CLAIMS PROCESSING

R H Administrators claims processing and administration services are performed at 5502 58th Street, Suite 700, Lubbock, Texas, our main office.

Claims are processed by our high tech system with state of the art equipment. LuminX is a fully automated claims adjudication system which combines integrated software design with the latest advanced technologies available in the computer industry. Although the design is global in scope, the user-defined system approach enables R H Administrators, Inc., to customize the system parameters to meet the requirements of our specialized client base.

Claims are processed by our highly trained benefit analysts, who have received and continue to receive up-to-date claim payment techniques using this advanced equipment. Coordination of benefits "reasonable and customary charges" by physicians and other providers, and other plan provisions are calculated automatically.

Checks to employees and/or providers are issued along with a detailed Explanation of Benefits (E.O.B.) of how benefit payments were calculated.

Claim payments are made for Self-Funded clients through separate bank accounts, set up and controlled by the client. A holding account (interest bearing by non corporate clients) is set up to place funds previously paid to a fully Insured Carrier. Then, another account is set up as a -0- balance account in which R H Administrators, Inc., and/or clients may have signature authority. Claims are processed, the client is informed of the amount, and funds are transferred. Claims clear and again -0- the account.

Checks are printed from our micro printing system, using blank check stock. All the information, routing instructions and account numbers are inserted instantly. Explanation of Benefits (E.O.B.) are attached to the checks for convenience and for instant recognition of how the benefits were paid. This, as well as our claim payments, are online for quick access.

USUAL AND CUSTOMARY

Charges for Usual, Reasonable, and Customary are verified online through the use of the MDR Database which automatically checks the charges for surgery, radiology, laboratory and office visits. Our MDR claims will be paid on the 90th percentile level.

TELEPHONE

R H Administrators provides Toll-Free Texas and National numbers for your employees convenience and to our and providers.