2017-537-E ES - ESO Solution, Inc. for EHR billing software

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DocuSign Envelope ID:5217DEC1-2EF1-4A49-AD1 F-F6CBCC3F8A9E EXHIBIT D Pricing Memorandum ESO offers subscriptions to its Software on a tier-based system derived from Customer electronic patient care record volume per year.Annual record volume may be estimated by averaging no less than six(6)consecutive months of Customer record volume from the current Term and multiplying the result by twelve.Should the annual record volume estimation described above result in Customer rising into a new pricing tier,ESO shall inform Customer of the impending change in pricing at least sixty(60)days prior to the issuance of the upcoming annual invoice. As of the effective date of this Agreement,Customer and ESO agree that Customer annual electronic patient care record volume per year has been estimated to fall between 12,500—15,000 records per year.Should Customer annual record volume be estimated to rise to 15,000—20,000 records per year,the following pricing shall apply prior to the issuance of the next annual invoice: EHR Suite w/QM&Mobile annual subscription: $22,761.00 Billing Standard Interface: $0.00 Cardiac Monitor Integration: $1165.50 CAD Integration annual subscription: $2695.50 Daily Data Backup: $995.00 Annually recurring grand total: $27,617.00 As of the effective date of this Agreement,Customer and ESO agree that Customer Billing record volume per year has been estimated to fall between 12,.500— 15,000 records per year.Should Customer Billing record volume be estimated to rise to 15,000—20,000 records per year,the following pricing shall apply prior to the issuance of the next annual invoice: Billing Software 15,000—20,000 Claims: $11,695.50 Billing Agency ePCR Import Module 10,000—30,000: $0.00 Payer Insight Flat Fee: $7000.00 Annually recurring grand total: $18695.50 As of the effective date of this Agreement,Customer and ESO agree that Customer Health Data Exchange record volume per year has been estimated to fall between 2,.500—15,000 records per year. Should Customer Health Data Exchange record volume be estimated to rise to 15,000—30,000 records per year,the following pricing shall apply prior to the issuance of the next annual invoice: HDE—ESO EHR Connection 15,000—30,000 Incidents: $1,495.00 Notwithstanding the foregoing,ESO reserves the right to increase the fees described in this exhibit by no more than three percent(3%)per year for each year the Agreement is in effect.Furthermore,ESO is under no obligation to provide this pricing beyond the term of the existing Agreement.