PRIOR AUTHORIZATION SERVICE TYPES ADDENDUM

BY ENTERING INTO AN ORDER UNDER WHICH CUSTOMER WILL BE PROVIDED PRIOR AUTHORIZATION SERVICES WHICH ARE PRICED BY SERVICE TYPE, CUSTOMER HEREBY ENTERS INTO THIS PRIOR AUTHORIZATION SERVICE TYPES ADDENDUM (THIS “ADDENDUM”) AND IS LEGALLY BOUND THEREBY. FOR THE AVOIDANCE OF DOUBT, THIS ADDENDUM DOES NOT APPLY TO THE PROVISION OF ANY PRIOR AUTHORIZATION OR OTHER SERVICES NOT PRICED BY SERVICE TYPE. THIS ADDENDUM IS HEREBY ATTACHED TO AND MADE A PART OF THE GENERAL TERMS AND CONDITIONS (“GENERAL TERMS”) SET FORTH AT HTTPS://WWW.INFINX.COM/TERMS-AND-CONDITIONS-FOR-CUSTOMER-AGREEMENTS BY AND BETWEEN THE CONTRACTING INFINX ENTITY PROVIDER DESIGNATED IN THE APPLICABLE ORDER(S) ON BEHALF OF ITSELF AND ITS AFFILIATES (INCLUDING WITHOUT LIMITATION, ITS OFF-SHORE AFFILIATES WHICH INCLUDE INFINX SERVICES PVT. LTD., LOCATED IN INDIA AND INFINX HEALTHCARE PHILIPPINES, INC., LOCATED IN THE PHILIPPINES) (COLLECTIVELY, “INFINX”), AND THE PURCHASING BUSINESS OR OTHER ENTITY WHO IS ENTERING INTO THE ORDER(S) (“CUSTOMER”), REGARDING THE PROVISION AND USE OF PRIOR AUTHORIZATION SERVICES PRICED BY SERVICE TYPE. THE PERSON EXECUTING THE ORDER(S) ON BEHALF OF CUSTOMER REPRESENTS AND WARRANTS TO INFINX THAT THEY HAVE FULL LEGAL AUTHORITY TO ACCEPT THE TERMS OF THIS ADDENDUM AND THAT THEY AND CUSTOMER ARE NOT BANNED FROM USING THE PROVIDED SERVICES UNDER THE LAWS OF THE UNITED STATES OR ANY OTHER COUNTRY. ALL CAPITALIZED TERMS USED IN THIS ADDENDUM BUT NOT DEFINED WILL HAVE THE SAME MEANINGS GIVEN IN THE GENERAL TERMS OR APPLICABLE ORDER. IN THE EVENT OF A CONFLICT BETWEEN THE TERMS OF THIS ADDENDUM, THE GENERAL TERMS AND THE ORDER, THE FOLLOWING DESCENDING ORDER OF PRECEDENCE WILL CONTROL: THE ORDER, THIS ADDENDUM AND THE GENERAL TERMS.  

 Prior Authorization Service Types: The Prior Authorization service types are as follows: 

 

Service Type  PA Type 
Surgical (includes Urology, Vascular and Vein Surgery)   PA II 
Diagnostic X-Ray  PA I 
Diagnostic Lab  PA II 
Radiation Therapy  PA II  
MRI Scan  PA I 
Pathology  PA II 
Chemotherapy  PA II 
Allergy Testing  PA I 
Podiatry  PA II 
Occupational Therapy  PA I 
Speech Therapy  PA I 
Skilled Nursing Care (Home Health)  PA II 
Orthopedic  PA I 
Cardiac   PA II 
Gastrointestinal  PA II 
Neurology  PA II 
Coronary Care  PA II 
Mammogram, High Risk Patient  PA I 
Durable Medical Equipment  PA II 
CAT Scan  PA I 
Ophthalmology  PA II 
Allergy  PA II 
Oncology  PA II 
Positron Emission Tomography (PET) Scan  PA I 
Physical Therapy  PA I 
Pediatric  PA II 
Specialty Pharmacy  PA II 
Other (any service type or specialty not listed)  PA II 

Prior Authorization Service Types Addendum to General Terms and Conditions, Version 1.1. Last revised July 24, 2025.