Document:

<PAGE>   1
                                                                   EXHIBIT 10.13

                          QUALITY CARE SOLUTIONS, INC.

                             QMACS SOFTWARE LICENSE

This License is made and entered by and between Quality Care Solutions, Inc, a
Nevada corporation with it's principal place of business at 5030 E. Sunrise
Drive, Phoenix, AZ 85044 (hereinafter referred to as "QCSI"), and Best Health
Care Management Company, Inc., a Pennsylvania corporation with it's principal
place of business at Penn Treaty Park Place, 1341 North Delaware Avenue,
Philadelphia, Pennsylvania 19125 (hereinafter referred to as "CLIENT").

                               TERMS & CONDITIONS

I.   QMACS(TM) SOFTWARE LICENSE GRANT

     a)   Grant of License. QCSI hereby grants to CLIENT a non-exclusive,
          non-transferable license ("License") to use QMACS(R) Software and
          QMACS Documentation. This License is expressly made and granted
          subject to the terms, conditions, limitations and restrictions as set
          forth herein.

     b)   Fees and Term. To maintain its License hereunder, CLIENT shall pay to
          QCSI all fees and costs as provided in Exhibit A to this License.
          Provided that all fees and costs are paid timely, and CLIENT complies
          with the terms and conditions of this License, the initial term of
          this License shall start on May 1, 1999 and end on December 31, 2002.
          Thereafter, the term of this License shall automatically be extended
          for consecutive additional terms of three (3) years each, unless
          either party provides the other with written notice of such party's
          intention not to extend the term at least one hundred twenty (120)
          days prior to the end of the initial term or any subsequent term.

     c)   Sole Use. This license authorizes CLIENT to use QMACS only for
          CLIENT's own internal purposes. CLIENT shall not allow any third party
          to access, copy or use QMACS or QMACS Documentation, nor shall it use
          QMACS to provide time-sharing or data processing services to a third
          party without a separate written agreement with QCSI.

     d)   Ownership/Derivative Works/Safeguard. QMACS Software, documentation,
          training materials, plans, prices, configurations, specifications,
          techniques, algorithms, schemas, screen prints and processes contained
          herein, or any modification, extraction, or extrapolations thereof,
          are the property and trade secrets of QCSI and are subject to
          copyright protections. Any copyright notice does not imply
          unrestricted or public access. No duplication, usage, disclosure, or
          publication thereof, in whole or in part, for any purpose is
          permitted, except that which is expressly permitted by this license or
          other written permission of QCSI. CLIENT shall include in all copies
          made by it notices of copyright and other proprietary rights included
          by QCSI in or on the QMACS Software and Documentation provided to
          CLIENT. All copies of QMACS Documentation are provided to CLIENT only
          for the duration of this License and only for the purpose of
          facilitating the use by CLIENT of QMACS. CLIENT specifically agrees
          that any derivative works or modifications of QMACS shall be the
          property of QCSI and CLIENT hereby assigns all title and ownership
          interest therein to QCSI. Derivative works are any modifications of
          QMACS Software or work, which is based on QMACS Software source or
          object code, or which requires QMACS Software to function. Such
          derivative works shall be deemed to be QMACS for the purposes of this
          License. QCSI's representations, warranties and liabilities shall not
          extend to derivative works and modifications. CLIENT agrees to
          safeguard all code against non-licensed use, copying, transfer or
          inspection by any third party. CLIENT shall require all persons and
          entities to whom CLIENT has granted authority to save data or who have
          access to any Executable Code to execute and submit to QCSI a
          confidentiality agreement.

     e)   Breach. In the event of a breach or the threat of a breach of this
          License, QCSI, in addition to any other remedies it may have at law or
          in equity, shall be entitled to a restraining order, preliminary
          injunction, and other appropriate relief so as to specifically enforce
          the terms of this License, and any other agreement entered into in
          conjunction with this license. CLIENT agrees that a breach of this
          License would cause QCSI irreparable injury. This License may be
          terminated with ninety (90) days prior written notice if either Party
          fails to comply with the terms, conditions or any covenant under this
          License and fails to perform or cure the same within forty-five (45)
          days of receipt of written notice.

     f)   Loss or Damages to QMACS Software and QMACS Documentation. In the
          event of loss, damage, or destruction of any of the QMACS Software or
          QMACS Documentation, it will be replaced by QCSI at the written
          request of CLIENT. CLIENT shall pay QCSI's reasonable reproduction and
          delivery expenses for such replacement.

     g)   Obligations Upon Termination. Upon expiration or termination of the
          License, all Copies of QMACS Software and QMACS Documentation shall
          promptly be delivered to QCSI or destroyed by CLIENT, and CLIENT shall
          certify the same in writing within ninety (90) days.

     h)   Standard Support. CLIENT shall receive standard support, as defined by
          QCSI policies and procedures, during the term of this License. CLIENT
          shall have option to purchase additional or extended support as
          mutually agreed by QCSI and CLIENT.

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II.  MISCELLANEOUS

     a)   QMACS Software and Documentation. QCSI will deliver at least one
          machine-readable copy (QMACS Executable Code form) of each program for
          each QMACS module in accordance with QMACS Documentation. QCSI agrees
          to provide one (1) hardcopy and one (1) electronic copy of QMACS
          Documentation corresponding to each module to CLIENT as such
          Documentation is published or updated. At CLIENT's option, CLIENT may
          purchase additional hardcopies of Documentation from QCSI at QCSI's
          list price in effect from time to time.

     b)   QMACS Standard Reports. QCSI will deliver a limited set of standard
          reports with the Software. CLIENT acknowledges that third-party report
          writing software tools are required to create new reports or modify
          QCSI's standard reports. The license fee, support and training cost
          for third-party report writing tools are not included in this License
          and must be acquired separately. CLIENT acknowledges that QCSI's
          standard reports are templates and examples of reports QCSI has
          developed for non-specific use. The CLIENT acknowledges responsibility
          for the design, development and production of its own reports,
          documents, letters and identification cards to be used in conjunction
          with the Software. CLIENT agrees the delivery of QMACS Standard
          Reports meets any report production requirements of CLIENT.

     c)   Electronic Data Interface (EDI) Engine. QCSI will deliver a method to
          facilitate electronic data import and export to and from the QMACS
          database using the National Standard Format ("NSF").

     d)   Reference Data. QCSI agrees to provide the minimal reference data as
          required to configure and test QMACS Software. CLIENT is responsible
          for the annual procurement, update and maintenance of all reference
          data required to operate the QMACS Software. Reference data includes
          but is not limited to the following: International Classification of
          Diseases - Version 9 (ICD-9); Common Procedure Terminology (CPT-4);
          Common Dental Terminology (CDT), Diagnostic Related Group (DRG);
          HCFA's Common Procedure Coding System (HCPCS); Revenue codes; Resource
          Based Relative Value Scale (RBRVS); Relative Value Units (RVU);
          Medicode's (MDR); Geographic Practice Cost Indices (GPCI), Usual and
          Customary Rates (UCR); custom fee schedules; provider types;
          specialties; reason codes; edits; service codes; modifiers; and rate
          structures. QCSI agrees to provide the data table structure and
          interface method to facilitate loading, editing and maintenance of
          reference data required to operate QMACS.

     e)   Software Modification Pursuant to Governmental Regulation. After
          written notice to QCSI, CLIENT shall be entitled to receive, without
          additional charge, such modifications to QMACS Software as are
          required to reflect any mandatory changes in federal government
          managed care regulations that are applicable where CLIENT is utilizing
          the QMACS Software, excluding EDI interfaces. CLIENT agrees to provide
          said regulatory requirement information to QCSI no later than ninety
          (90) days prior to its effective date. QCSI shall provide only a
          single solution to any given mandatory change, which is required by
          the appropriate controlling government agency.

     f)   Escrow Statement. QCSI shall maintain a copy of the most recent Source
          Code for QMACS Software with Ft. Knox Escrow Services Inc. or a
          trustee mutually acceptable to QCSI and CLIENT. In the event QCSI
          becomes insolvent, makes an assignment of assets for the benefit of
          creditors, has a trustee or receiver appointed (either voluntary or
          involuntarily), is adjudicated bankrupt, or involuntary bankrupt
          proceedings are commenced against QCSI or receiver, or commences any
          dissolution or liquidation proceedings, then the trustee shall be
          directed to deliver the Source Code to CLIENT. CLIENT shall provide
          written notification to both QCSI and trustee of intention to access
          Source Code. QCSI shall notify CLIENT who the appointed trustee is,
          and give notice prior to any of the actions mentioned herein. CLIENT
          shall pay or reimburse QCSI for any costs of Source Code escrow,
          escrow maintenance or Source Code access.

III. LIMITED WARRANTY, PATENT, AND COPYRIGHT INFRINGEMENT

     a)   Limited Warranty. QCSI warrants that it shall remedy any Anomaly
          within QCSI's support policy response time after notification is
          received from CLIENT. Upon receipt of CLIENT's notice that the
          Software is not functioning according to the QMACS Documentation, QCSI
          will, without additional cost to CLIENT, provide the technical and/or
          programming resources, including personnel with the requisite
          expertise, necessary to address and correct the problem provided that
          QCSI can replicate the reported problem using CLIENT supplied data in
          a standard computing environment. This warranty is conditional upon
          CLIENT's computing environment being consistent with QCSI's
          recommended hardware and software specifications and in good working
          order and further provided that the Software has been properly used
          and has not been modified and/or serviced by an entity other than
          QCSI. QCSI does not warrant that the QMACS Software will meet CLIENT's
          requirements or will operate in the combinations which may be selected
          for use by CLIENT, or that the operation of the QMACS Software will be
          uninterrupted or error free. This warranty does not extend to QMACS
          Software modified by CLIENT or for Anomalies due to CLIENT misuse of
          third-party products. QCSI's warranty covers only service to correct
          Anomalies reported during the term of this License.

     b)   NO OTHER WARRANTIES. THE FOREGOING IS IN LIEU OF ALL OTHER WARRANTIES
          EXPRESSED OR IMPLIED. QCSI HEREBY DISCLAIMS ALL WARRANTIES NOT
          EXPRESSLY SET FORTH IN THIS LICENSE INCLUDING BUT NOT LIMITED TO, ANY
          IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A

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<PAGE>   3
          PARTICULAR PURPOSE. CLIENT HEREBY DISCLAIMS ANY RELIANCE ON ANY
          WARRANTY OR REPRESENTATION NOT EXPRESSLY SET FORTH IN THIS LICENSE.

     c)   NO LIABILITY FOR CONSEQUENTIAL DAMAGES. IN NO EVENT WILL QCSI BE
          LIABLE FOR ANY DAMAGES CAUSED BY CLIENT'S FAILURE TO PERFORM CLIENT'S
          RESPONSIBILITIES, OR FOR ANY LOST PROFITS, LOST SAVINGS, LOSS OF DATA,
          LOSS OF USE OF THE QMACS(TM), COSTS OF RECREATING LOST DATA, OR ANY
          OTHER INDIRECT, SPECIAL OR OTHER CONSEQUENTIAL DAMAGES, EVEN IF QCSI
          HAD BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, OR FOR ANY CLAIM
          AGAINST CLIENT BY ANY OTHER PARTY.

     d)   LIMITATIONS ON LIABILITY AND REMEDIES. QCSI'S AGGREGATE LIABILITY FOR
          DAMAGES TO CLIENT FROM ANY CAUSE WHATSOEVER, AND REGARDLESS OF THE
          FORM OF ACTION, INCLUDING CONTRACT, TORT, COMPUTER MALPRACTICE,
          PRODUCTS LIABILITY, STRICT LIABILITY, OR OTHERWISE SHALL BE LIMITED TO
          THE AMOUNT OF THE IMPLEMENTATION FEES PAID TO QCSI.

     e)   Time Limitations. No action, regardless of form, arising out of this
          license may be brought by CLIENT later than two (2) years after the
          cause of action has arisen and CLIENT has acquired knowledge thereof.

     f)   Indemnification. QCSI promises to indemnify CLIENT, at QCSI's expense,
          against any claim that QMACS Software infringes on a valid patent,
          copyright, or trade secret in the United States. QCSI will also pay
          all costs, damages, and attorney's fees that a court finally awards as
          a result of such claim, to the limit of QCSI's liability as determined
          by the court. QCSI's duties under this section are conditioned upon
          the following:

          1)   CLIENT shall give QCSI prompt written notice of any actual or
               threatened claim.

          2)   QCSI shall have control of the defense of any claim and of all
               negotiations for the settlement or compromise of such claim.

          3)   CLIENT shall cooperate with QCSI in the defense or settlement of
               any claim at QCSI's expense.

          4)   The claim does not arise out of CLIENT's modification of QMACS
               Software or the use of QMACS Software in combination with
               anything not approved by QCSI.

          If a patent, trade secret or copyright infringement occurs, or in
          QCSI's judgment is likely to occur, QCSI, at it's option and expense,
          may either procure the right for CLIENT to continue using the QMACS
          Software, or replace or modify it to be functionally equivalent, to
          the satisfaction of CLIENT, so that it becomes non-infringing. If
          neither of the foregoing alternatives is reasonably available in
          QCSI's judgment, CLIENT shall return all copies of QMACS Software and
          Documentation in question to QCSI upon QCSI's written request. QCSI
          shall refund the pro-rata cost of the implementation fee paid to QCSI
          of the specific module based on a five-year useful life.

IV.  GENERAL PROVISIONS

     a)   Applicable Law and Arbitration. This License shall be construed and
          interpreted in accordance with the laws of the State of Arizona and
          the venue for any dispute whatsoever shall be in the Superior Court of
          Maricopa County, Arizona. In the event that the Parties are unable to
          resolve within a reasonable time any controversy, dispute or claim
          arising out of or in connection with this License, or its
          interpretation, performance or termination, binding arbitration shall
          be conducted in accordance with the rules of the Arizona Arbitration
          Act, A.R.S. Section Section 12-1501 et seq., and the Commercial
          Arbitration Rules of the American Arbitration Association ("AAA"). In
          the event of arbitration or litigation, the prevailing Party shall be
          entitled to recover costs and expenses including reasonable attorney's
          fees.

     b)   Assignment. CLIENT has neither the power nor the right to delegate any
          duty under this License, to grant any sub-license under this License,
          or to assign or transfer the license, or any right under any agreement
          executed in connection with this license without the prior written
          approval of QCSI, which shall not be reasonably withheld. Any attempt
          by CLIENT to assign any right or duty under this license shall be void
          as a matter of law.

     c)   Export Act. CLIENT hereby warrants and certifies that no part of the
          QMACS Software, modifications thereof, documentation thereto,
          applicable manual(s) or any related item or product will be made
          available or exported to any country in contravention of any law of
          the United States, including the Export Administration Act of 1979 and
          regulations relating thereto.

     d)   Modification of the Agreement/Entire Agreement. This License
          supersedes all oral or written agreements, if any, between the Parties
          and constitutes the entire agreement between the parties with respect
          to the matters contained herein. Any modification, amendment,
          cancellation, or waiver of rights under this License shall be
          effective only if in writing signed by an Officer of the Party against
          whom enforcement of the same is sought. No waiver of any breach of
          this License shall be construed as a waiver of any other rights under
          this License. No delay in acting with regard to any breach shall be
          construed as a waiver of the breach.

     e)   Reservation of Rights. All rights of QCSI not expressly granted to
          CLIENT in writing are reserved.

     f)   Severability. In the event that any provision of this License shall
          become or be unenforceable, invalid, void or voidable, the same shall
          be limited, construed or, if necessary, limited to the extent
          necessary to remove such defect and the remaining provisions shall
          continue to bind the Parties as though the unenforceable, invalid,
          void or voidable part are not a part of the License.

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<PAGE>   4
     g)   Force Majeure. Either party shall be excused for failures and delays
          in performance of their respective obligations under this License
          caused by war, riots or insurrections, laws and regulations, strikes,
          floods, fires, explosions, or other catastrophes beyond the control
          and without the fault of such party. This provision, shall not,
          however, release such Party from using its best efforts to avoid or
          remove such cause, and such party shall continue performance hereunder
          with the utmost dispatch whenever such causes are removed. Upon
          claiming any such excuse or delay for nonperformance, such Party shall
          give prompt notice thereof to the other Party.

     h)   Recruitment of Personnel. During the initial and any subsequent term
          of this License and for a period of one (1) year thereafter, neither
          QCSI nor CLIENT will hire, employ or contract with directly or
          indirectly any key employee(s) of the other for a period of one
          hundred twenty (120) days following termination of such employee's
          employment, without the prior written consent of the other.

     i)   Exhibits. All exhibits attached to this License are incorporated into
          and made part of this License.

IN WITNESS WHEREOF, the Parties hereto have executed this License:

         QUALITY CARE SOLUTIONS, INC.
         By:  /s/ Gregory S. Anderson
         Name:    Gregory S. Anderson
         Title:   Chief Executive Officer
         Date:

         CLIENT
         By:  /s/
         Name:
         Title:   CEO
         Date:    7/28/99

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(C)Quality Care Solutions, Inc.
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<PAGE>   5
                                    EXHIBIT A

                        FEES, RATES AND PAYMENT SCHEDULE
                                   DATA CENTER

                  [Confidential treatment has been requested]

DATA CENTER/SERVICE CENTER SERVICES:

In addition to a QMACS(TM) Software license, CLIENT has elected to purchase the
following services from QCSI according to the scope of services as defined by
QCSI policies and procedures:

                         [****]     Data Center Core Solution
                           ---

                                    Data Center Core Solution Plus
                           ---

                                    Service Center Core Solution
                           ---

                                    Service Center Core Solution Plus
                           ---

SOFTWARE LICENSE FEE SCHEDULE:

In consideration for the license and services granted hereunder, CLIENT hereby
agrees to pay QCSI according to the following Software License Fee Schedule.
CLIENT hereby agrees to permit QCSI electronic access to CLIENT's enrollment
database monthly for the purpose of determining the count of active members
enrolled on the first day of the respective month for Software License Fee
billing purposes, if applicable. In the event QCSI is unable to determine the
proper enrollment on the first of each month, CLIENT agrees to accept QCSI's
estimation of the enrollment. All estimations of monthly Software License Fees
will be reconciled within ninety (90) days to a corrected amount. The Software
License Fees and the Communication Link are payable beginning with the earliest
of the effective date of this License or the activation of the WAN link and due
monthly thereafter.

         MINIMUM MONTHLY FEE:

         The Minimum Monthly Fee shall be [****] for [****].

         PMPM SOFTWARE LICENSE FEE:

         The PMPM Software License Fee shall be the following:

         Minimum Monthly Fee plus
         $ [****] Per Member Per Month ("PMPM") from [****] members per
           month plus
         $ [****] Per Member Per Month ("PMPM") over [****] members per month

         The above fees are cumulative up to the respective total number of
         CLIENT's active members being administered through the use of QMACS(TM)
         Software.

         COMMUNICATIONS LINK FEE:

         CLIENT shall pay [****] per month for WAN/Communication Link services
         required for the operation and support of QMACS(TM) Software. WAN
         Charges incurred by QCSI over the [****] will be payable by CLIENT.
         CLIENT shall be provided with advance notice if WAN charges exceed
         [****] and are subject to CLIENT's written consent.

LATE PAYMENT AND INTEREST

CLIENT agrees any payment under this Exhibit A which is more than thirty (30)
days late will accrue interest at the rate of twelve percent (12.00%) per annum
until paid in full. QCSI shall have the right to suspend all its obligations
under this License in the event that any payment is more than forty-five (45)
days late. QCSI agrees to notify CLIENT in writing at least 15 days prior to
suspending its obligations for late or non-payment.

In the event that CLIENT determines in its reasonable judgment that a billing
error has occurred, CLIENT must notify QCSI in writing within thirty (30) days
of receipt of such erroneous items. CLIENT agrees to pay all undisputed items on
an invoice, which may have disputed items contained thereon. QCSI agrees that no
interest shall be applicable for contested invoice items until thirty (30) days
following QCSI's response to CLIENT's notice of billing error.

TRAVEL AND EXPENSE GUIDELINES

CLIENT agrees to reimburse or pay QCSI for reasonable travel, lodging, and per
diem expenses for meals, which are incurred by QCSI at the CLIENT's office
within 30 days of receipt of invoice for reimbursement of expenses. Such
guidelines shall apply to all services provided by QCSI including installation
of QMACS(TM) Software, Implementation Services, Training, and Support Services.

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                    **** - Confidential Treatment Requested
<PAGE>   6
CONVERSION OPTION

At any time during the term of this License, CLIENT may exercise the option to
discontinue use of QCSI services for data center/service center programs and
convert to the standard QMACS licensing program ("Conversion"). Under such
Conversion, CLIENT shall assume QCSI's responsibilities under QCSI data
center/service program per QCSI policies and procedures. The following shall
apply the first day of the month following such Conversion:

         MINIMUM MONTHLY FEE: [Confidential treatment has been requested]

         The Minimum Monthly Fee shall be [****] for [****].

         PMPM SOFTWARE LICENSE FEE:

         The PMPM Software License Fee shall be the following PMPM Software
         License Fee to the respective level of active members:

         Minimum Monthly Fee plus
         $ [****] Per Member Per Month ("PMPM") from [****] members per month
         plus
         $ [****] Per Member Per Month ("PMPM") over [****] members per month

         The above fees are cumulative up to the respective total number of
         CLIENT's active members being administered through the use of QMACS(TM)
         Software.

         COMMUNICATIONS LINK

         CLIENT shall be financially responsible for all costs associated with
         the communication link for QCSI support.

         SUPPORT

         CLIENT shall receive standard support per QCSI policies and procedures.

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                    **** - Confidential Treatment Requested
<PAGE>   7
                                    EXHIBIT B

                         IMPLEMENTATION SERVICES PROGRAM
                                   DATA CENTER

ASSESSMENT AND IMPLEMENTATION FEE [Confidential treatment has been requested]

CLIENT agrees to pay QCSI [****] for assessment, implementation, QCSI purchase
of hardware and communications link, set-up and training for each of CLIENT's
subcontractors as mutually agreed in Exhibit C to this License; provided,
however that CLIENT shall not be required to pay QCSI such Assessment and
Implementation Fee for any subcontractor so long as CLIENT has converted from
the QCSI data center program to the standard QMACS licensing program as provided
in Exhibit A, it being understood that following such conversion: (i) CLIENT
will function as the central contact between QCSI and such subcontractor, (ii)
CLIENT will provide all administrative and processing services to such
subcontractor, (iii) QCSI will not be required to establish a separate
communications link for such subcontractor, and (iv) QCSI will not be required
to upgrade and/or purchase additional hardware for such subcontractor.

QCSI acknowledges the payment of the Assessment and Implementation Fee for El
Paso First Health Network.

IMPLEMENTATION SERVICES

For each of CLIENT's subcontractors and upon execution of an amendment to
Exhibit C to this License, the Implementation Fund will be credited with 100
Service Units. All Implementation Services rendered by QCSI on behalf of CLIENT
are charged to the Implementation Fund. Implementation Services means all
services rendered by QCSI on behalf of CLIENT during each Implementation plan
phase and as governed by IMPACT.

The Implementation Fund is reconciled upon completion of Implementation. If the
Implementation Fund has a Deficit, CLIENT must pay such Deficit within thirty
(30) days from date of notice by QCSI. Such Service Units will be charged QCSI's
prevailing rates and according to QCSI policies and procedures.

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(C)Quality Care Solutions, Inc.
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                    **** - Confidential Treatment Requested
<PAGE>   8
                                    EXHIBIT C

                             CLIENT'S SUBCONTRACTORS

QCSI acknowledges that CLIENT is providing certain administrative and management
services to CLIENT's subcontractors. QCSI grants express permission for CLIENT
to utilize QMACS in order to render such services. CLIENT shall assure that such
third parties shall agree to the terms and conditions expressed in this License
herein. CLIENT shall not be permitted to assign or sublicense QMACS without the
express written permission of QCSI.

<TABLE>
<CAPTION>
SUBCONTRACTOR                       LOCATION                  EFFECTIVE DATE
-------------                       --------                  --------------
<S>                                 <C>                       <C>
El Paso Health Network              El Paso, TX               05/01/99
</TABLE>

The monthly fees payable to QCSI pursuant to Exhibit A shall be computed based
on the total enrollment of CLIENT and all of CLIENT's subcontractors, so long as
CLIENT has converted from the data center program to the standard QMACS
licensing program, it being understood that following such conversion: (i)
CLIENT will function as the central contact between QCSI and each of CLIENT's
subcontractors, (ii) CLIENT will provide all administrative and processing
services to CLIENT's subcontractors, (iii) QCSI will not be required to
establish a separate communications link for such subcontractors, and (iv) QCSI
will not be required to upgrade and/or purchase additional hardware for such
subcontractors.

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(C)Quality Care Solutions, Inc.
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<PAGE>   9

Quality Care Solutions
Information Technology
       for Health Care

May 12, 1999

Ken Atlee
VP, Information Services
Best Health Care Management Co.
Penn Treaty Park Place
1341 No. Delaware Avenue, Ste. 500
Philadelphia, PA 19125

Dear Ken:

This is a letter of agreement for the purpose of allowing Best Health Care
Management ("CLIENT") to evaluate certain "beta" software ("Beta Software")
developed and owned by Quality Care Solutions, Inc. ("QCSI"). Please sign below
and return this original to my attention to accept the terms of this letter of
agreement ("Agreement").

/ / QCSI is granting CLIENT a non-exclusive and limited right to use the Case
    Management module of QMACS(c) including database schema. This Agreement does
    not entitle CLIENT to any documentation, support or telephone assistance.

/ / CLIENT will use Beta Software for evaluation purposes only for a period of
    no longer than sixty (60) days from the date of this Agreement. At the end
    of sixty (60) days, CLIENT will provide to QCSI a written statement
    certifying that the Beta Software was destroyed and/or permanently erased.

/ / There is no warranty for this Beta Software and QCSI shall not be liable for
    any damages or loss of data due to the use of this Beta Software.

/ / QCSI is under no obligation to develop, maintain or market the Beta
    Software. Future versions of the Beta Software, if any, may not be
    compatible with the current evaluation or beta-test release of the Software.

/ / All Terms and Conditions of the Agreement between QCSI and CLIENT effective
    May 1, 1999 remain as executed.

CLIENT agrees to the terms and conditions of this Agreement.

By:
Name:
Title:
Date:

Sincerely yours,

/s/ Kara Dowdall
----------------------------------
Kara Dowdall
Vice President, Client Communications &
  Contract Management
QCSI

[QMACS LOGO]                                                    [MICROSOFT LOGO]
 5030 E. Sunrise Drive // Phoenix, AZ 85044 // 602.940.6432 // FAX 602.940.1388

<PAGE>   10
                          QUALITY CARE SOLUTIONS, INC.

                             QMACS SOFTWARE LICENSE

                              AMENDMENT NUMBER ONE

     This is Amendment Number One to the License Agreement (the "License")
entered effective May 1, 1999 by and between Quality Care Solutions, Inc., a
Nevada corporation with its principal place of business at 5030 E. Sunrise
Drive, Phoenix, Arizona 85044 ("QCSI"), and Best Health Care Management, Inc.,
a Pennsylvania corporation with a principal place of business at Penn Treaty
Park Place, 1341 North Delaware Avenue, Philadelphia, Pennsylvania 19125
("CLIENT").

     WHEREAS, the parties wish to amend the terms of the License;

     NOW, THEREFORE, the parties hereby agree as follows:

     1.   Section I, Paragraph (a) is hereby amended by adding the following
new sentences at the end of such Paragraph:

          "The License includes the right to use newly released versions of the
          QMACS Software and updates. The currently released version of the
          QMACS Software that is being provided to CLIENT is Version 4 without
          case management and imaging functionality. Capitalized terms used but
          not defined herein shall have the meanings ascribed to such terms in
          the QCSI Client Guide (the "Client Guide"), dated February 25, 1999, a
          copy of which was provided to CLIENT, which Client Guide may be
          amended or updated from time to time provided that it does not limit
          or decrease CLIENT's rights thereunder or under the License; provided,
          however, that the definition of the term "Anomaly" in the Client
          Guide shall be deemed to include the failure of the QMACS Software to
          function, at any time during the term of this License, in accordance
          with the Documentation, the Client Guide or QCSI's responses to
          CLIENT's Request for Proposal, as such responses are reasonably
          interpreted by QCSI, or any other technical specifications published
          by QCSI; and provided, further, however, that the annual percentage
          increase in the Unit Rate for Purchased Service Units shall not be
          greater than the annual percentage increase in the Consumer Price
          Index (All Urban Consumers - U.S. City Average - All Items). The
          Client Guide is hereby incorporated herein by reference."

     2.   Section I, Paragraph (b) is hereby amended by adding the following
new sentences at the end of such Paragraph:

<PAGE>   11

          "After the initial term, QCSI shall have the right to adjust the
          software license fee rates, effective January 1 of each year, in
          accordance with QCSI's prevailing policies; provided, however, that
          in no event shall the software license fee rate be increased more
          than 3% each year. QCSI shall provide CLIENT with thirty (30) days
          prior written notice of any software license fee adjustments. Upon
          the good faith termination of this Agreement or the expiration of
          this Agreement, QCSI shall negotiate in good faith with El Paso
          County Hospital District and with CLIENT's subcontractors, including,
          without limitation, El Paso First Health Network, a Texas
          not-for-profit corporation, to grant each of them a license to use
          QMACS Software and QMACS Documentation at QCSI's prevailing rates and
          terms."

     3.   Section I, Paragraph (c) is hereby amended by adding the following new
sentences at the end of such Paragraph:

          "Notwithstanding the foregoing, QCSI acknowledges that CLIENT is
          providing certain administrative and management services to CLIENT's
          subcontractors, which includes the use of QMACS Software and QMACS
          Documentation. QCSI grants express permission for CLIENT to utilize
          QMACS Software and QMACS Documentation in order to render such
          services and, in connection therewith, for CLIENT's subcontractors to
          use QMACS Software and QMACS Documentation, provided, however, that
          any such subcontractors shall agree to the terms and conditions
          expressed in this License. CLIENT shall have the right, in its sole
          discretion, to provide such services to additional subcontractors
          other than those listed on Exhibit C to the License. CLIENT agrees to
          use reasonable commercial efforts to provide QCSI with 90 days prior
          notice if QCSI implementation work is required with respect to any
          such additional subcontractors."

     4.   Section I, Paragraph (e) is hereby amended by adding the following new
sentence at the end of such Paragraph:

          "CLIENT may terminate this License if the QMACS Software does not
          function in accordance with the QMACS Documentation, the Client Guide
          and QCSI's responses to CLIENT's Request for Proposal, as such
          responses are reasonably interpreted by QCSI, if QCSI fails to cure
          the same within the cure period set forth in the QMACS Documentation
          or the Client Guide, as applicable, or if no such cure period is set
          forth therein, then within forty-five (45) days of receipt of written
          notice thereof."

     5.   Section I, Paragraph (g) is hereby amended by adding the following new
sentence at the end of such Paragraph:

                                       2

<PAGE>   12
          "Notwithstanding the foregoing, upon expiration or termination of this
          License, QCSI shall deliver all archived data and backups to CLIENT on
          Microsoft SQL Server back-up format."

     6.   Section I, Paragraph (h) is hereby amended by adding the following
new sentence at the end of such Paragraph:

          "QCSI policies and procedures shall mean those policies and procedures
          outlined in the QCSI Client Guide."

     7.   Section II, Paragraph (f) is hereby amended by adding the following
new sentences at the end of such Paragraph:

          "The parties agree that the license granted herein is a right to
          intellectual property as that term is used in Section 365(n) of Title
          11, United States Code (the "Bankruptcy Code") and in addition to any
          other rights, Client shall have all rights under Section 365(n) of the
          Bankruptcy Code. QCSI acknowledges that if QCSI, as a
          debtor-in-possession or a Trustee in Bankruptcy in a case under the
          Bankruptcy Code, rejects the License or this Escrow Statement, Client
          may elect to retain its right under the License or this Escrow
          Statement as provided in Section 365(n) of the Bankruptcy Code. Upon
          CLIENT's written request to QCSI or such Bankruptcy Trustee, QCSI or
          such Bankruptcy Trustee shall not interfere with the right of Client
          as provided herein, including the right to obtain the Source Code."

     8.   Section III, Paragraph (a) is hereby amended as follows:

          a.   By deleting the phrase "standard computing environment" and
          replacing such phrase with "CLIENT'S computing environment, as
          reviewed and approved by QCSI."

     9.   Section III, Paragraph (d) is hereby amended by deleting the words
"THE IMPLEMENTATION FEES PAID TO QCSI" and replacing them with the following:

          "TWO HUNDRED AND FIFTY THOUSAND DOLLARS ($250,000). NOTWITHSTANDING
          THE FOREGOING, NO SUCH LIMITATION ON QCSI'S AGGREGATE LIABILITY SHALL
          APPLY WITH RESPECT TO CLAIMS ASSERTED UNDER SECTION III, PARAGRAPH (F)
          HEREOF."

10.  Section IV, Paragraph (b) is hereby amended by adding the following new
sentences at the end of such Paragraph:

          "QCSI shall not assign its rights or obligations hereunder without
prior written consent of CLIENT, which consent shall not be unreasonably
withheld. Notwithstanding the foregoing, either party shall have the right to
assign this

                                       3
<PAGE>   13
          License to any affiliate of such party with prior written notice to
          the other party."

     11.  Section IV, Paragraph (g) is hereby amended by adding the following
new sentence at the end of such Paragraph:

          "It is expressly understood that the failure of QMACS Software to
          function in accordance with the QMACS Documentation, the Client Guide
          and QCSI's responses to CLIENT's Request for Proposal, as such
          responses are reasonably interpreted by QCSI, which failure arises
          solely out of the occurrence of the Year 2000, shall not constitute a
          force majeure event as contemplated in this Paragraph (it being
          understood that the foregoing exclusion shall not apply where such
          failure is caused by power outages or other events outside of the
          control of QCSI, which events are caused by the occurrence of the Year
          2000)."

     12.  Except as expressly modified hereby, all other terms of the License
shall remain in full force and effect.

     IN WITNESS WHEREOF, the parties hereto have executed this Amendment Number
One as of the date first set forth above.

                              Quality Care Solutions, Inc.

                              By: /s/ Gregory S. Anderson
                                  --------------------------------------------
                                  Name: Gregory S. Anderson
                                  Title: President and Chief Executive Officer

                              Best Health Care Management, Inc.

                              By: /s/ Donald J. Balaban, M.D.
                                  --------------------------------------------
                                  Name: Donald J. Balaban, M.D.
                                  Title: Chief Executive Officer

                                       4
<PAGE>   14

                       QMACS(TM) IMPLEMENTATION AGREEMENT

This Agreement is made effective as of February 4, 1999 by and between Best
Health Care Management Company Inc. of Penn Treaty Park Place, 1341 N. Delaware
Ave., Philadelphia, PA 19125 referred to as ("CLIENT") and Quality Care
Solutions, Inc., of 5050 E. Sunrise Drive, Phoenix, AZ 85044 referred to as
("QCSI").

In this Agreement, the Party who is contracting to receive services shall be
referred to as CLIENT and the Party who will be providing the services shall be
referred to as QCSI (collectively "the Parties".)

                                  WITNESSETH:

Whereas, QCSI has developed a Managed Care software product referred to as
"QMACS(TM)";

Whereas, CLIENT and QCSI are negotiating the terms and conditions of a separate
agreement (QMACS(TM) System Timeshare and License Agreement, referred to as the
"Current Agreement") whereby CLIENT would license or otherwise use the
QMACS(TM) Software;

Whereas, CLIENT is negotiating certain issues with its customer concerning the
use of the QMACS(TM) Software, including whether such customer might enter into
an agreement directly with QCSI;

Whereas, CLIENT or its customer intend to enter into an agreement (either the
Current Agreement, or a QMACS(TM) DataCenter License Agreement or a QMACS(TM)
License Agreement, collectively referred to as "QMACS(TM) Agreement") with QCSI;

Whereas, CLIENT desires to begin the QMACS(TM) Software implementation process
prior to entering into any such agreement;

Whereas, QCSI is willing and able to commence the implementation process upon
execution of this QMACS(TM) Implementation Agreement;

Now, therefore, CLIENT and QCSI, intending to be legally bound, agree as
follows:

1.   SCOPE OF ENGAGEMENT AND SERVICES. Beginning on or before February 12, 1999,
     QCSI will provide Implementation services as defined in "Exhibit A - Scope
     of Work (collectively, the Services). The overall scope of this engagement
     is to assist CLIENT with installation and configuration services for the
     set-up and operation of the QMACS(TM) Software on computer and network
     systems provided by CLIENT.

2.   PERFORMANCE OF SERVICES. The manner in which the Services are performed
     and the specific hours to be worked by QCSI shall be determined by QCSI.
     The Parties agree that time is of essence and the Parties will use their
     best efforts to insure the timely progress of their respective
     responsibilities. CLIENT will rely on QCSI to work as many hours as may be
     reasonably necessary to fulfill QCSI's obligation under this Agreement.

3.   FEES AND PAYMENT. CLIENT agrees to pay QCSI for all services performed and
     billed to CLIENT by QCSI as follows: [Confidential treatment has been
     requested]

                                       1

(C)Quality Care Solutions, Inc.                                        02/03/99

                    **** - Confidential Treatment Requested
<PAGE>   15
     CLIENT agrees to pay QCSI [****] upon signing this Agreement for Services
     as set out in Exhibit A. This payment entitles CLIENT to up to one hundred
     (100) person hours of work effort for the implementation of the
     QMACS(TM)software.

     The [****] implementation payment will be applied to either the CLIENT's
     QMACS(TM) Agreement or the CLIENT's customer's QMACS(TM) Agreement if the
     customer signs a QMACS(TM) Agreement instead of the CLIENT, and in any
     case, is not refundable.

     The CLIENT will receive a written estimate of additional time required, if
     any, beyond the [****] hours stating the reason for the need for additional
     time, and that CLIENT must give prior written approval before the
     additional work starts.

     Additional time required will be charged to the CLIENT based on Service
     Units. The rate per Service Unit when billed by QCSI is $[****] per Service
     Unit per person. A Service Unit is equivalent to one (1) person hour of
     work but will be adjusted for the skill and experience level of the person
     selected or required to do the work. More experienced and senior level
     consultants or very complex tasks will be quoted from one and one-half (1
     1/2) to three times (3) the base Service Units per person hour.

     Alternatively, CLIENT can purchase Service Units in blocks of forty service
     units for a discounted amount when scheduled and paid in advance and
     according to the following service unit fee schedule:

     The rate for a [****] Service Unit block is $[****]
     The rate for a [****] Service Unit block is $[****]
     The rate for a [****] Service Unit block is $[****]
     The rate for a [****] Service Unit block is $[****]

     CLIENT agrees any payment under this section which is more than thirty (30)
     days late will accrue interest at the rate of Twelve (12%) percent per
     annum (or the highest rate of interest allowed by applicable law if lower)
     until paid in full.

4.   EXPENSE REIMBURSEMENT. QCSI shall be entitled to reimbursement from CLIENT
     for all reasonable and customary travel, food, lodging and "out of pocket"
     expenses incurred during this engagement. QCSI will use best efforts to
     utilize economy class air travel. CLIENT will approve air travel requiring
     Business Class or First Class fares in writing before ticket purchase.

5.   SUPPORT SERVICES. CLIENT will provide the following support services for
     the benefit of QCSI staff working on this engagement:
           - Conference room or office space to conduct meetings
           - Staff time and secretarial support as requested and needed
           - Access to office equipment i.e. Fax, Phone, Computer equipment
             while on site if needed.

6.   NEW PROJECT APPROVAL. Both Parties recognize that QCSI's Services could
     include working on various other associated sub-projects for CLIENT. QCSI
     and CLIENT agree all changes in project scope, deliverables and additional
     costs will be communicated and agreed to in writing, prior to the
     commencement of new services or requests.

(c) Quality Care Solutions, Inc.               2                      02/03/99

                     **** - Confidential Treatment Requested
<PAGE>   16

7.   TERM/TERMINATION.

     The term of this Agreement shall be for a period defined as the
     Effective Date of this Agreement through April 15, 1999. The parties agree
     that fees earned, billed and paid for services rendered are non-refundable
     when this Agreement is terminated.

     If the CLIENT or its customer does not execute a QMACS(TM) Agreement on or
     before March 31, 1999, then QCSI shall discontinue Implementation work
     effort and all fees and monies due QCSI shall be immediately paid to QCSI
     by CLIENT. In the event that a QMACS(TM) Agreement is not executed with
     QCSI, then neither Party will have a future claim against the other Party,
     except for any unpaid fees owing to QCSI as set forth in Section 3 - FEES
     AND PAYMENT.

     This Agreement will be superseded in its entirety by any new QMACS(TM)
     Agreement.

8.   RELATIONSHIP OF PARTIES. The parties agree that QCSI is an independent
     contractor with respect to CLIENT, and not an employee of CLIENT. CLIENT
     will not provide fringe benefits, including health insurance benefits, paid
     vacation, or any other employee benefit, for the benefit of QCSI.

9.   EMPLOYEES. QCSI'S employees, sub contractors hired by QCSI if any, who
     perform Service for CLIENT under this Agreement shall also be bound by the
     provisions of this Agreement.

10.  INTELLECTUAL PROPERTY. The following provisions shall apply with respect to
     copyrightable works, ideas, discoveries, inventions, applications for
     patents, and patents (collectively, "Intellectual Property"):

          a.   QCSI'S Intellectual Property. QCSI holds an interest in the
               Intellectual Property that is QMACS(TM) (Quality Managed Care
               Solution) Managed Care Software and various software products
               and enhancements which are products CLIENT is considering
               licensing. QCSI will be discussing QMACS(TM) trade secrets and
               intellectual property with CLIENT as a result of this engagement.
               CLIENT agrees that all notes, design documents, evaluation
               documents, schemas, questionnaires, transcribings are the sole
               property of QCSI and considered by QCSI as its intellectual
               property.

          b.   Development of Intellectual Property. Any improvements to
               Intellectual Property items of QCSI, further inventions or
               improvements, and any new items of intellectual Property
               discovered or developed by QCSI (or QCSI's employees, if any)
               during the term of this Agreement shall be the property of QCSI,
               subject to CLIENT'S right to acquire such Intellectual Property
               on terms agreeable to QCSI and CLIENT through a license
               agreement. CLIENT will not acquire development, experimentation,
               or adaptation for manufacture, sale or use.

11.  CONFIDENTIALITY. In order for the parties to discuss a potential business
     relationship, they may need to disclose confidential or proprietary
     information to each other regarding their business activities and plans,
     including but not limited to information relating to their respective
     financial results and projections, costs and prices, customers, suppliers,
     employees, consultants, technologies, database schema, intellectual
     property, documentation, software screens, development plans, technical and
     business strategies, and trade secrets (the "Confidential Information").
     Confidential Information includes draft and executed contracts and exhibits
     exchanged by the parties. The parties agree to protect each other's
     Confidential Information disclosed before or after the execution of this,
     Agreement on the following terms:

(c)Quality Care Solutions, Inc.                                         02/03/99
                                       3
<PAGE>   17
     a.   Each Party shall use its reasonable best efforts to keep the other's
          Confidential Information secret. Each Party shall use at least the
          same degree of care to avoid unauthorized disclosure or use of the
          other's Confidential Information as it employs with respect to its own
          Confidential Information of like importance.

     b.   Neither Party has any obligation with respect to any Confidential
          Information which (1) that Party independently develops; (2) is or
          becomes publicly known without a breach of this Agreement by either
          Party; (3) is disclosed to it by a third person who is not required to
          maintain its confidentiality; (4) is known by the receiving Party
          prior to the date hereof without obligations of confidentiality; or
          (5) is approved for release by the other Party in writing. The Party
          claiming any of the above exceptions has the burden of proving its
          applicability.

     c.   Each Party may disclose Confidential Information to its own officers,
          directors, employees and advisors whom reasonably needs to know it.
          Each Party shall take appropriate action (by instructions, agreement,
          or otherwise) with its employees and advisors to satisfy its
          obligations under this Agreement. Each Party shall be responsible to
          the other for any violation of this Agreement by its own officers,
          directors, employees, or advisors.

     d.   Neither Party may disclose Confidential Information to any person not
          described in Section 11 above without the prior written consent of the
          other Party, and without also first obtaining from each such person an
          agreement substantially identical to this Agreement in form (a
          "Companion Agreement").

     e.   Neither Party may print or copy, in whole or in part, any documents or
          magnetic media containing any Confidential Information without the
          prior written consent of the other Party other than copies for its
          directors, employees or advisors who are working on the matter.

     f.   Neither Party may use the other's Confidential Information for
          competing with the other or for any purpose in furtherance of the
          business relationship between them.

     g.   Each Party's Confidential Information shall remain its own property.
          Upon the termination of the business relationship or upon request,
          whichever is sooner, each Party shall return all of the other's
          Confidential Information, or destroy it and provide the other Party
          with written certification of such destruction.

     h.   If either Party becomes legally obligated, or receives a subpoena or
          other legal demand, to disclose any of the other Party's Confidential
          Information, the Party subject to the obligation shall notify the
          other Party in writing immediately, shall cooperate with the other
          Party in seeking a protective order or other appropriate remedy, and
          shall use its reasonable best efforts to protect the confidential and
          proprietary status of any disclosed Confidential Information.

     i.   Each Party agrees that in the event of a breach or threatened breach
          by either Party, including its agents, directors, or employees, of the
          provisions of this Agreement, the non-breaching Party may have no
          adequate remedy in money damages and, accordingly, shall be entitled
          to an injunction against such breach, in addition to any other legal
          or equitable remedies available to it.

     j.   Neither Party may assign its rights or obligations under this
          Agreement. No modification of this Agreement shall be effective unless
          in writing and signed by both parties. No waiver of any provision of
          this Agreement shall be effective unless signed by the waiving Party.
          This Agreement is the entire agreement between the parties on
          nondisclosure of confidential information and supersedes all prior
          representations and agreements between the parties on that subject.

11.  RETURN OF INFORMATION AND INTELLECTUAL PROPERTY. Upon termination of this
     Agreement or upon request, each Party shall deliver all intellectual
     property, software, schemas, records, notes, data, memoranda, models and
     equipment of any nature belonging to the other Party to the owner.

(c) Quality Care Solutions, Inc.                                        02/03/99
                                       4
<PAGE>   18
12.  NOTICES. All notices required or permitted under this Agreement shall be in
     writing and shall be deem delivered when delivered in person or deposited
     in the United States mail, postage prepaid and addressed as follows:

     FOR QCSI:                         FOR CLIENT:
     Chief Executive Officer           Chief Executive Officer
     Quality Care Solutions, Inc.      Best Health Care Management Company, Inc.
     5030 E. Sunrise Drive             Penn Treaty Park Place,
     Phoenix, AZ 85044                 1341 N. Delaware Ave., Suite 500
                                       Philadelphia, PA 19125

13.  ENTIRE AGREEMENT. This Agreement contains the entire Agreement of the
     parties and there are no other promises or conditions in any other
     agreements whether oral or written except as mentioned and provided for in
     this Agreement.

14.  AMENDMENT. This Agreement may be modified or amended if the amendment is
     made in writing and is signed by both parties.

15.  SEVERABILITY. If any provision of this Agreement shall be held to be
     invalid or unenforceable for any reason, the remaining provisions shall
     continue to be valid and enforceable. If a court finds that any provision
     of this Agreement is invalid or unenforceable, but that by limiting such
     provision it would become valid and enforceable, then such provision shall
     be deemed to be written, construed and enforced as so limited.

16.  WAVIER OF CONTRACTUAL RIGHT. The failure of either Party to enforce any
     provision of this Agreement shall not be construed as a wavier or
     limitation of that Party's right to subsequently enforce and compel strict
     compliance with every provision of this Agreement.

17.  APPLICABLE LAW. This Agreement is governed by the laws of Arizona without
     regard to its rules on conflicts of law, and both parties consent to the
     venue and jurisdiction of its courts.

IN WITNESS WHEREOF, the Parties hereto have executed this Agreement which is
effective as of the fourth day of February, 1999.

CLIENT:                                        QCSI:
Best Health Care Management Company, Inc.      Quality Care Solutions, Inc.

By:  /s/ Donald J. Balaban, MD                 By:  /s/ Gregory S. Anderson
     -------------------------                      ----------------------

Printed Name: Donald J. Balaban, MD            Printed Name: Gregory S. Anderson

Title:  President & CEO                        Title: President & CEO
<PAGE>   19
                                  EXHIBIT "A"

                  SCOPE OF WORK FOR IMPLEMENTATION ENGAGEMENT

OBJECTIVE OF ENGAGEMENT:
The goal of this engagement is for QCSI and CLIENT staff to configure set-up
and implement the QMACS(TM) Software for the use and benefit in the CLIENT's
business.

STATEMENT OF UNDERSTANDING:
The Parties agree that the success of this engagement is dependent upon each
other providing accurate and factual information to each other timely. The
responsibilities and tasks outlined in this exhibit require cooperative effort
and are not exclusive to one Party. The Parties agree that time is of essence
and agree to use their best efforts to meet deadlines and dates.

The Parties recognize the possibility of differences in interpretation and
meaning between the questions included in the QCSI'S questionnaire and CLIENT'S
responses thereto as incorporated herein and included in this Exhibit A, if
applicable. The Parties therefore agree that in the event of a difference of
opinion as to the nature or extent of any function to be performed by any of the
QCSI's Applications or QCSI's reasonable interpretation and meaning of a
question and/or response in the questionnaire, then the QCSI's interpretation
shall prevail.

SCOPE OF WORK TO BE PERFORMED BY QCSI:
The Scope of Work to be performed by under this Agreement is outlined in the
following document titled "DataCenter IMPACT"

                               DATACENTER IMPACT
   Implementation Model for Planned Application Configuration and Transition

                       INTRODUCTION TO DATACENTER IMPACT

DataCenter IMPACT is QCSI's Implementation Model for Planned Application
Configuration and Transition for DataCenter clients. It was developed to ensure
successful implementations of QMACS(TM) for small healthcare organizations. It
marries proven techniques for enterprise-wide deployment of technology with
tested methodologies appropriate to the unique characteristics of the
healthcare industry.

The purpose of DataCenter IMPACT is to orchestrate a smooth transition to the
QMACS system and business processes. An ideal DataCenter IMPACT project will be
evolutionary from the perspective of the end user, while being revolutionary
from the perspective of gained business intelligence and control. However,
because of the interdepartmental dependencies inherent in healthcare management
and administration, most operational departments in your organization will be
effected by QMACS(TM). Managing the changes that effect people and processes for
a positive result is the primary objective of DataCenter IMPACT.

QMACS(TM) was selected by your organization because of its unsurpassed
functionality and state-of-the-art technology. Once implemented, QMACS(TM)
positions you for rapid growth, unparalleled access to business intelligence
and protection from technology obsolescence that can compromise competitiveness
and quality initiatives. The enterprise-wide benefits of a QMACS(TM)

(c) Quality Care Solutions, Inc.        6                         02/03/99
<PAGE>   20
DataCenter IMPACT project are significant and fully justify the effort,
discipline and commitment required by your company's executive management team
and the DataCenter IMPACT team.

                           DATACENTER IMPACT PROCESS

There are six (6) phases to DataCenter IMPACT. Each phase requires its own
timeline and is dependent upon the successful completion of previous phases. A
standard DataCenter IMPACT project requires a minimum of 60 days to complete.
Your organization's ability to assist the QCSI DataCenter team and your ability
to complete each phase as quickly and accurately as possible will be the
primary contributing factors to the ability of the DataCenter IMPACT team to
meet its target dates.

DataCenter IMPACT begins the day the QMACS(TM) Software License is executed. It
ends when the first check processed by QMACS(TM) is mailed to a provider or
member. Longer time lines may be required if product enhancements are required,
the conversion effort is challenging, or the information and resources required
from your organization are not readily available.

Weekly updates during DataCenter IMPACT are generated for management review to
monitor progress and, if necessary, remove potential barriers or extend target
dates. This document describes each phase of DataCenter IMPACT with
expectations and optimal time requirements.

                         DATACENTER IMPACT PARTNERSHIP

DataCenter IMPACT is successful only when there is cohesive thinking,
planning and commitment from the QCSI DataCenter/Client partnership.

This partnership can result in growth and profitability for both organizations
and is strengthened by a shared commitment to success. While risk is an
inherent factor in any business endeavor or partnership, DataCenter IMPACT's
collaborative processes were designed to minimize or eliminate most of the
risks associated with a QMACS(TM) implementation are.

DataCenter IMPACT is a proven model. However, its success in your organization
is largely dependent on the following:

          -   The commitment and sponsorship of your executive team.

          -   A corporate initiative that encourages creativity and change.

          -   The full-time participation and direction of a DataCenter IMPACT
              project manager.

          -   The expertise and availability of your DataCenter IMPACT team.

          -   The timely completion of required tasks and activities.

From Agreement execution to completed implementation, QCSI DataCenter will
support you during the IMPACT project. In fact, QCSI assigns our own
cross-functional DataCenter IMPACT team to work with your teams throughout the
IMPACT. Experience has taught us that only through this partnership can we
mutually benefit and achieve the desired results.

                            DATACENTER IMPACT RISKS

                                        7

(c) Quality Care Solutions, Inc.                                        02/03/99
<PAGE>   21
The majority of activities that must be completed during your QMACS(TM)
implementation are based on proven standards QCSI DataCenter has implemented.
Throughout DataCenter IMPACT there will be milestones and decision points. A
great deal of work must be completed in a short amount of time. One group of
activities is often dependent upon completion of another group of activities.
Targeted completion dates can be ambitious. Resources are limited. These
characteristics provide unique challenges and are the foundation for risks
associated with a DataCenter IMPACT project. Specific elements that would
negatively affect your DataCenter IMPACT time lines include the following:

        -    Limited availability of personnel.

        -    Lack of information or incomplete information.

        -    Unrealistic deadlines or unmet deadlines and milestones.

        -    Unrealistic conversion requirements.

        -    Availability of required hardware and software.

        -    Development time for custom EDI, reports or enhanced functionality.

                            DATACENTER IMPACT TEAMS

DataCenter IMPACT requires participation by two (2) cross-functional teams of
experts - one each from QCSI and your organization. These teams should be
established immediately after your decision to implement QMACS(TM) and empowered
to operate throughout the DataCenter IMPACT project. Modifications to the size,
skill set or dedication of the recommended teams may result in an
unsatisfactory implementation that requires many months of attention before
acceptance by your staff is finally achieved. Utilization of predefined
packages offered by the DataCenter will expedite the implementation process.

STEERING COMMITTEE
This team functions as the Steering Committee for DataCenter IMPACT. It
typically meets on a monthly basis and is 'on call' as required. The Steering
Committee is responsible for DataCenter IMPACT strategy development and
management. It is charged with organizational molding and change management.
This team should be empowered with the ability to make business decisions and
effect business processes as required for successful DataCenter IMPACT
completion. The team's ability to anticipate and guide DataCenter IMPACT
activities, as well as corporate cultural conditioning, will effect the speed
with which QMACS(TM) will be integrated in your company.

DataCenter IMPACT Committee includes the following:

Executive Sponsor - Client
DataCenter IMPACT Project Manager - QCSI DataCenter
Chief Financial Officer - Client
Chief Information Officer - QCSI DataCenter
Implementation Executive - QCSI DataCenter
Account Executive - QCSI DataCenter

DATACENTER IMPACT ACTION TEAM
The second team required by DataCenter IMPACT functions as the DataCenter
IMPACT Action Team, responsible for all tasks and activities associated with
the project. Their full-time

                                       8

(c) Quality Care Solutions, Inc.                                        02/03/99
<PAGE>   22
involvement throughout DataCenter IMPACT is a requirement. Limitations in
availability or dedication during the DataCenter IMPACT process will negatively
affect the time required to complete the project as well as the degree to which
QMACS(TM) is accepted and assimilated into your organization.

DataCenter IMPACT Action Team includes the following:

      DataCenter IMPACT Project Manager - QCSI DataCenter
      Systems/Network Analyst (Communications, NT) - QCSI DataCenter
      Data Analyst (EDI, Conversion, Reporting) - QCSI DataCenter/Client
      Data Analyst (Database Administration) - QCSI DataCenter
      Help Desk Consultant** - QCSI DataCenter/Client
      Payment, Capitation, Financial Analysis Professional - Client
      Authorization/Utilization Management Professional - Client
      Claims Processing Professionals - QCSI DataCenter/Client
      Member/Benefits Professional - QCSI DataCenter/Client
      Provider/Contracts Professional - QCSI DataCenter/Client
      QCSI DataCenter Implementation Team

Team Leader
Team Members
Technical Services Analyst
Account Manager/Coordinator

**Participates in both Technical and business discussions.

                      QCSI DATACENTER IMPACT PARTICIPANTS

Several members of both QCSI and QCSI DataCenter staff are assigned to your
DataCenter IMPACT project. Two (2) QCSI executives participate on your Steering
Committee, which include the Director or Manager of DataCenter and your QCSI
Account Executive. These executives are experienced healthcare professionals
with many years' experience at the executive and management levels of major
healthcare plans.

Five (5) QCSI QMACS(TM) experts participate on your DataCenter IMPACT Action
Team. Each of these participants individually represents many years' experience
and training in a particular discipline. Together, they are an invaluable
resource to quickly, correctly and smoothly complete your DataCenter IMPACT
project.

DATACENTER/ENGINEERING SERVICES DIRECTOR
The Director or Manager of the DataCenter is responsible for the Implementation
Team, which will be a part of both the Steering Committee and the DataCenter
IMPACT Action Team. This executive's participation on your Steering Committee
solidifies and ensures QCSI commitment and execution of decisions and
activities required from the QCSI Implementation consultants.

This QCSI Executive remains actively involved in your account throughout
DataCenter IMPACT or during implementation of a new line of business where your
organization may require the assistance of an Implementation Team. A primary
responsibility of this position is to identify barriers to achieving the
Success Criteria established and agreed upon by the Steering Committee as well
as ensuring the criteria can be achieved in the time frames identified.

DATACENTER IMPLEMENTATION TEAM
Your QMACS(TM) Implementation Team will participate in the DataCenter IMPACT
Action Team. The members of the team are experienced healthcare professionals
who have received extensive training and are experienced in the QMACS(TM)
system. The Implementation Team Leader is your

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<PAGE>   23
primary contact and will be responsible for all deliverables identified in the
DataCenter IMPACT program. The team conducts the Business Assessment, develops
and presents the Assessment and prepares the QMACS(TM) sample configuration
design documents and the master DataCenter IMPACT project plan. The
Implementation Team remains assigned to your account throughout DataCenter
IMPACT.

ACCOUNT EXECUTIVE
Your QCSI Account Executive is responsible for QCSI compliance with our mutual
agreement. This executive represents QCSI on your Steering Committee and
ensures our adherence and delivery of agreed-upon contractual elements. The
Account Executive will remain actively involved in your account throughout the
term of the agreement and available at any time during and after DataCenter
IMPACT to provide your company with executive level representation.

TECHNICAL ANALYST
A QMACS(TM) Technical Analyst has a role on the DataCenter IMPACT Action Team
and is responsible for conducting the Technical Assessment. This professional
will develop and present your Technical Assessment and remains available as a
technical consultant throughout DataCenter IMPACT.

ACCOUNT MANAGER/COORDINATOR
An Account Manager and Coordinator is assigned to your account upon delivery of
the Master Project Plan. While your Implementation Team Leader is your primary
consulting contact throughout DataCenter IMPACT, the Account Manager assumes
day-to-day responsibility for coordination, scheduling and task management of
DataCenter IMPACT activities once a mutually agreed-upon DataCenter IMPACT
project plan has been developed. The QCSI Account Manager remains responsible
for coordination of day-to-day interaction with QCSI throughout the life of the
Agreement.

SUPPORT STAFF
While the above-identified QCSI and QCSI DataCenter staff are assigned to your
DataCenter IMPACT project and share responsibility for a successful and timely
implementation, a full scope of experts is available throughout the project.
These professionals will be called upon at different intervals during
DataCenter IMPACT to manage the following:

     - Design and develop custom EDI utilities or unique reports (Engineering
       Services)

     - Deliver train-the-trainer seminars and communications (Client
       Communications)

     - Deliver and install the hardware, database and software installations
       and configurations (Systems and Networks Group)

     - Assist in hardware and software audits (Technical/Systems and Network
       Services)

     - Troubleshoot problems and answer questions (Application Engineers)

     - Research, specify and evaluate unique functionality that may be
       beneficial to your organization and QMACS(TM) customer base (Business
       Analysts)

     - Respond to any activity that is related to the DataCenter IMPACT project
       that will contribute to its success.

                                TRANSITION PHASE

QCSI has the following responsibilities during the Transition Phase:

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<PAGE>   24
     - Advance your account from the Sales and Marketing focus to the Client
       Services focus. Consistency is maintained by your Account Executive, who
       remains involved with your organization throughout the life of your
       Agreement.

     - Send a DataCenter IMPACT Start Up Package to help you with the following:

          - Identify your Steering Committee and Action Team members
          - Identify your QCSI DataCenter IMPACT consultants
          - Assemble the discovery documents
          - Begin drafting your Success Criteria Document

     - Introductory meetings will be conducted with your staff (Steering
       Committee and IMPACT Action Team) to review the DataCenter IMPACT process
       and the responsibilities of each partner (QCSI DataCenter and your
       organization). This is the first opportunity for your IMPACT teams to
       meet their QCSI DataCenter counterparts.

     - Order the T1 communication line and QMACS(TM) servers according to the
       specifications as agreed by your company and QCSI.

- The Success Criteria Document is presented and reviewed by the IMPACT Action
  Team at this meeting. Revisions are made and approved by the Steering
  Committee if necessary.

CLIENT RESPONSIBILITIES
Your organization has the following responsibilities during the Transition
Phase:

     -    Begin to recruit your IMPACT teams and draft the Success Criteria
       Document upon receipt of the IMPACT Start Up package. The Success
       Criteria Document must identify measurable goals to be achieved at the
       Start Up, three-month, six-month and 12-month stages following DataCenter
       IMPACT.

     -    Participate in the Introductory Meeting.

INTRODUCTORY MEETING
The objective of the first Steering Committee meeting is to formalize and agree
upon the Success Criteria. The objective of the first Action Team meeting is to
resolve any questions or concerns related to completing the Business Analysis
Questionnaire or collecting the required discovery documents.

Presentations will be made by QCSI DataCenter staff at both meetings to
describe the DataCenter IMPACT process and QCSI DataCenter policies and
procedures for expediting each DataCenter IMPACT activity. It is expected that
this meeting will be completed at your facility and will require approximately
four hours. All IMPACT team members should have been previously recruited and
should be available to participate in these meetings.

The Assessment Meetings are scheduled at this time. Be sure to allow sufficient
time for your IMPACT staff to complete all discovery documents and return them
to the DataCenter IMPACT team members at least five (5) working days before the
Assessment Meeting date.

If you have questions when you receive your package, contact your
Implementation Team Leader at the telephone, e-mail or beeper number indicated
on the DataCenter IMPACT Contact sheet included in the Start Up package.

DURATION OF TRANSITION PHASE

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<PAGE>   25
This phase begins when your QMACS(TM) Agreement is executed and is completed
with the Introductory Meeting. The Transition Phase can be completed three (3)
weeks after the license agreement is executed.

DELIVERABLES
QCSI DataCenter     provides DataCenter IMPACT Start Up Package
                    Conduct Introductory Meeting
                    Order T1 line and QMACS(TM) server(s)

CLIENT              Draft Success Criteria Document
                    Participate in the Introductory Meeting

                                DISCOVERY PHASE

The Discovery Phase is completed when the Assessment Meeting is held. It is
expected that the Assessment Meeting will be conducted two (2) weeks after the
Introductory Meeting is held (five weeks after the license agreement is
executed). The objective of this phase is to compile a complete, documented
reference base to be used to define, configure and setup your QMACS(TM) system
for optimal performance in your business environment. Incomplete or inaccurate
information may result in a faulty or failed project.

QCSI DataCenter has the following responsibilities during the Discovery Phase:

Review Discovery Documents
Conduct Assessment Meetings

ASSESSMENT MEETINGS
The Assessment Meetings include a Technical Assessment and a Business
Assessment. QCSI DataCenter staff will chair each of these meetings and full
participation from the IMPACT Action Team is required. These meetings will be
conducted at your facility and will be held after all discovery documents are
completed and have been reviewed by your DataCenter IMPACT team members. Be
sure that all discovery documents are delivered to your DataCenter team at
least five (5) working days before the Assessment meeting.

The TECHNICAL ASSESSMENT MEETING is chaired by the DataCenter Technical Analyst
assigned to your IMPACT project. Your assigned DataCenter IMPACT Database
Analyst and Systems and Network Analyst will participate.

This meeting should be preceded by a tour of your organization with special
emphasis on your workstations. Approximately four (4) hours are required to
complete this portion of the discovery process at your facility.

The BUSINESS ASSESSMENT MEETING is chaired by the DataCenter Implementation
Team Leader assigned to your DataCenter IMPACT project. Your IMPACT Project
Manager and Professionals must participate. This meeting is dependent upon
completion of the Business Analysis Questionnaire. If this document is not
complete, and has been reviewed by the DataCenter Implementation Team Leader
prior to the Business Assessment, this meeting will be rescheduled.

This meeting should be preceded by a tour of your organization with special
emphasis on the departments that will be using QMACS(TM). Your DataCenter
IMPACT consultants will want to observe the following processes:

Enrollment of a new member
Addition of a provider or contract

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Addition of a new benefit plan
Changes to member, provider, contracts or benefit plan information
Issuing and changing authorizations
Processing claims
Generating payments for capitation and fee for service claims
Generating financial reports

Approximately two (2) days are required to complete this portion of the
discovery process at your facility.

While the above-noted assessment meetings may be scheduled for different dates,
both meetings must be successfully completed prior to development of your
DataCenter IMPACT Assessment and QMACS(TM) Design Document.

CLIENT RESPONSIBILITIES
You have the following responsibilities during the Discovery Phase:

Be prepared to provide all discovery documentation and any pertinent
information about your business and infrastructure at least five (5) working
days prior to the meeting. Key staff from your organization (in addition to
your IMPACT team) may be required to assist in process definition or business
requirements. Please ensure that this personnel is available during this
meeting.

Provide a tour of your operational facilities. This tour should occur prior to
this Assessment meeting.

DURATION OF DISCOVERY PHASE
This phase begins when you receive your Start Up package. It is completed when
all discovery documents have been provided to your DataCenter IMPACT
consultants (approximately two (2) weeks after completion of your Introductory
Meeting) and the Assessment Meetings have been completed at your site
(approximately five (5) working days after the DataCenter receives your
discovery documents). However, since the majority of the discovery effort is
dependent upon the ability of your IMPACT team to collect and document the
information, additional time may be required.

DELIVERABLES
QCSI DataCenter     Review of Discovery Documents
                    Completion of Assessment Meeting

CLIENT              Delivery of all Discovery Documents to DataCenter
                    Tour of operational facility
                    Participation in Introductory and Assessment Meetings
                    Approve Success Criteria Document

                          ASSESSMENT AND DESIGN PHASE

QCSI DataCenter has the following responsibilities during the Assessment and
Design Phase:

DataCenter IMPACT consultants will draft the Assessment document describing
your business infrastructure as it currently exists and as it will be
structured using QMACS(TM) and the DataCenter. These documents will identify
where changes in equipment, processes or staff are necessary.

The DataCenter will also develop a companion Design and Configuration Document,
which describes your QMACS(TM) system. This design/configuration represents the
optimal approach for using QMACS(TM) in your business based on:

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<PAGE>   27
The knowledge gained during the Discovery phase
Your Success Criteria document
The functionality of the QMACS(TM) system
The considerable experience of the DataCenter and QCSI(c)QCSI staff (to include
product designers and engineers where necessary).

During the presentation of these documents your Implementation Team will
provide a "Working System" demonstration of the QMACS(TM) system, configured as
well as defined by the Design/Configuration document. This demonstration
dataset will be used during later phases of your IMPACT project for customized
training and validation.

Client Responsibilities
You have the following responsibilities during the Assessment and Design Phase:

Your IMPACT team will develop a Validation Checklist identifying the tasks that
the fully implemented QMACS(TM) system will be able to demonstrate. Special
attention should be paid to WHAT task should be completed (i.e. 'issue an
authorization within 3 minutes') instead of HOW the task should be completed
(i.e. 'a single data entry screen will be used throughout the new authorization
process'). Additionally, IMPACT participants should be sure to include tasks
that demonstrate completion of the Success Criteria.

The Validation Checklist should be provided to your QCSI Implementation Team at
least five (5) working days prior to the presentation of your individualized
Assessment and QMACS(TM) Design Documents.

During this phase your IMPACT team will be collecting all data to be configured
and loaded into your QMACS(TM) system according to the checklist and worksheets
provided by your DataCenter IMPACT team members.

Duration of Assessment/Design Phase

The Assessment and Design Phase begins with the completion of the Assessment
meeting. Completion of the Assessment and Design/Configuration documents
requires a minimum of 10 working days after the completion of the Assessment
Meeting. In addition, the DataCenter must receive the Validation Document no
later than five (5) working days prior to the Assessment Review meeting. This
phase is completed when the Assessment and Design/Configuration documents are
verified by the DataCenter against your Validation Document and presented to
your IMPACT team at an Assessment Review meeting conducted at your facility.

Deliverables
QCSI DataCenter Assessment Documents (Technical and Business Assessments);
QMACS(TM) Design/Configuration Document;
QMACS(TM) 'Working System' Demonstration;
     Conduct Assessment Review Meeting

CLIENT Approved Success Criteria Document
     Develop Validation Checklist
     Participate in Assessment Review Meeting
     Assemble all data to be loaded into the QMACS(TM) system
     Approve Assessment/Configuration Document

PLANNING AND PREPARATION PHASE

     This phase begins upon your acceptance of the Assessment/Configuration
Document and is completed when all necessary data for QMACS(TM) loading is
complete. This process typically

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requires two (2) weeks but depends in large part on the availability of
information/data within your organization.

DATACENTER RESPONSIBILITIES
QCSI DataCenter has the following responsibilities during the Planning and
Preparation Phase:

The Master Project Plan will be reviewed upon approval of the Assessment,
Design/Configuration, Validation and Success Criteria Documents. The Master
Project Plan will be adjusted, if needed, to ensure timelines are met on
mutually agreed-upon dates.

Upon acceptance of the Master Project Plan by both the DataCenter and your
IMPACT team, the overall management of the IMPACT project passes to the
DataCenter Project Manager. Your QCSI Account Manager is introduced to the
IMPACT team for day-to-day coordination of project activities for which the
DataCenter is responsible or is a participant.

Development of custom EDI processes and reports will begin during this phase.
These customized executables require a minimum of 90 days to design and develop
before they will be available for testing. Development can be delayed if
information provided is incomplete or inaccurate. Response to questions
regarding these processes should be expedited. Contact your Account Manager for
information or status of EDI development.

During this phase we will provide training for your IMPACT team members at
QCSI's Phoenix Training Center.

Your T1 line and QMACS(TM) server(s) will be installed.

CLIENT RESPONSIBILITIES
You have the following responsibilities during the Planning and Preparation
Phase:

The IMPACT team is scheduled for "QMACS(TM) Complete" and 'Train-the-Trainer'
training classes at QCSI's Phoenix Training Facility.

The IMPACT team completes the collection and organization of data for
QMACS(TM) loading using the worksheets provided. Your Account Manager can
verify training schedules and requirements.

DURATION OF PLANNING AND PREPARATION PHASE
This phase begins upon acceptance of the Assessment/Configuration Document. It
includes the development, presentation and acceptance of the IMPACT Master
Project Plan. This phase is completed when training, equipment installation and
data collection/organization is concluded. This process typically requires a
minimum of eight (8) working days.

DELIVERABLES
QCSI DataCenter     IMPACT Master Project Plan
                    QMACS(TM) Complete and Train the Trainer Training
                    Install T1 line and QMACS(TM) Server(s)
Verification of delivery and installation of hardware and software required to
operate the QMACS(TM) system according to your agreement with QCSI

CLIENT              Acceptance of IMPACT Master Project Plan
                    Complete Service Project Requests for EDI and Reports
Scheduling and Completion of QMACS(TM) Complete and Train-the-Trainer training
Develop customized training materials using Trainer Curriculum provided at QCSI
Train-the-Trainer class
Completion of data collection and organization

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<PAGE>   29
                         INSTALLATION AND SET UP PHASE

DataCenter has the following responsibilities during the Installation and Set
Up Phase:

To coordinate and complete:

Validation of your QMACS(TM) server(s)
Building of your production and test databases on your QMACS(TM) database
  server
Installation of QMACS(TM) software on your server
Installation of Terminal Server Client on your QMACS(TM) and report server
Deliver client-specific training based on QMACS(TM) configuration
Perform the data load

CLIENT RESPONSIBILITIES
You have the following responsibilities during the Installation and Set Up
Phase:

Your IMPACT team will participate in customized training based on your
QMACS(TM) design by a member of your DataCenter Implementation Team. This
training will be conducted at your site. All training and validation will be
conducted using the QMACS(TM) test database.

DURATION OF INSTALLATION AND SET UP PHASE
This phase begins with the installation of your hardware and QMACS(TM) database
and software. It's complete when your DataCenter IMPACT team has loaded all
setup data. Depending on the amount of data to be loaded, and with proper
planning and preparation, the process can be completed in approximately 17
working days.

DELIVERABLES
QCSI DataCenter
     Install QMACS(TM) test and production databases and QMACS(TM) server
       software
     Install QMACS(TM) required hardware and software
     Conduct business specific training workshops
     Provide QMACS(TM) set up, depending on the agreement between your company
       and QCSI
     CLIENT Complete customized training

                                VALIDATION PHASE

DATA CENTER RESPONSIBILITIES
QCSI Data Center has the following responsibilities during the Validation Phase:

Testing of your eligibility EDI and Check.dll using your QMACS(TM) test database
will occur in this phase. While a QCSI technical consultant may be available
on-site during this test, it's typical for your IMPACT staff to execute the
check process with remote, telephone support from your QCSI Account Manager.

Execution of the Validation Checklist. Outcome of the validation process is
forwarded to the Client for review and discussion.

CLIENT RESPONSIBILITIES
You have the following responsibilities during the Validation Phase:

Test your Check.dll using your QMACS(TM) test database.

Execution of the Validation Checklist by your IMPACT team using the QMACS(TM)
test database. Where necessary and appropriate, modifications are made to the
set up and configuration. Both

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<PAGE>   30
the test and production databases will be modified, as will be the QMACS(TM)
design/configuration document

          DURATION OF VALIDATION PHASE
This phase begins when all QMACS(TM) setup has been completed in the production
database and is complete when the Validation Checklist has been reviewed. Upon
completion of the Validation Checklist the QMACS(TM) system and configuration
are considered accepted by your organization.

DELIVERABLES
QCSI DataCenter     Eligibility EDI and Check.dll
                    Execution of Validation Checklist
                    Results of Validation forwarded to Client for review

CLIENT              Check stock for testing Check.dll
                    Member/Eligibility file according to EDI specifications
                    Execution and completion of Validation Checklist

                                MIGRATION PHASE

This phase requires approximately eight (8) days to complete and begins with
the entry of the first claim to be processed by the QMACS(TM) system. It
concludes when the first check generated from QMACS(TM) is mailed to a provider
or member.

The completion of this phase constitutes finalization of 'go live'
requirements--the ability to process and pay claims with QMACS(TM). It should be
noted that an additional three to four months is typically required to
fine-tune your QMACS(TM) configuration and for your staff to complete their
initial training. During this time you should be prepared for some resistance
to change from your operational staff and for minor adjustments to be made to
both the software and your processes. Support from the Steering Committee and
executive management is essential during, and immediately after, the Migration
Phase.

QCSI DataCenter has the following responsibilities during the Migration Phase:

Your DataCenter IMPACT team (Implementation Team) remains responsible for
on-site support throughout the Migration Phase. They will arrange to be on-site
at least one day each week during this phase and will be available when you
complete your first check run. Celebration luncheons are typically scheduled
at both your site and at QCSI by your DataCenter team when this phase is
completed.

Post-DataCenter IMPACT support is provided by your Account Manager and a
Maintenance Team, who can be requested for on-site assistance, troubleshooting
and fine-tuning. Your Account Executive remains an active participant and
management resource through the critical, post-migration acceptance phase.

The DataCenter will schedule and conduct a 90-day, post-live audit at the
completion of the Migration Phase.

CLIENT RESPONSIBILITIES
You have the following responsibilities during the Migration Phase:

During this phase both the Steering Committee and Action Team must be actively
involved and supportive of operational usage and acceptance of QMACS(TM) in
your Organization. Every effort must be made to anticipate and avoid resistance
to necessary process and procedural changes in business operation.

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<PAGE>   31
Experience has shown that despite an exceptionally smooth DataCenter IMPACT
project, where every consideration has been made for current business needs and
staff acceptance, resistance from operational staff will occur. Problems and
failure to achieve production goals during this period are almost always
directly related to user resistance rather than configuration or software
functionality.

Some clients have found that incorporation 'Change Management' workshops for
their operational and managerial staff during the Migration Phase significantly
collapses the acceptance period. Financial and/or 'time off' incentives for
achievement of measurable production goals are also useful in facilitating
acceptance and reducing resistance.

DURATION OF VALIDATION PHASE
As noted above, the Migration Phase begins with the entry of the first claim
into the QMACS(TM) system and concludes with the generation of the first check
to be mailed to a provider or member. The period of time required to secure
user acceptance, however, will extend 3-4 months beyond finalization of the
Migration Phase and typically requires fine tuning of your QMACS(TM)
configuration and business processes as well as close management attention and
support.

DELIVERABLES
QCSI DataCenter     Weekly on-site assistance
                    Celebration luncheon at your site and QCSI
                    Schedule 90-day, post-live audit

CLIENT              Attention to user resistance
                    Management support of change
                    Willingness to fine tine configuration and processes

NOTE: Changes to above after sign off may result in financial impact and delays
in implementation.

(c) Quality Care Solutions, Inc.             18                         02/03/99<PAGE>   1
                                                                   Exhibit 10.14

                          QUALITY CARE SOLUTIONS, INC.

                            QMACS(TM) SOFTWARE LICENSE

This License is made and entered by and between Quality Care Solutions, Inc, a
Nevada corporation with it's principal place of business at 5030 E. Sunrise
Drive, Phoenix, AZ 85044 (hereinafter referred to as "QCSI"), and Altius Health
Plans, a Utah corporation with it's principal place of business at 10421 South
Jordan Gateway, Ste 400, South Jordan, UT 84095 (hereinafter referred to as
"CLIENT").
                               TERMS & CONDITIONS

I.       QMACS(TM) SOFTWARE LICENSE GRANT

         a)       Grant of License. QCSI hereby grants to CLIENT a
                  non-exclusive, non-transferable license ("License") to use
                  QMACS(TM) Software and QMACS(TM) Documentation. This License
                  is expressly made and granted subject to the terms,
                  conditions, limitations and restrictions as set forth herein.

         b)       Fees. To maintain its License hereunder, CLIENT shall pay to
                  QCSI all fees and costs as provided in Exhibit A to this
                  License. Provided that all fees and costs are paid timely, and
                  CLIENT complies with the terms and conditions of this License,
                  the initial term of this License shall be for a period of
                  three (3) years beginning on the first day of the month after
                  the date of execution of this License. Thereafter, the term of
                  this License shall automatically be extended for consecutive
                  additional terms of one (1) year each, unless either party
                  provides the other with written notice of such party's
                  intention not to extend the term at least one hundred twenty
                  (120) days prior to the end of the initial term or any
                  subsequent term. At such time, the license can be extended for
                  an additional sixty (60) days or upon mutual agreement of the
                  parties on a month to month basis while CLIENT converts to
                  another system.

         c)       Sole Use. This license authorizes CLIENT to use QMACS(TM) only
                  for CLIENT's own internal purposes. CLIENT shall not allow any
                  third party to access, copy or use QMACS(TM) or QMACS(TM)
                  Documentation, nor shall it use QMACS(TM) to provide
                  time-sharing or data processing services to a third party
                  without a separate written agreement with QCSI. CLIENT may
                  allow University of Utah Health Network (UUHN) and Utah Valley
                  Physicians Network (UVPN) to provide ability to issue Prior
                  Authorizations using QMACS(TM) and for View purposes only. Any
                  other additions to use of QMACS(TM) for delegated partners or
                  contracted vendors needs prior written approval by QCSI.

         d)       Ownership/Derivative Works/Safeguard. QMACS(TM) Software,
                  documentation, training materials, plans, prices,
                  configurations, specifications, techniques, algorithms,
                  schemas, screen prints and processes contained herein, or any
                  modification, extraction, or extrapolations thereof, are the
                  property and trade secrets of QCSI and are subject to
                  copyright protections. Any copyright notice does not imply
                  unrestricted or public access. No duplication, usage,
                  disclosure, or publication thereof, in whole or in part, for
                  any purpose is permitted, except that which is expressly
                  permitted by this license or other written permission of QCSI.
                  CLIENT shall include in all copies made by it notices of
                  copyright and other proprietary rights included by QCSI in or
                  on the QMACS(TM) Software and Documentation provided to
                  CLIENT. All copies of QMACS(TM) Documentation are provided to
                  CLIENT only for the duration of this License and only for the
                  purpose of facilitating the use by CLIENT of QMACS(TM). CLIENT
                  specifically agrees that any derivative works or modifications
                  of QMACS(TM) shall be the property of QCSI and CLIENT hereby
                  assigns all title and ownership interest therein to QCSI.
                  Derivative works are any modifications of QMACS(TM) Software
                  or work, which is based on QMACS(TM) Software source or object
                  code, or which requires QMACS(TM) Software to function. Such
                  derivative works shall be deemed to be QMACS(TM) for the
                  purposes of this License. QCSI's representations, warranties
                  and liabilities shall not extend to derivative works and
                  modifications. CLIENT agrees to safeguard all code against
                  non-licensed use, copying, transfer or inspection by any third
                  party. CLIENT shall require all persons and entities to whom
                  CLIENT has granted authority to save data or who have access
                  to any Executable Code to execute and submit to QCSI a
                  confidentiality agreement.

<PAGE>   2
         e)       Breach. In the event of a breach or the threat of a breach of
                  this License, QCSI, in addition to any other remedies it may
                  have at law or in equity, shall be entitled to a restraining
                  order, preliminary injunction, and other appropriate relief so
                  as to specifically enforce the terms of this License, and any
                  other agreement entered into in conjunction with this license.
                  CLIENT agrees that a breach of this License would cause QCSI
                  irreparable injury. This License may be terminated with ninety
                  (90) days prior written notice if either Party fails to comply
                  with the terms, conditions or any covenant under this License
                  and fails to perform or cure the same within forty-five (45)
                  days of receipt of written notice.

         f)       Loss or Damages to QMACS(TM) Software and QMACS(TM)
                  Documentation. In the event of loss, damage, or destruction of
                  any of the QMACS(TM) Software or QMACS(TM) Documentation, it
                  will be replaced by QCSI at the written request of CLIENT.
                  CLIENT shall pay QCSI's reasonable reproduction and delivery
                  expenses for such replacement.

         g)       Obligations Upon Termination. Upon expiration or termination
                  of the License, all Copies of QMACS(TM) Software and QMACS(TM)
                  Documentation shall promptly be delivered to QCSI or destroyed
                  by CLIENT, and CLIENT shall certify the same in writing within
                  ninety (90) days.

         h)       Standard Support. CLIENT shall receive standard support, as
                  defined by QCSI policies and procedures, during the term of
                  this License.

(c) Quality Care Solutions, Inc.              Page 1
Software License
Rev.02/16/99
<PAGE>   3
                  CLIENT shall have option to purchase additional or extended
                  support as mutually agreed by QCSI and Client.

II.      MISCELLANEOUS

         a)       QMACS(TM) Software and Documentation. QCSI will deliver at
                  least one machine-readable copy (QMACS(TM) Executable Code
                  form) of each program for each QMACS(TM) module in accordance
                  with QMACS(TM) Documentation. QCSI agrees to provide one (1)
                  hardcopy and one (1) electronic copy of QMACS(TM)
                  Documentation corresponding to each module to CLIENT as such
                  Documentation is published or updated. At CLIENT's option,
                  CLIENT may purchase additional hardcopies of Documentation
                  from QCSI at QCSI's list price in effect from time to time.

         b)       QMACS(TM) Standard Reports. QCSI will deliver a limited set of
                  standard reports with the Software. CLIENT acknowledges that
                  third-party report writing software tools are required to
                  create new reports or modify QCSI's standard reports. The
                  license fee, support and training cost for third-party report
                  writing tools are not included in this License and must be
                  acquired separately. CLIENT acknowledges that QCSI's standard
                  reports are templates and examples of reports QCSI has
                  developed for non-specific use. The CLIENT acknowledges
                  responsibility for the design, development and production of
                  its own reports, documents, letters and identification cards
                  to be used in conjunction with the Software. CLIENT agrees the
                  delivery of QMACS(TM) Standard Reports meets any report
                  production requirements of CLIENT. Training on reports
                  provided by QCSI will be limited to use of Crystal Reports,
                  Report Administrator and QCSI standard reports as they apply
                  to QCSI's standard report set.

         c)       Electronic Data Interface (EDI) Engine. QCSI will deliver a
                  method to facilitate electronic data import and export to and
                  from the QMACS(TM) database using the HIPAA mandated X.12 ASC
                  Format.

         d)       Reference Data. QCSI agrees to provide the minimal reference
                  data as required to configure and test QMACS(TM) Software.
                  QCSI agrees to provide and maintain for CLIENT the reference
                  data as outlined in EXHIBIT B, Scope of Services. For any
                  other reference data CLIENT is responsible for the annual
                  procurement, update and maintenance of all reference data.
                  QCSI agrees to provide the data table structure and interface
                  method to facilitate loading, editing and maintenance of
                  reference data required to operate QMACS(TM).

         e)       Software Modification Pursuant to Governmental Regulation.
                  After written notice to QCSI, CLIENT shall be entitled to
                  receive, without additional charge, such modifications to
                  QMACS(TM) Software as are required to reflect any mandatory
                  changes in federal government managed care regulations that
                  are applicable where CLIENT is utilizing the QMACS(TM)
                  Software. CLIENT agrees to provide said regulatory requirement
                  information to QCSI no later than ninety (90) days prior to
                  its effective date. QCSI shall provide only a single solution
                  to any given mandatory change, which is required by the
                  appropriate controlling government agency. Such solution will
                  satisfy the mandatory change required by appropriate
                  controlling government agency.

         f)       Escrow Statement. QCSI shall maintain a copy of the most
                  recent Source Code for QMACS(TM) Software with Ft. Knox Escrow
                  Services Inc. or a trustee mutually acceptable to QCSI and
                  CLIENT. In the event QCSI becomes insolvent, makes an
                  assignment of assets for the benefit of creditors, has a
                  trustee or receiver appointed (either voluntary or
                  involuntarily), is adjudicated bankrupt, or involuntary
                  bankrupt proceedings are commenced against QCSI or receiver,
                  or commences any dissolution or liquidation proceedings, then
                  the trustee shall be directed to deliver the Source Code to
                  CLIENT. In the event that QCSI does not resolve reproducible,
                  critical Anomalies as defined in EXHIBIT E within a mutually
                  agreed upon timeframe, CLIENT may obtain access to QCSI's
                  Source Code held in escrow by trustee. CLIENT shall provide
                  written notification to both QCSI and trustee of intention to
                  access Source Code. QCSI shall notify CLIENT who the appointed
                  trustee is, and give notice prior to any of the actions
                  mentioned herein. CLIENT shall reimburse QCSI for any costs of
                  Source Code escrow, escrow maintenance or Source Code access.

III.     LIMITED WARRANTY, PATENT, AND COPYRIGHT INFRINGEMENT

         a)       Limited Warranty. QCSI warrants that it shall remedy any
                  Anomaly within QCSI's support policy response time after
                  notification is received from CLIENT. Upon receipt of CLIENT's
                  notice that the Software is not functioning according to the
                  QMACS(TM) Documentation, QCSI will, without additional cost to
                  CLIENT, provide the technical and/or programming resources,
                  including personnel with the requisite expertise, necessary to
                  address and correct the problem provided that QCSI can
                  replicate the reported problem using CLIENT supplied data in a
                  standard computing environment. This warranty is conditional
                  upon CLIENT's computing environment being consistent with
                  QCSI's recommended hardware and software specifications and in
                  good working order and further provided that the Software has
                  been properly used and has not been modified and/or serviced
                  by an entity other than QCSI. QCSI does not warrant that the
                  QMACS(TM) Software will meet CLIENT's requirements or will
                  operate in the combinations which may be selected for use by
                  CLIENT, or that the operation of the QMACS(TM) Software will
                  be uninterrupted or error free. This warranty does not extend
                  to QMACS(TM) Software modified by CLIENT or for Anomalies due
                  to CLIENT misuse or third-party products. QCSI's warranty
                  covers only service to correct Anomalies reported during the
                  term of this License.

         b)       NO OTHER WARRANTIES. THE FOREGOING IS IN LIEU OF ALL OTHER
                  WARRANTIES EXPRESSED OR IMPLIED. QCSI HEREBY DISCLAIMS ALL
                  WARRANTIES NOT EXPRESSLY SET FORTH IN THIS LICENSE INCLUDING
                  BUT NOT LIMITED TO, ANY IMPLIED WARRANTIES OF MERCHANTABILITY
                  OR FITNESS FOR A PARTICULAR PURPOSE.

                                     Page 2
(c) Quality Care Solutions, Inc.
Software License
Rev. 02/16/99

<PAGE>   4
                  CLIENT HEREBY DISCLAIMS ANY RELIANCE ON ANY WARRANTY OR
                  REPRESENTATION NOT EXPRESSLY SET FORTH IN THIS LICENSE.

         c)       NO LIABILITY FOR CONSEQUENTIAL DAMAGES. IN NO EVENT WILL QCSI
                  BE LIABLE FOR ANY DAMAGES CAUSED BY CLIENT'S FAILURE TO
                  PERFORM CLIENT'S RESPONSIBILITIES, OR FOR ANY LOST PROFITS,
                  LOST SAVINGS, LOSS OF DATA, LOSS OF USE OF THE QMACS(TM),
                  COSTS OF RECREATING LOST DATA, OR ANY OTHER INDIRECT, SPECIAL
                  OR OTHER CONSEQUENTIAL DAMAGES, EVEN IF QCSI HAD BEEN ADVISED
                  OF THE POSSIBILITY OF SUCH DAMAGES, OR FOR ANY CLAIM AGAINST
                  CLIENT BY ANY OTHER PARTY.

         d)       LIMITATIONS ON LIABILITY AND REMEDIES. QCSI's AGGREGATE
                  LIABILITY FOR DAMAGES TO CLIENT FROM ANY CAUSE WHATSOEVER, AND
                  REGARDLESS OF THE FORM OF ACTION, INCLUDING CONTRACT, TORT,
                  COMPUTER MALPRACTICE, PRODUCTS LIABILITY, STRICT LIABILITY, OR
                  OTHERWISE SHALL BE LIMITED TO THE AMOUNT OF THE IMPLEMENTATION
                  FEES PAID TO QCSI.

         e)       Time Limitations. No action, regardless of form, arising out
                  of this license may be brought by CLIENT later than two (2)
                  years after the cause of action has arisen.

         f)       Indemnification. QCSI promises to indemnify CLIENT, at QCSI's
                  expense, against any claim that QMACS(TM) Software infringes
                  on a valid patent, copyright, or trade secret in the United
                  States. QCSI will also pay all costs, damages, and attorney's
                  fees that a court finally awards as a result of such claim, to
                  the limit of QCSI's liability as determined by the court.
                  QCSI's duties under this section are conditioned upon the
                  following:

                           1) CLIENT shall give QCSI prompt written notice of
                           any actual or threatened claim.

                           2) QCSI shall have control of the defense of any
                           claim and of all negotiations for the settlement or
                           compromise of such claim.

                           3) CLIENT shall cooperate with QCSI in the defense or
                           settlement of any claim at QCSI's expense.

                           4) The claim does not arise out of CLIENT's
                           modification of QMACS(TM) Software or the use of
                           QMACS(TM) Software in combination with anything not
                           approved by QCSI.

                  If a patent, trade secret or copyright infringement occurs, or
                  in QCSI's judgment is likely to occur, QCSI, at its option
                  and expense, may either procure the right for CLIENT to
                  continue using the QMACS(TM) Software, or replace or modify it
                  to be functionally equivalent, to the satisfaction of CLIENT,
                  so that it becomes non-infringing. If neither of the foregoing
                  alternatives is reasonably available in QCSI's judgment,
                  CLIENT shall return all copies of QMACS(TM) Software and
                  Documentation in question to QCSI upon QCSI's written request.
                  QCSI shall refund the pro-rata cost of the implementation fee
                  paid to QCSI of the specific module based on a three-year
                  useful life.

  III.   GENERAL PROVISIONS

         a)       Applicable Law and Arbitration. This License shall be
                  construed and interpreted in accordance with the laws of the
                  State of Arizona and the venue for any dispute whatsoever
                  shall be in the Superior Court of Maricopa County, Arizona. In
                  the event that the Parties are unable to resolve within a
                  reasonable time any controversy, dispute or claim arising out
                  of or in connection with this License, or its interpretation,
                  performance or termination, binding arbitration shall be
                  conducted in accordance with the rules of the Arizona
                  Arbitration Act, A.R.S. Sections 12-1501 et seq., and the
                  Commercial Arbitration Rules of the American Arbitration
                  Association ("AAA"). In the event of arbitration or
                  litigation, the prevailing Party shall be entitled to recover
                  costs and expenses including reasonable attorney's fees.

         b)       Assignment. CLIENT has neither the power nor the right to
                  delegate any duty under this License, to grant any sub-license
                  under the License, or to assign or transfer the license, or
                  any right under any agreement executed in connection with this
                  license without prior written approval of QCSI, which shall
                  not be reasonably withheld. Any attempt by CLIENT to assign
                  any right or duty under this license shall be void as a matter
                  of law.

         c)       Export Act. CLIENT hereby warrants and certifies that no part
                  of the QMACS(TM) Software, modifications thereof,
                  documentation thereto, applicable manual(s) or any related
                  item or product will be made available or exported to any
                  country in contravention of any law of the United States,
                  including the Export Administration Act of 1979 and
                  regulations relating thereto.

         d)       Modification of the Agreement/Entire Agreement. This License
                  supersedes all oral or written agreements, if any, between the
                  Parties and constitutes the entire agreement between the
                  parties with respect to the matters contained herein. Any
                  modification, amendment, cancellation, or waiver of rights
                  under this License shall be effective only if in writing
                  signed by an Officer of the Party against whom enforcement of
                  the same is sought. No waiver of any breach of this License
                  shall be construed as a waiver of any other rights under this
                  License. No delay in acting with regard to any breach shall be
                  construed as a waiver of the breach.

         e)       Reservation of Rights. All rights of QCSI not expressly
                  granted to CLIENT in writing are reserved.

         f)       Severability. In the event that any provision of this License
                  shall become or be unenforceable, invalid, void or voidable,
                  the same shall be limited, construed or, if necessary, limited
                  to the extent necessary to remove such defect and the
                  remaining provisions shall continue to bind the Parties as
                  though the unenforceable, invalid, void or voidable part are
                  not a part of the License.

         g)       Force Majeure. Either party shall be excused for failures and
                  delays in performance of their

                                     Page 3

(C) Quality Care Solutions, Inc.
Software License
Rev. 02/16/99
<PAGE>   5
                  respective obligations under this License caused by war, riots
                  or insurrections, laws and regulations, strikes, floods,
                  fires, explosions, or other catastrophes beyond the control
                  and without the fault of such party. This provision, shall
                  not, however, release such Party from using its best efforts
                  to avoid or remove such cause, and such party shall continue
                  performance hereunder with the utmost dispatch whenever such
                  causes are removed. Upon claiming any such excuse or delay for
                  nonperformance, such Party shall give prompt notice thereof to
                  the other Party.

         h)       Recruitment of Personnel. During the initial and any
                  subsequent term of this License and for a period of one (1)
                  year thereafter, neither QCSI nor CLIENT will hire, employ or
                  contract with directly or indirectly any key employee(s) of
                  the other for a period of one hundred twenty (120) days
                  following termination of such employee's employment, without
                  the prior written consent of the other.

         i)       All Exhibits attached to this License Agreement are
                  incorporated into and made part of this License Agreement.

IN WITNESS WHEREOF, the Parties hereto have executed this License which is
effective as first day of the month following execution:

QCSI:                                       QUALITY CARE SOLUTIONS, INC.
                                            By:      /s/ Gregory S. Anderson
                                                     --------------------------
                                            Name:    Gregory S. Anderson
                                            Title:   Chief Executive Officer
                                            Date:    2/16/99

CLIENT:                                              CLIENT
                                            By:      /s/ Larry D. Hancock
                                                     --------------------------
                                            Name:    Larry D. Hancock
                                            Title:   President
                                            Date:    2/23/99

(C) Quality Care Solutions, Inc.
Software License
Rev. 02/16/99

                                     Page 4
<PAGE>   6
                                    EXHIBIT A

                        FEES, RATES AND PAYMENT SCHEDULE
                                   DATA CENTER

DATA CENTER/SERVICE CENTER SERVICES:

In addition to a QMACS(TM) Software license, CLIENT has elected to purchase the
following services from QCSI according to the scope of services as defined
herein:

         Exhibit B Scope of Services

CONVERSION OPTION

CLIENT may elect to convert from Data Center Core Solution to Full license
QMACS(TM) agreement prior to the expiration of the 36 month agreement. In the
event CLIENT decides to convert the agreement, CLIENT agrees to pay QCSI a
conversion fee of Fifty thousand dollars ($50,000) which will cover five
hundred (500) hours of service. Any excess hours utilized will be billed at the
hourly rate of $140.00/hour. All hardware lease fees will be transferred to
CLIENT at such time and will be a continuation of the lease in place.

SOFTWARE LICENSE FEE SCHEDULE:

In consideration for the license and services granted hereunder, CLIENT hereby
agrees to pay QCSI according to the following Software License Fee Schedule.
CLIENT hereby agrees to permit QCSI electronic access to CLIENT's enrollment
database monthly for the purpose of determining the count of active members
enrolled on the first day of the respective month for Software License Fee
billing purposes. The SQL access to the member data file will be completed
within the first 5 working days of the month. The actual enrollment will vary
until adjustments are no longer made to the data base for the specific billing
date. In the event QCSI is unable to determine the proper enrollment on the
first of each month, CLIENT agrees to accept QCSI's estimation of the
enrollment. Each monthly Software License Fee subject to PMPM rate will be
reconciled within one hundred and eighty (180) days to a corrected amount. The
Software License Fee is payable beginning with the earliest of the October 1,
1999 or the first of the month of Live Operation as defined below.

         MINIMUM MONTHLY FEE: [Confidential treatment has been requested]

         The Minimum Monthly Fee for the term of the License Agreement of
         [****] shall be equal to the PMPM Software License Fee at [****]
         members of $[****].

         PMPM SOFTWARE LICENSE FEE:

         The PMPM Software License Fee shall be $[****] Per Member Per Month
         ("PMPM") over [****] members per month.

LIVE OPERATION [Confidential treatment has been requested]

Live Operation means the date the CLIENT begins using the System to enroll or
manage membership, administer providers, record or issue authorizations and pay
claims in a parallel pre-production or production environment. In the event
CLIENT begins claims processing for University of Utah employees and/or the
Public Health employees prior to the date of Live Operation, QCSI will allow
CLIENT to limit payment of PMPM fees to membership levels for these two groups
only, up to [****] members, rather than payment of PMPM fee for the minimum
membership of [****] members. ...

EARLY PAYMENT DISCOUNT

CLIENT shall be entitled to a two percent (2.00%) discount of the total monthly
software license fee if payments are made to QCSI in advance on a quarterly
basis. Payments must be received by QCSI no later than the first (1st) day of
the beginning of the calendar quarter for the discount to apply that same
calendar quarter.

LATE PAYMENT AND INTEREST

If Software License Fees are not paid within 30 days of invoice date, CLIENT
agrees to pay a late payment penalty of five percent (5.00%) of the Software
License Fee due in addition to the Software License Fee. CLIENT agrees any
payment under this Exhibit A which is more than thirty (30) days late will
accrue interest at the rate of twelve percent (12.00%) per annum (or the highest
rate of interest allowed by applicable law if lower) until paid in full. QCSI
shall have the right to suspend all its obligations under this License in the
event that any payment is more than forty-five (45) days late. QCSI agrees to
notify CLIENT in writing at least 15 days prior to suspending its obligations
for late or non-payment.

In the event that CLIENT determines in its reasonable judgment that a billing
error has occurred, CLIENT must notify QCSI in writing within thirty (30) days
of receipt of such erroneous items. CLIENT agrees to pay all undisputed items on
an invoice, which may have disputed items contained thereon. QCSI agrees that no
late payment penalty shall be applicable for contested invoice items until
thirty (30) days following QCSI's response to CLIENT's notice of billing error.

TRAVEL AND EXPENSE GUIDELINES

CLIENT agrees to reimburse or pay QCSI for reasonable travel, lodging, and per
diem expenses for meals, which are incurred by QCSI at the CLIENT's office
within 15 days of receipt of invoice for reimbursement of expenses. CLIENT
agrees to pay travel time at a reduced rate of fifty (50%) percent of the hourly
cost to a maximum of four (4) hours of travel time per day. Such guidelines
shall apply to all services provided by QCSI including installation of QMACS(TM)
Software, Implementation Services, Training, and Support Services.

Quality Care Solutions, Inc.         Page 1

                    **** - Confidential Treatment Requested
<PAGE>   7
SUPPORT [Confidential treatment has been requested]

CLIENT shall accrue [****] service units per month to be used for support
according to QCSI policies and procedures. For every thousand dollars in
software license fees paid above 100,000 members, CLIENT shall receive
additional service units at the rate of [****] per [****] of software license
fees paid.

Quality Care Solutions, Inc.            Page 2

                     **** - Confidential Treatment Requested

<PAGE>   8
                                    EXHIBIT B

                                SCOPE OF SERVICES

QCSI SHALL PROVIDE THE FOLLOWING SERVICES:

         -        INSTALL AND MAINTAIN T1 LINES

         -        PERFORM HARDWARE AUDIT - VALIDATE WORKSTATIONS/USERS ON
                  CUSTOMER SITE

         -        IDENTIFY AND INSTALL STANDARD EDI INTERFACES USING HIPAA
                  MANDATED X.12 ASC FORMAT

         -        IDENTIFY AND CREATE CUSTOMER DEFINED CHECK.DLL

         -        IDENTIFY AND INSTALL STANDARD QMACS REPORTS

         -        INSTALL, MAINTAIN AND LICENSE SERVER HARDWARE

         -        INSTALL, MAINTAIN AND LICENSE QMACS SOFTWARE

         -        INSTALL AND MAINTAIN ROUTERS

         -        INSTALL, MAINTAIN AND LICENSE CURRENT CPT-4, HCPCS, ICD-9,
                  REVENUE, RBRVS, GLOBAL DAYS, DRGS

                  -        QCSI DataCenter will purchase actual codes and
                           licensing fees at a minimum of annually

                  -        QCSI DataCenter will maintain files that are
                           considered the standards by the industry

                  -        QCSI DataCenter will maintain State specific HCPCS:
                           custom DRG tables: custom coding

         -        PERFORM DAILY SYSTEM OPERATIONS - BACKUPS

         -        INSTALL AND MAINTAIN DATABASE

         -        IMPLEMENT MUTUALLY AGREED UPON DISASTER RECOVERY PLAN

         -        IMPLEMENT AND MAINTAIN USER SECURITY ACCOUNTS

                  -        Map Client users to pre-defined roles in QMACS system

                  -        Maintain current user profile files

         -        PERFORM TRAINING FOR CLIENT AS OUTLINED IN IMPACT DOCUMENT

         -        CREATE, IMPLEMENT AND MAINTAIN CARRIER, PROGRAM, POLICY
                  APPLICATIONS

                  -        Responsible for defining Client corporate structure
                           (carrier) within QMACS

                  -        Define applicable products to each line of business
                           within QMACS

                  -        Define lines of business offered by Client's
                           corporate structure within QMACS

        -        CREATE, IMPLEMENT AND MAINTAIN CONTRACTS

                  -        Define provider reimbursement w/in QMACS based on
                           written documentation from Client

                  -        Ambiguous areas (not well defined terms) must be
                           approved by Client in writing

                  -        Client to approve all contract set up within QMACS
                           completed by DataCenter

        -        CREATE, IMPLEMENT AND MAINTAIN BENEFITS

                  -        Define Evidence of Coverage, State Statutes and/or
                           Federal Regulations within QMACS

                  -        System based on written documentation obtained from
                           Client

                  -        Ambiguous areas (not well defined terms) must be
                           approved by Client in writing

                  -        Client to approve all benefit set up within QMACS
                           completed by DataCenter

        -        CREATE, IMPLEMENT AND MAINTAIN CLAIM EDIT RULES

                  -        Define Edit Rule set up based on Client's business;
                           policies; procedures; State/Local or

                  -        Federal regulations and/or guidelines

                  -        Maintain Edit Rules in order to achieve an agreed
                           upon percentage rate of first pass adjudication

                  -        Through QMACS(TM) adjudication application

                                     Page 1

Quality Care Solutions, Inc.
Rev. 02/16/99
<PAGE>   9
         -        CREATE, IMPLEMENT AND MAINTAIN UCR AND CUSTOMER FEE SCHEDULES

                  -        QCSI DataCenter will load UCR and custom fee
                           schedules based on written documentation from Client

                  -        QCSI DataCenter will load capitation tables based on
                           written documentation from Client

 QCSI SHALL PERFORM THE FOLLOWING SERVICES:

                  -        Provide necessary hardware, software and
                           communications equipment located at CLIENT facilities
                           to maintain an emergency "hot site" as defined by
                           QCSI.

                  -        Provide hardware maintenance and equipment upgrades
                           to all servers and scanners (when scanners available)
                           as required.

                  -        As soon as available from QCSI and generally
                           available for implementation and use by CLIENT,
                           provide all required hardware and software for
                           scanning and storage sufficient to accommodate CLIENT
                           claim volume. Until such time as scanning hardware
                           and software is available and in operation by CLIENT,
                           the PMPM fee will be reduced by $ .09 PMPM. The $ .09
                           PMPM fee will be assessed when scanning functionality
                           is utilized by CLIENT.

                  -        Provide an allowance of up to $25,000 for license,
                           implementation, integration, conversion and support
                           fees for a CLIENT selected accounting package.

                  -        QCSI has provided an estimate of communication costs
                           and incorporated these costs into the PMPM fee. If at
                           a future date, significant cost savings are realized
                           due to CLIENT's ability to contract for such services
                           locally and/or newer technology is utilized which
                           provides significant cost savings, such savings will
                           be passed on to CLIENT. CLIENT will be required to
                           use the communication lines as outlined in this
                           Agreement until QCSI's contract for such lines
                           expires and the lines can be converted.

                  -        QCSI will facilitate the ability of CLIENT to
                           retrieve IVR information from the QMACS(TM) database.

                                     Page 2

Quality Care Solutions, Inc.
Rev. 02/16/99
<PAGE>   10
                                    EXHIBIT C

                         IMPLEMENTATION SERVICES PROGRAM
                                   DATA CENTER

ASSESSMENT AND IMPLEMENTATION FEE [Confidential treatment has been requested]

CLIENT agrees to pay QCSI [****] for assessment, implementation, QCSI purchase
of hardware and communications link, set-up and training.

The Assessment and Implementation fee is payable as follows:

<TABLE>
<S>               <C>
[****]            Execution of Software License
[****]            Remaining four (4) payments due on the first (1st) day of each month following execution of the
                  Software License.
</TABLE>

IMPLEMENTATION SERVICES

Upon execution of this Agreement, the Implementation Fund will be credited with
4000 Service Units. All Implementation Services rendered by QCSI on behalf of
CLIENT are charged to the Implementation Fund. Implementation Services means all
services rendered by QCSI on behalf of CLIENT during each Implementation plan
phase and as governed by IMPACT.

The Implementation Fund is reconciled upon completion of Implementation. CLIENT
will be provided with a monthly accounting of implementation hours utilized. If
the Implementation Fund has a Deficit, CLIENT must pay such Deficit within
thirty (30) days from date of notice by QCSI. Such Service Units will be charged
QCSI's prevailing rates and according to QCSI policies and procedures.

                                     Page 1

(c) Quality Care Solutions, Inc.

                     **** - Confidential Treatment Requested
<PAGE>   11
                                   EXHIBIT D
                 HARDWARE, SYSTEM SOFTWARE & SUPPORT EQUIPMENT
                      LEASE AGREEMENT TERMS AND CONDITIONS

HARDWARE, SYSTEM SOFTWARE & SUPPORT EQUIPMENT:
In addition to a QMACS(TM) Software License, CLIENT has elected to lease
equipment, system software, and support equipment from QCSI as defined herein.
For the purpose of this Exhibit D, QCSI shall be known as "Lessor" and CLIENT
shall be known as "Lessee".

RATES:
     MINIMUM MONTHLY FEE AND PMPM FEE:
     The Minimum Monthly Lease Fee shall be inclusive within the PMPM Software
     License Fee in Exhibit A to this license.

LEASE:
Lessor leases to Lessee, and Lessee hires and takes from Lessor, subject to
terms and conditions set forth in this Lease, the Units described in the
Schedules executed hereunder.

TITLE:
All equipment shall remain personal property, and the title thereto shall
remain exclusively in Lessor.

FILING:
Lessee shall execute or cause to be executed such supplemental instruments,
financing statements and landlord's waivers as Lessor deems necessary or
advisable and shall cooperate to defend the title of Lessor in the equipment by
filing or otherwise.

TAXES:
Lessee shall pay in a timely fashion, and shall indemnify and Lessor harmless
against all federal, state and local taxes, assessments, license and
registration fees.

ASSIGNMENTS AND SUBLEASES:
WITHOUT THE PRIOR WRITTEN CONSENT OF LESSOR, LESSEE SHALL NOT ASSIGN, PLEDGE,
GRANT A SECURITY INTEREST IN, OTHERWISE ENCUMBER, SUBLEASE OR TRANSFER ANY UNIT
OF EQUIPMENT OR ALL OR ANY PART OF ITS RIGHTS, AND OBLIGATIONS UNDER THIS LEASE.

LOCATION:
Lessee shall keep the Equipment at its place of business as specified in this
agreement. Lessee shall not permit any Equipment to be moved to a new location
without prior written consent of Lessor.

RIGHTS OF INSPECTION:
Lessor and its agents shall have the right, at any time during normal business
hours, to inspect the Equipment.

MAINTENANCE:
Lessee shall not make any alterations, additions or improvements to the
Equipment, which detract from its economic value or functional ability.

FINANCIAL STATEMENTS; OTHER INFORMATION:
Lessee shall provide to the Lessor financial statements prepared in accordance
with generally accepted accounting principles as a practicable after the end of
the fiscal year.

INSURANCE:
Lessee shall agree to keep all equipment at their location fully insured
against loss until the Agreement is paid in fill and to have the Lessor named
as loss payee.

DEFAULT AND REMEDIES:
If Lessee does not pay when due or if there is a breach or failure to perform
any of the covenants and promises under the Agreement or any other agreement
entered into by the Lessee and held or serviced by the Lessor or if you declare
bankruptcy or insolvency or if you dissolve or terminate your entity existence
you will be in default. Upon the occurrence and during the continuance of any
event of default the Lessor shall take possession of any or all Units of
Equipment with or without any court order or other process of law.

Quality Care Solutions, Inc.         Page 1

<PAGE>   12
                                   EXHIBIT E

                                  DEFINITIONS

The following definitions are applied during to the QMACS(TM) Software License
including but not limited to Implementation Services and Support Services:

ANOMALY or ANOMALIES means a function of QMACS(TM) Software is not working
according to QMACS(TM) Documentation.

CERTIFIED IMPLEMENTATION PARTNER or CIP means a third-party organization with
which QCSI has a business relationship and employs consultants who have been
trained, certified and authorized by QCSI to provide specific Training and
Implementation Services to QCSI clients.

CLIENT EXECUTABLE(S) means a program that resides and operates on the Client (as
in Client-Server) machine.

DATA SERVER means a computer whose hardware and software configuration have been
approved by QCSI as appropriate to execute the Data Server portions of the
QMACS(TM) Software, used to hold large amounts of electronic data plus provide
database management and access services to Client (as in Client-Server)
computers on a computer network.

QMACS(TM) DOCUMENTATION or DOCUMENTATION is instructional material designed to
educate the user with the configuration, set-up and operation of QMACS(TM)
Software modules.

ENHANCEMENT(S) mean revised Software, which QCSI may, from time to time, release
to QCSI clients, which is an update of existing QMACS(TM) Software, a new
version of QMACS(TM) Software, which may improve existing functionality, ease of
use, or productivity of the Software, including generally available
enhancements. Enhancements do not include New Software, customized versions, or
beta versions of Enhancements, which are not yet generally released to all users
of QMACS(TM) Software.

EXECUTABLE CODE means an executable program, which is part of the Software and
actually performs the functions in conjunction with the Client or the Data
Server as compared to the Source Code which is the code from which the
Executable Code is compiled.

IMPLEMENTATION means the process and activities for configuration of QMACS(TM)
Software based upon business rule definitions and set-up, input and population
of the QMACS(TM) database by electronic or manual processes, workflow or
business process adaptation including configuration and application of QMACS(TM)
for specific business needs.

INSTALLATION means the initial set-up of the Microsoft Windows(R) NT operating
system software, core relational database Microsoft SQL Server(R) software,
QMACS(TM) database tables and initial QMACS(TM) Software.

MODULE means one or more Client Executables designed to accomplish a specified
business function as listed in QMACS(TM) Documentation.

NEW SOFTWARE means new Executable Code, including beta versions of New Software,
which would allow the CLIENT to perform significantly new functions, or a family
of functions not listed in an Exhibit herein.

QMACS(TM), QMACS(TM) SOFTWARE or SOFTWARE means the current released computer
software developed and owned by QCSI including but not limited to all
executables, Modules, display screens, Source Code, and any schema, stored
procedures, triggers or wizards.

SOURCE CODE means that code from which the QMACS(TM) executables are compiled.

SUPPORT SERVICES means the variety of services offered by QCSI including
consulting, resolution of questions and issues, training, software validation,
business process improvement, database administration, systems and network
consulting detailed in QCSI policies and procedures.

TRAINING means a series of classes and/or educational materials produced by QCSI
and made available by QCSI or a CIP to teach the

(C)Quality Care Solutions, Inc.          Page 1

<PAGE>   13
steps necessary to define, set-up, configure and maintain the QMACS(TM) Software
according to QMACS(TM) Documentation.

(C)Quality Care Solutions, Inc.          Page 2
<PAGE>   14
                               AMENDMENT NUMBER 1

To the agreement between Quality Care Solutions, Inc., and Altius Health Plans,
Inc.

Quality Care Solutions, Inc. (QCSI) and Altius Health Plans, Inc. (Client) do
hereby form the following amendment as modification to the original agreement
between the parties dated February 16, 1999.

QCSI and Client agree that the work performed by QCSI submitted as QCSI invoice
number 1891.1 represents system set up tasks ordinarily performed prior to a
client's go-live on the information system. Since Client's actual go-live date
was so aggressive as to prevent completion of invoiced services prior to
Client's go-live date, these services were completed and implemented post
go-live. However, QCSI does hereby represent, and Client agrees that the service
units billed on this invoice reflect work done on a developmental basis which
are core functions to be performed by the system on an ongoing basis. QCSI's
system functionality modifications supported by this service unit billing do and
will remain in place in Client's system throughout the term of the original
agreement amended hereby.

CLIENT:

Altius Health Plans, Inc.

By:
       ----------------------------
Name:  Larry Hancock

Title: President

Date:
       ----------------------------

QCSI:

Quality Care Solutions, Inc.

By:
       ----------------------------

Name:
       ----------------------------

Title:
       ----------------------------

Date:
       ----------------------------
<PAGE>   15
                          QUALITY CARE SOLUTIONS, INC.

                          RETRO TERMINATION OF MEMBERS

The Retro Termination of Members is supported by QMACS and aQDEN through three
(3) Retro Termination Options. Each of the retro termination options requires
the manual reversal of finalized claims where recoupment of payments to
providers is desired. The reconciliation process in capitation and premium
billing from the enrollment termination date is handled correctly in each
option.

OPTION ONE

     NOT able to retro terminate a member's eligibility prior to the end date of
     any claim or authorization (regardless of status) attached to that member.
     If claims or auths exist for the member prior to the date of the
     termination, place a restriction on the member for the termination date and
     manually process (reverse, etc.) claims and authorizations. Use of a
     restriction will activate reconciliation of premium billing and capitation
     for the restriction period. Claims subsequently received with a date of
     service during the restriction period will deny if edit 217, Member has an
     active restriction on enrollment, is set to fire.

     This option must be requested by the client.

OPTION TWO

     NOT able to retro terminate a member's eligibility prior to the end date of
     a finalized claim or authorization. If an unfinalized claim with an end
     date prior to the retro termination date is attached to the member, the
     claim will automatically be reopened for adjudication. During adjudication
     it will be denied.

     If an unused authorization with an end date prior to the retro termination
     date is attached to the member, the authorization will not be closed. A
     message will be displayed to the user informing them that the member has
     open authorizations that exist after the eligibly segment's effective date
     range. The user can then abort the retro term wizard; change the end date
     on the attached authorization to reflect the member's termination; and,
     restart retro termination.

     If the desired retro termination is for a date prior to the end date of a
     finalized claim or authorization, a restriction must be placed on the
     member for the retro termination date. Use of a restriction will activate
     reconciliation of premium billing and capitation for the restriction
     period. Claims subsequently received with a date of service during the
     restriction period will deny if edit 217, Member has an active restriction
     on enrollment, is set to fire.

     If there are no finalized claims the PCP/PDP assignment will be terminated
     using the date entered for the retro termination of the enrollment. Recon
     for capitation paid out for dates after the retro termination date will be
     accurate.

Retro Termination Option Three Agreement                                  Page 1
<PAGE>   16
     While this option may require two activities to complete the retro
     termination (one for the earliest date where there are no finalized claims
     or authorizations; and a second to restrict the member for an earlier date
     where finalized claims and authorizations may exist), it is the recommended
     approach to handle retro terminations. This option is the standard approach
     delivered with the software.

OPTION THREE

     ABLE to retro terminate a member's eligibility prior to the end date of any
     claim or authorization (regardless of status).

     If an unfinalized claim with an end date prior to the retro termination
     date is attached to the member, the claim will automatically be reopened
     for adjudication. During adjudication it will be denied.

     If an unused authorization with an end date prior to the retro termination
     date is attached to the member, the authorization will not be closed. A
     message will be displayed to the user informing them that the member has
     open authorizations that exist after the eligibly segment's effective date
     range. The user can then abort the retro term wizard; revise the
     authorization to reflect the member's termination; and, restart retro
     termination.

     If the retro termination is for a date prior to the end date of a finalized
     claim or authorization, the retro termination will be allowed. No notice is
     provided to the user and these claims may later appear to have been paid
     outside a valid enrollment segment. If the paid claims are not reversed and
     recouped, financial and statistical reporting may be incorrect. Currently
     referenced data for reporting may no longer be accurate and reports and
     finance manager queries may need to be modified.

     If there are no finalized claims the PCP/PDP assignment will be terminated
     using the date entered for the retro termination of the enrollment.
     However, if a PCP/PDP assignment exists with an effective date AFTER the
     retro termination date, the old PCP assignment (previously terminated) will
     be left unchanged. The current PCP assignment will be terminated on the
     current date. The current date will be stamped in the retro termination
     date column in the enrollment table. Recon for capitation paid out (both
     PCP CAP and Global CAP) for dates after the retro termination date will be
     accurate.

     Option three is configured for clients only at their specific request and
     only after the client has read and agreed to the provisions of this
     document.

By signing this document the client understands that they are requesting
configuration of their QCSI software for Option Three Retro Termination and that
inclusion of this option in their software will potentially create the
appearance of data inconsistencies that cannot be determined at this time. No
support for any perceived defects caused by the use of this option will be
provided by QCSI. This software option is provided on an "as is" basis "with all
faults." By using this software option, you assume the entire risk as to its
quality and performance. Specifically, QCSI makes no representation or warranty
that such software option is "error-free" or meets any user's particular
standards, requirements, or needs. Should you request that Option 3 be re-set to
either Option 2 or Option 1, such request must be in writing and will be honored

Retro Termination Option Three Agreement                                  Page 2
<PAGE>   17
without charge. However you understand that this disclaimer will still apply to
any claims or data records affected by the Retro Term Option 3 prior to the
re-set.

Furthermore, you understand that use of this option may cause claims within the
database to appear to be erroneously paid outside a valid enrollment segment.
If financial and statistical reports are not modified to reference the correct
data fields, results from the reports may be incorrect. Numerous other data
relationships may appear to be affected and may result in perceived defects in
payment, reporting, etc. Finance Manager results may be indeterminate and must
be verified or may not work at all. Support for perceived errors in the
operation of the software as a result of use of this option may be unavailable
or undeliverable.

WITH REGARDS TO THE RETRO TERMINATION OPTION THREE, QCSI SPECIFICALLY DISCLAIMS
ANY CONDITIONS AND WARRANTIES, EXPRESS, IMPLIED, STATUTORY OR OTHERWISE,
INCLUDING BUT NOT LIMITED TO, ANY IMPLIED CONDITION OR WARRANTY OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.

LIMITATION OF LIABILITY - In no event will QCSI be liable for any direct or
indirect damages, including loss of profits, lost data, interruption of
business, or other special, indirect, incidental, or consequential damages of
any kind arising out of the use, reliance on or inability to use this software
option. Should it prove defective, you and not QCSI shall assume the entire
cost of all necessary servicing and repair. Such defects are not considered
"anomalies" per usual QCSI policies and procedures.

I have reviewed the disclaimer concerning Retro Termination of Members. I
request QCSI to provide Retro Termination Option Three for use by my
organization.

Lance Davis                             /s/ Lance Davis
-----------------------------           ------------------------------
Print Name                              Signature

Altius Health Plans, Inc.               10/29/99
-----------------------------           ------------------------------
Organization                            Date

Retro Termination Option Three Agreement                                  Page 3

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