tahoma" color="#006486"> <a target="pright" href="../../www_phc_new/00-Forms/00-reqdemo.htm"> <font color="#006486" style="font-size: 8pt"> Request a demo...</font></a></font></span></td> </tr> <tr> <td width="15" align="center" height="20" valign="top">  </td> <td align="left" height="20" valign="top" width="131">  </td> </tr> </table> <p style="line-height: 11pt; margin-top: 0; margin-bottom: 0"> </p> <p style="line-height: 11pt; margin-top: 0; margin-bottom: 0"> </p> <p style="line-height: 11pt; margin-top: 0; margin-bottom: 0"> </p> <table border="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="150"> <tr> <td align="left" width="2"> </td> <td align="left"> <p style="margin-top: 0; margin-bottom: 2" align="center"> <a target="_blank" href="https://onesource.passporthealth.com/_members/default.asp?"> <img border="0" src="../../www_phc_new/01-Images/onesource.jpg" width="142" height="30"></a><br> <a target="_blank" href="https://onesource.passporthealth.com/_members/default.asp?" style="text-decoration: none"> <font face="Verdana" color="#000080" style="font-size: 7pt"> (Registered Users Only)</font></a></td> </tr> </table> <div align="center"> <center> <table border="1" cellspacing="0" style="border-collapse: collapse" bordercolor="#000080" width="138" cellpadding="2" bgcolor="#E2F1F1"> <tr> <td width="153"> <table border="0" cellspacing="0" width="138" style="line-height: 9pt; border-collapse:collapse" bordercolor="#111111"> <tr> <td width="41"> <a target="_blank" href="https://onesource.passporthealth.com/_members/default.asp?"> <img border="0" src="../../www_phc_new/01-Images/oslogbut.jpg" width="42" height="19"></a><td width="101"> <b> <a target="_blank" href="https://onesource.passporthealth.com/_members/default.asp?"> <font face="Verdana" color="#000080" style="font-size: 7pt"> OneSource</font><font color="#000080" style="font-size: 7pt">®</font><font face="Verdana" color="#000080" style="font-size: 7pt"> Login</font></a></b></td> </tr> <tr> <td width="41"> <a target="_blank" href="https://onesource.passporthealth.com/members/default.asp?"> <img border="0" src="../../www_phc_new/01-Images/oslogbut.jpg" width="42" height="19"></a><td width="101"> <b><font face="Verdana"> <a target="_blank" href="https://onesource.passporthealth.com/members/default.asp?"> <font color="#000080" style="font-size: 7pt">Certificate Login</font></a></font></b></td> </tr> </table> </td> </tr> </table> </center> </div> <table border="0" cellspacing="0" width="150" cellpadding="0" style="line-height: 9pt; border-collapse:collapse" bordercolor="#FFFFFF" bgcolor="#FFFFFF"> <tr> <td width="3" align="center">  </td> <td width="188" align="center"> <p style="margin-top: 2; margin-bottom: 0; margin-left:-7"> <FONT face=Verdana color=blue style="font-size: 7pt; font-weight: 700"> <a target="_blank" href="https://onesource.passporthealth.com/_members/security/challenge_fgpass.asp?sendingurl=/_members/default.asp"> <font color="#000080">Forgot Your Password?</font></a></FONT></td> </tr> </table> <p> <p style="line-height: 11pt; margin-top: 0; margin-bottom: 0"></td> <td width="2" valign="top" align="left"> <font face="Verdana" style="font-size: 2pt"> <img border="0" src="../../www_phc_new/01-Images/titleback1.jpg" width="1" height="310"></font></td> </tr> </table> </td> <td width="3" valign="top" align="left"> <font face="Verdana" style="font-size: 2pt"> <img border="0" src="../../www_phc_new/01-Images/titleback1.jpg" width="1" height="310"></font></td> <td width="365" valign="top" align="left"> <table border="0" width="611" cellpadding="0" style="border-collapse: collapse" bordercolor="#111111" cellspacing="0"> <tr> <td width="2" align="center" valign="top"> </td> <td width="424" align="center" height="20"> <p style="margin-bottom: 3"> <b> <font face="Tahoma" style="font-size: 8pt" color="#000080">Accelerate Your Revenue Cycle</font></b><table border="0" width="399" cellpadding="0" style="border-collapse: collapse" bordercolor="#111111" cellspacing="0"> <tr> <td width="133" align="center"> <a href="../03-Products/01-ProdHome/01-ProdOver.htm"> <img border="2" src="../../www_phc_new/01-Images/icon1.jpg" width="80" height="80"></a><br> <b><font face="Tahoma" style="font-size: 8pt" color="#000080"> <a href="../03-Products/01-ProdHome/01-ProdOver.htm" style="text-decoration: none"> <font color="#000080">Eliminate Countless Hours</font></a></font></b></td> <td width="133" align="center"> <a href="../03-Products/01-ProdHome/01-ProdOver.htm"> <img border="2" src="../../www_phc_new/01-Images/icon2.jpg" width="80" height="80"></a><b><font FACE="MS Sans Serif" style="font-size: 9pt"><br> </font><font face="Tahoma" style="font-size: 8pt" color="#000080"> <a href="../03-Products/01-ProdHome/01-ProdOver.htm" style="text-decoration: none"> <font color="#000080">Verify Patient<br>  Insurance</font></a></font></b></td> <td width="133" align="center"> <a href="../03-Products/01-ProdHome/01-ProdOver.htm"> <img border="2" src="../../www_phc_new/01-Images/icon3.jpg" width="80" height="80"></a><br> <b> <font FACE="Tahoma" style="font-size: 8pt" color="#000080"> <a href="../03-Products/01-ProdHome/01-ProdOver.htm" style="text-decoration: none"> <font color="#000080">Collect More <br> Money</font></a></font></b></td> </tr> <tr> <td valign="top" width="133"> <p ALIGN="center"> <font color="#006486" face="Tahoma" style="font-size: 8pt; ">  <a href="../03-Products/01-ProdHome/01-ProdOver.htm" style="text-decoration: none"><font color="#006486">Internet-Based <br> Passport OneSource</font></a></font><font color="#006486"><a href="../03-Products/01-ProdHome/01-ProdOver.htm" style="text-decoration: none"><i><font color="#006486" face="Verdana" style="font-size: 8pt; ">®</font><font color="#006486" face="Tahoma" style="font-size: 8pt; "> </font> </i></a> </font> <a href="../03-Products/01-ProdHome/01-ProdOver.htm" style="text-decoration: none"> <font face="Tahoma" style="font-size: 8pt" color="#006486">Solutions</font></a></p> </td> <td valign="top" width="133"> <p ALIGN="center"> <font color="#006486" face="Tahoma" style="font-size: 8pt; "> <a href="../03-Products/01-ProdHome/01-ProdOver.htm" style="text-decoration: none"> <font color="#006486">Pre-Registration<br> Self-Pay Review<br> Integrated HIS  </font></a></font></p> </td> <td valign="top" width="133"> <p ALIGN="center"> <font color="#006486" face="Tahoma" style="font-size: 8pt; "> <a href="../03-Products/01-ProdHome/01-ProdOver.htm" style="text-decoration: none"> <font color="#006486">Credit Card and E-Checking<br> Address Verification<br>  Cash Flow Workshops</font></a></font></p> </td> </tr> </table> </td> <td width="185" align="center" rowspan="4" valign="top"> <div align="right"> <table border="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="183" bgcolor="#DEEDF1" cellpadding="0"> <tr> <td width="8">  </td> <td width="175"> <p style="margin-top: 0; margin-bottom: 0" align="left"> <b><font face="Tahoma" size="1">Contact Us. Submit Form or Call:</font></b><p style="margin-top: 0; margin-bottom: 0" align="left"> <b> <font face="Tahoma" color="#000080" size="1">1-888-661-5657</font></b></td> </tr> </table> </div> <div align="right"> <table border="0" cellspacing="1" style="border-collapse: collapse" bordercolor="#111111" width="183" bgcolor="#DEEDF1"> <form method="POST" action="../../_vti_bin/shtml.dll/_01-Old/Unused/default.htm" name="New Lead (Main Page)" onSubmit="" webbot-action="--WEBBOT-SELF--"> <input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"> <tr> <td width="18"><br>  </td> <td width="158"> <p style="margin-top: 0; margin-bottom: 0"> <b> <font FACE="Verdana" color="#000080" size="1"> Name:</font><font FACE="Verdana" style="font-size: 7pt" color="#000080"><br> </font></b><font face="Tahoma" style="font-size: 8pt"> <input type="text" name="Name" size="28" style="font-family: Tahoma; font-size: 8pt" tabindex="1"><br> </font> <b> <font FACE="Verdana" color="#000080" size="1"> Email:</font><font FACE="Verdana" style="font-size: 7pt" color="#000080"><br> </font></b><font face="Tahoma" style="font-size: 8pt"> <input type="text" name="Email" size="28" style="font-family: Tahoma; font-size: 8pt" tabindex="2"></font></p> <table border="0" cellpadding="0" style="border-collapse: collapse" bordercolor="#111111" width="150"> <tr> <td> <b> <font FACE="Verdana" color="#000080" size="1"> Telephone:</font><font FACE="Verdana" style="font-size: 7pt" color="#000080"><br> </font></b><font face="Tahoma" style="font-size: 8pt"> <input type="text" name="Telephone1" size="17" style="font-family: Tahoma; font-size: 8pt" tabindex="3"></font></td> <td> </td> <td> <b> <font face="Verdana" size="1" color="#000080">State:</font><font FACE="Verdana" style="font-size: 7pt" color="#000080"><br> </font></b><font face="Tahoma" style="font-size: 8pt"> <input type="text" name="State" size="5" style="font-family: Tahoma; font-size: 8pt" tabindex="4"></font></td> </tr> </table> <p style="margin-top: 0; margin-bottom: 0"> <b> <font FACE="Verdana" color="#000080" size="1"> Facility or Organization:</font><font FACE="Verdana" style="font-size: 7pt" color="#000080"><br> </font></b><font face="Tahoma" style="font-size: 8pt"> <input type="text" name="FacilityOrganizaition" size="28" style="font-family: Tahoma; font-size: 8pt" tabindex="4"><br> </font> <b><font face="Verdana" color="#000080" size="1">Type of Facility:</font></b><br> <select size="1" name="Type_of_Facility" style="font-family: Tahoma; font-size: 8pt" tabindex="6"> <option>Please Select</option> <option value="Hospital">Hospital</option> <option value="Physician Office">Physician's Office</option> <option value="Other">Other</option> </select><b><font face="Verdana" color="#000080" size="1"><br> </font></b> <font face="Verdana" style="font-weight:700" size="1" color="#000080"> Bed/Practice Size:</font><br> <select size="1" name="BedSize_Physicians" style="font-family: Tahoma; font-size: 8pt" tabindex="6"> <option>Please Select</option> <option>1-10</option> <option>10-25</option> <option>25-100</option> <option>100-200</option> <option>200-300</option> <option>300-400</option> <option>400-500</option> <option>500+</option> </select><b><font face="Verdana" color="#000080" size="1"><br> Tell Me More About?</font></b><br> <select size="1" name="InfoRequest" style="font-family: Tahoma; font-size: 8pt" tabindex="6"> <option>Please Select</option> <option>Passport OneSource</option> <option>Compliance Checker</option> <option>Integrated HIS Solutions</option> <option>Pre-Registration</option> <option>Self-Pay/File Batch</option> <option>Financial Products</option> <option>Corporate Information</option> <option>Other</option> </select><br> <b><font face="Verdana" color="#000080" size="1">Comments:</font><font face="Verdana" style="font-size: 7pt" color="#000080"><br> <textarea rows="2" name="Notes" cols="24" style="font-family: Tahoma; font-size: 8pt" tabindex="7"></textarea></font></b><br> <font FACE="Verdana" SIZE="1"> <b> <input type="submit" value="Submit" name="Submit" style="font-size: 7pt; font-family: Verdana; font-weight: bold"></b></font></p> </td> <td width="8">  </td> </tr> <tr> <td width="18"><font face="Verdana" style="font-size: 3pt"> </font></td> <td width="158"> <b><font face="Verdana" style="font-size: 3pt"> </font></b></td> <td width="8"> <font face="Verdana" style="font-size: 3pt"> </font></td> </tr> </table> </div> </td> </tr> <tr> <td width="2" align="center"> </td> </tr> <tr> <td valign="top" width="2"> </td> </tr> <tr> <td width="2"> </td> <td width="424"> <p ALIGN="center" style="margin-top: 0; 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margin-bottom: 0"> <font FACE="Tahoma" style="font-size: 8pt" SIZE="1"> <br> </font> <font style="font-size: 8pt"> <a href="../02-Company/00-aboutusp1.htm" style="text-decoration: none; font-weight:700"> <font color="#000000" face="Tahoma">Passport Health Communications, Inc.</font></a></font><font FACE="Verdana" style="font-size: 8pt"> offers revenue tools and real-time, direct access to one of the largest collections of <a href="../../www_phc_new/00-PayerCoverage/00-paycover.htm" style="text-decoration: none"> payer </a>and patient information in the U.S. </font></p> <p ALIGN="LEFT" style="margin-top: 0; margin-bottom: 0">  </p> <p ALIGN="LEFT" style="margin-top: 0; margin-bottom: 0"> <font FACE="Verdana" style="font-size: 8pt">W</font><span style="font-family: Verdana; font-size: 8pt">e connect you to patient data at all points of access, from registration to billing.  Our strategy is to provide your healthcare facility with the best tools and services to improve your revenue cycle.</span></p> </td> </tr> </table> </td> </tr> </table> <body link="#000000"> </body> <div align="left"> <table border="0" cellspacing="0" width="772" cellpadding="0" bgcolor="#FFFFFF"> <tr> <td height="4"> <font size="1"> </font></td> <td height="4"> <p align="center"> <font face="Verdana" style="font-size: 7pt">©</font><font face="Verdana, Arial" style="font-size: 7pt"> Copyright 2004 Passport Health Communications, Inc.  All Rights Reserved.   </font> <font size="1" face="Verdana, Arial" color="#9d9d9d"> <a href="../00-copyright.htm"> <font color="#00607C">Copyright Policy</font></a></font><font size="1" face="Verdana, Arial" color="#00607C">   </font> <font size="1" face="Verdana, Arial" color="#9d9d9d"> <a href="../00-privacy.htm"><font color="#59118E">Privacy Policy</font></a></font><font color="#59118E" face="Verdana, Arial" size="1"> <b>   </b> </font> <font size="1" face="Verdana, Arial" color="#006486"><br> </font> <font size="1" face="Verdana, Arial" color="#000080">720 Cool Springs Blvd. Suite 450, Franklin, Tennessee 37067. Telephone: 1-888-661-5657 </font> <font size="1" face="Verdana, Arial" color="#FFFFFF"> <a href="mailto:Corporate@passporthealth.com"> <font color="#000080">Corporate@passporthealth.com</font></a></font><font size="1" face="Verdana, Arial" color="#000080"> <br> </font> <FONT face=Verdana style="font-size: 7pt">Data Delivered via OneSource® is Confidential and Protected under Federal Law.  Inappropriate Disclosure of this Data is Considered a Felony. </FONT> </td> </tr> </table> </div> </body>