Business Expansion Portfolio and Prospectus Twin City Care of The Virgin Islands 9 At TCMIH “Quality” will be the benchmark for our day to day performance. We believe quality can be measured in many ways, from customer service surveys, on time performance measures, to clinical indicator reviews and run report accuracy just to name a few. To ensure that TCMIH remains focused on providing exceptional patient care from the request for service on through to the reimbursement cycle, we have established quality assurance processes to create a culture in which quality, excellence and accuracy is our focus. To achieve this, each day we will look at the transports from the previous day and review how we performed. We will measure our on-time performance, looking at each run report line-by-line to ensure we have met our protocol requirements. We will make certain the crews have gathered the appropriate information allowing us to properly bill on behalf of the patients while maintaining compliance with all Medicare, Medicaid and other healthcare regulations. Medical Necessity Health Insurance providers and Medicare in particular, have strict guidelines on what they will cover and what is deemed as “medically necessary”. For the service to be determined medically necessary, the patient’s medical condition at the time of transport must be such that any other means of transportation would have placed the patient at risk for harm or deterioration. In addition, Medicare and Medicaid have guidelines requiring all non-emergency ambulance transports from a hospital, nursing home, physician’s office, out-patient facility or clinic to obtain a Physician’s Certification statement (PCS). We will collect this statement at the time the request for service is received as part of our normal practice. Stand By / Special Events TCMIH will provide both committed and non-committed ambulance standby / first aid station support during sporting events, community gatherings, concerts, fairs, parades,