Vendor Pricing Template
       Instructions: Please ask the vendor that you are evaluating to fill out dollar values in each of the cells in the appropriate row. If the vendor does not have a price for 
       a particular item, then leave "$0" for calculation purposes. 
       In terms of implementation and training costs for the main Electronic Health Record (EHR)/Practice Management (PM) system, there are two scenarios:
       1. Fixed fee for a specific number of providers. We display 1-, 5-, and 10-provider levels as a base from which to work. A practice needs to substitute the actual 
       number of providers for the particular practice.
       2. Hourly rate, which then can be used in a calculation based on the number of hours specified for the particular practice.
       Descriptions:
       * Licensing Model: There is a one-time licensing purchase fee paid upfront for perpetual use of the software. 
       ** Software as a Service (SAAS) Model: Also known as cloud-based deployment, Web-based deployment, or Application Service Provider deployment. The EHR/PM 
       system is hosted at a third-party location, with both use of the software and hosting charged as a monthly fee per provider. Some advantages of such a remotely 
       hosted model versus a locally hosted model are potentially lower and more predictable costs, simpler security, easier upgrades and updates, improved accessibility, 
       and better data exchange. 
                                                   Vendor Name
                                                                                                             License 
                                               Vendor Licensing Model*                                     Fee/Provider
                                                 Vendor Licensing Model *
                                                                                                              $0 
                                                Vendor SAAS Model**                                        Provider/Month
                                                 Vendor SAAS Model **
                                                                                                              $0 
                                                      NOTES
       Note 1: Implementation hours and number of training days needed vary by practice and should be discussed with the vendor.
       Note 2: Prices reflected are base fees only; additional fees for other required and optional features may apply.
       Vendor Pricing Template                                     1                                                 October 21, 2011
      Note 3: Training is onsite.
      Note 4: Training is remote.
      Note 5: Additional information or comments may be placed in the boxes to the right.
      Vendor Pricing Template                      2                                     October 21, 2011
                                                                                                Portal                                               Meaningful Use        1-Provider
            License Fee/Part-   License Fee/Mid-    Portal Activation   Portal/Provider/   Implementation/         Portal          Mobile Phone         Analytics        Implementation/ 
            Time (PT) Provider        Level               Fee               Month              Practice       Training/Practice     Fee/Month          Dashboard            Practice
                   $0                  $0                 $0                 $0                  $0                 $0                  $0                 $0                  $0 
                                                                                                Portal                                               Meaningful Use 
                                                    Portal Activation   Portal/Provider/   Implementation/         Portal          Mobile Phone         Analytics          1-Provider
            PT Provider/Month   Mid-Level/Month           Fee               Month              Practice       Training/Practice     Fee/Month          Dashboard         Implementation 
                   $0                  $0                 $0                 $0                  $0                 $0                  $0                 $0                  $0 
           Vendor Pricing Template                                                                      3                                                                              October 21, 2011
     Vendor Pricing Template                  4                                  October 21, 2011