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                                                                     Exhibit 4.9

                              AMENDED AND RESTATED
                          SUBORDINATED PROMISSORY NOTE

         THIS AMENDED AND RESTATED SUBORDINATED PROMISSORY NOTE dated April 12,
2002, amends and restates, without interruption or novation, all indebtedness
evidenced by that certain Subordinated Promissory Note dated May 18, 2001 by the
Company to the Holder, in the original principal amount of $250,000.

               THIS PROMISSORY NOTE HAS NOT BEEN REGISTERED UNDER THE SECURITIES
               ACT OF 1933, AS AMENDED, OR ANY STATE SECURITIES OR "BLUE SKY"
               LAW OR REGULATION IN RELIANCE UPON AN EXEMPTION FROM SUCH
               REGISTRATION REQUIREMENTS. IT MAY NOT BE TRANSFERRED UNLESS SUCH
               TRANSFER IS REGISTERED OR THE HOLDER PROVIDES THE COMPANY WITH AN
               OPINION OF COUNSEL ACCEPTABLE TO THE COMPANY THAT SUCH
               REGISTRATION IS NOT REQUIRED IN ORDER TO COMPLY WITH SUCH
               SECURITIES LAW.

               THE INDEBTEDNESS EVIDENCED BY THIS INSTRUMENT IS SUBORDINATED TO
               THE PRIOR PAYMENT IN CASH IN FULL OF THE SENIOR OBLIGATIONS (AS
               DEFINED IN THE AMENDED AND RESTATED SUBORDINATION AGREEMENT DATED
               AS OF APRIL 12, 2002) PURSUANT TO, AND TO THE EXTENT PROVIDED IN,
               THE SUBORDINATION AGREEMENT BY THE MAKER HEREOF IN FAVOR OF THE
               ADMINISTRATIVE AGENT, LENDERS AND SERIES C PREFERRED STOCKHOLDERS
               (AS SUCH TERMS ARE DEFINED IN THE SUBORDINATION AGREEMENT).

April 12, 2002                                              $250,000.00
                                              Mecklenburg County, North Carolina

     PLANVISTA CORPORATION, a Delaware corporation (the "Company"), hereby
promises to pay to JOHN D. RACE, (the "Payee" or the "Holder"), the principal
amount of Two Hundred Fifty Thousand United States Dollars ($250,000.00),
together with interest thereon at the rate from time to time reported as the
Prime Rate by the Wall Street Journal plus four percent (4%) per annum. This
Note is being issued as one of a series of notes (the "Director Notes") being
sold by the Company to certain of its Directors in order to provide the Company
funds to partially pay certain payables to the New England Financial in
connection with the sale of certain Company assets.

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     Section 1. Payment of Principal.

         (a) Maturity. To the extent not theretofore paid pursuant to Section
1(b) hereof, the entire principal amount of this Note plus all accrued and
unpaid interest shall become due and payable on December 1, 2004 (the "Maturity
Date").

         (b) Optional Prepayment. Subject to any restrictions contained in the
Subordination Agreement referenced in Section 3 hereof, the Company may, at any
time and from time to time, without premium or penalty, prepay all or a portion
of the unpaid principal amount of this Note, together with accrued and unpaid
interest to the date of such repayment. Prepayments shall be applied first to
accrued and unpaid interest and then to principal.

         (c) Payments Pro Rata. Any payment or prepayment of principal of the
Director Notes shall be made pro rata among the Holders thereof based on the
respective principal amounts of Director Notes held by such Holders. The Company
will not redeem, repurchase or otherwise acquire any Director Notes other than
in accordance with this Section 1 or pursuant to an offer made available to all
Holders of Director Notes on a pro rata basis.

     Section 3. Subordination. Repayment of the principal and interest due under
this Note is subordinated in right and time of payment to any and all
obligations and liabilities of the Company to (i) the Administrative Agent (as
defined below) and Lenders (as defined below) under or in connection with the
Third Amended and Restated Credit Agreement dated as of April 12, 2002 among the
Company and PlanVista Solutions, Inc, a New York corporation and a wholly owned
subsidiary of the Company, as borrowers, the lenders referred to therein (the
"Lenders") and Wachovia Bank, National Association (f/k/a First Union National
Bank), as administrative agent ("Administrative Agent") (from time to time
amended, restated, supplemented or otherwise modified, the "Company Credit
Facility") and any other Loan Document (as defined in the Company Credit
Facility) and (ii) the Administrative Agent and the holders of Series C
Convertible Preferred Stock of the Company, par value $0.01 per share (the
"Series C Preferred Stock") with the terms set forth in the Company's
Certificate of Designation of Series and Determination of Rights and Preferences
of Series C Convertible Preferred Stock relating to the Series C Preferred Stock
(as such provisions may be amended, restated, supplemented or otherwise modified
from time to time), in each case in accordance with the provisions of that
certain Subordination Agreement attached hereto as Exhibit A.

     Section 4. Events of Default. Subject to any restrictions contained in the
Subordination Agreement referenced in Section 3 hereof, upon the occurrence and
during the continuance of an Event of Default, the Holder may declare all or any
portion of the unpaid principal amount of the Director Notes due and payable and
may otherwise take action to enforce the Director Notes (except that, in the
case of an Event of Default described in clause (ii) below, such acceleration
shall be automatic with no action required on the part of any Holder). For
purposes of this Note, an "Event of Default" shall be deemed to have occurred
upon the delivery of notice to the Company by the Holder following the
occurrence of any of the events set forth below (except that, in the case of the
events described in clause (ii) below, no such notice shall be required):

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          (i) the Company's failure to pay when due (without regard to the
     provisions of Section 3) any portion of the principal amount of this Note
     or any other Director Note or any accrued and unpaid interest thereon;

          (ii) the commencement of bankruptcy, reorganization, insolvency or
     liquidation proceedings with respect to the Company other than an
     involuntary proceeding which is dismissed, terminated, bonded or stayed
     within 60 days after it is commenced;

          (iii) the acceleration of any indebtedness under the Credit Agreement
     which is not rescinded, waived or otherwise cured within 30 days.

     Section 5. Amendment and Waiver. The Company may not amend any Director
Note without the written consent of a majority in principal amount of the
outstanding Director Notes.

     Section 6. Costs of Collection and Documentary Stamps. The Company shall be
liable to the Holder of this Note for all costs incurred by such Holder
(including attorneys' fees) in collecting any amount due and owing hereunder or
otherwise in enforcing the obligations of the Company hereunder. Additionally,
the Company shall pay any documentary stamps or other taxes which may be due as
a result of the issuance of this Note.

     Section 7. Cancellation. After all unpaid principal and interest owed on
this Note has been paid in full, this Note shall be surrendered to the Company
for cancellation and shall not be reissued.

     Section 8. Waiver. The Company hereby waives diligence, presentment,
demand, protest and notice of any kind. The failure to exercise any right
hereunder in any particular instance shall not constitute a waiver thereof.

     Section 9. Governing Law. This Note will be governed by the internal law,
and not the law of conflicts, of the State of Florida.

     IN WITNESS WHEREOF, the Company has executed and delivered this Note on the
date first written above.

                                               PLANVISTA CORPORATION


                                               By:   /s/Donald W. Schmeling
                                                  ------------------------------
                                                     Donald W. Schmeling
                                                     Chief Financial Officer

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