Attachment A
SmartShopper Program.
Except as the parties may otherwise agree and document in an amendment, Sapphire Digital shall
adhere to the following requirements for the SmartShopper Program:
A. A Member shall be able to obtain provider related cost information for select medical
procedures as well as information regarding the availability of any associated Incentive
Reward Payment, by either contacting Sapphire Digital through a toll free telephone
number or a website, both of which shall be provided for by Sapphire Digital.
B. The list of medical procedures included in the SmartShopper Program are described in
“Attachment B”.
C. Sapphire Digital shall issue Incentive Reward Payments to Members in the amounts
mutually agreed upon by the Customer and Sapphire Digital as described in Attachment
B.
D. Prior to providing any information, Sapphire Digital shall require the Member to verify
Member’s eligible status to use the SmartShopper Program.
E. Following Sapphire Digital’s verification of eligibility, the Member shall indicate the
healthcare procedure to be performed as well as his/her initial preference, if they were to
have one, on the location to have the procedure performed.
F. Sapphire Digital shall provide to the Member cost-related information related to
Customer’s participating providers who can perform the requested procedure. Sapphire
Digital shall also inform the Member which providers, if any; will qualify the Member for
an Incentive Reward Payment.
G. Upon Sapphire Digital’s verification of the Member’s use of a provider that qualified
him/her for an Incentive Reward Payment, Sapphire Digital shall send the Incentive
Reward Payment to the Member. Sapphire Digital shall verify Member’s qualification for
an Incentive Reward Payment by confirming, utilizing claims payment information
provided by Anthem Inc. that a request for payment from the provider for the specific
service in question was received and processed by Anthem Inc.
H. Reporting: Sapphire Digital will provide the Customer with Standard Performance
Reports monthly, no later than the last day of the month following the applicable reporting
month (e.g., Sapphire Digital provides January reports by the last day of February).
I. | Website and Phone Support: Sapphire Digital will make available and maintain the
Sapphire Digital website for use by Members for the delivery of the Program. The website
will be hosted by Sapphire Digital , using industry standard security measures, and shall
be available twenty-four (24) hours per day to provide Members the capability to search
and identify relative costs and Member Incentive Reward information for select medical
procedures included in the applicable Program, with the exception of regularly scheduled
maintenance and downtime, which shall not occur during Sapphire Digital’s regular
business hours. Sapphire Digital shall also make available telephonic support through a
dedicated toll free telephone number to its Call Center during its standard operating hours.
