MedE America Corporation

                                3,600,000 Shares
                                  Common Stock
                                ($.01 par value)

                             Underwriting Agreement

                                                              New York, New York
                                                                          , 1998

Smith Barney Inc.
William Blair & Company, L.L.C.
Volpe Brown Whelan & Company, LLC
As Representatives of the several Underwriters,
  c/o Smith Barney Inc.
  388 Greenwich Street
  New York, New York 10013


Ladies and Gentlemen:

          MedE America  Corporation,  a Delaware  corporation  (the  "Company"),
proposes  to sell to the  several  underwriters  named in Schedule I hereto (the
"Underwriters"),   for  whom  you  (the   "Representatives")   are   acting   as
representatives,  3,600,000  shares of  common  stock,  $.01 par value  ("Common
Stock") of the Company  (said shares to be issued and sold by the Company  being
hereinafter called the "Underwritten Securities").  The Company also proposes to
grant to the Underwriters an option to purchase up to 540,000  additional shares
of Common Stock to cover  over-allotments (the "Option  Securities";  the Option
Securities,  together with the Underwritten Securities, being hereinafter called
the "Securities").  To the extent there are no additional Underwriters listed on
Schedule I other than you,  the term  Representatives  as used herein shall mean
you, as Underwriters,  and the terms Representatives and Underwriters shall mean
either the singular or plural as the context requires. Certain terms used herein
are defined in Section 17 hereof.

          1. Representations and Warranties. The Company represents and warrants
to, and agrees with, each Underwriter as set forth below in this Section 1.

               (a) The  Company has  prepared  and filed with the  Commission  a
          registration  statement (file number 333-55977) on Form S-1, including
          a related  preliminary  prospectus,  for registration under the Act of
          the  offering and sale of the  Securities.  The Company may have filed
          one or  more  amendments  thereto, 

          including  a  related  preliminary  prospectus,   each  of  which  has
          previously  been furnished to you. The Company will next file with the
          Commission either (1) prior to the Effective Date of such registration
          statement,   a  further  amendment  to  such  registration   statement
          (including  the form of final  prospectus)  or (2) after the Effective
          Date of such registration  statement, a final prospectus in accordance
          with Rules 430A and 424(b). In the case of clause (2), the Company has
          included in such registration  statement,  as amended at the Effective
          Date, all information  (other than Rule 430A Information)  required by
          the Act and the rules  thereunder to be included in such  registration
          statement and the  Prospectus.  As filed,  such  amendment and form of
          final  prospectus,  or such final  prospectus,  shall contain all Rule
          430A Information,  together with all other such required  information,
          and, except to the extent the  Representatives  shall agree in writing
          to a modification,  shall be in all  substantive  respects in the form
          furnished  to you prior to the  Execution  Time or, to the  extent not
          completed at the  Execution  Time,  shall  contain only such  specific
          additional information and other changes (beyond that contained in the
          latest  Preliminary  Prospectus) as the Company has advised you, prior
          to the Execution Time, will be included or made therein.

               (b) On the  Effective  Date,  the  Registration  Statement did or
          will,  and when  the  Prospectus  is  first  filed  (if  required)  in
          accordance  with  Rule  424(b)  and on the  Closing  Date (as  defined
          herein) and on any date on which Option  Securities are purchased,  if
          such  date  is  not  the  Closing  Date  (a  "settlement  date"),  the
          Prospectus (and any supplements  thereto) will, comply in all material
          respects  with the  applicable  requirements  of the Act and the rules
          thereunder;  on the  Effective  Date and at the  Execution  Time,  the
          Registration  Statement  did  not  or  will  not  contain  any  untrue
          statement  of a  material  fact or omit to  state  any  material  fact
          required  to be  stated  therein  or  necessary  in  order to make the
          statements  therein not  misleading;  and, on the Effective  Date, the
          Prospectus, if not filed pursuant to Rule 424(b), will not, and on the
          date of any filing pursuant to Rule 424(b) and on the Closing Date and
          any  settlement  date,  the  Prospectus  (together with any supplement
          thereto) will not,  include any untrue statement of a material fact or
          omit to  state  a  material  fact  necessary  in  order  to  make  the
          statements therein, in the light of the circumstances under which they
          were made, not misleading;  provided,  however, that the Company makes
          no representations or warranties as to the information contained in or
          omitted from the  Registration  Statement,  or the  Prospectus (or any
          supplement   thereto)  in  reliance  upon  and  in   conformity   with
          information  furnished  herein or in writing  to the  Company by or on
          behalf of any Underwriter through the Representatives specifically for
          inclusion  in the  Registration  Statement or the  Prospectus  (or any
          supplement thereto).

               (c) Each of the Company and its  Subsidiaries (as defined herein)
          has been duly incorporated and is validly existing as a corporation in
          good  standing  under  the  laws of the  jurisdiction  in  which it is
          chartered or organized with full corporate  power and authority to own
          or  lease,  as the case may be,  and to  operate  its  properties  and
          conduct  its  business as  described  in the  Prospectus,  and is duly


                                       2

          qualified  to do  business  as a  foreign  corporation  and is in good
          standing  under  the laws of each  jurisdiction  which  requires  such
          qualification;

               (d)  All  the   outstanding   shares  of  capital  stock  of  the
          Subsidiaries  has been duly and validly  authorized and issued and are
          fully paid and  nonassessable,  and,  except as otherwise set forth in
          the  Prospectus,  all  outstanding  shares  of  capital  stock  of the
          Subsidiaries  are owned by the Company  directly free and clear of any
          perfected security interest or any other security  interests,  claims,
          liens or encumbrances;

               (e) The  Company's  authorized  equity  capitalization  is as set
          forth in the Prospectus;  the capital stock of the Company conforms in
          all  material  respects to the  description  thereof  contained in the
          Prospectus;  the outstanding shares of Common Stock have been duly and
          validly  authorized  and issued and are fully paid and  nonassessable;
          the Securities have been duly and validly authorized, and, when issued
          and  delivered  to and paid for by the  Underwriters  pursuant to this
          Agreement,  will be fully paid and  nonassessable;  the Securities are
          duly  listed,  and  admitted and  authorized  for trading,  subject to
          official notice of issuance and evidence of satisfactory distribution,
          on the Nasdaq National Market; the certificates for the Securities are
          in valid and sufficient  form;  the holders of  outstanding  shares of
          capital  stock of the Company are not entitled to  preemptive or other
          rights to subscribe for the Securities  except for such rights of WCAS
          Capital Partners II, L.P. as have been effectively waived; and, except
          as set forth in the Prospectus,  no options,  warrants or other rights
          to purchase,  agreements or other  obligations to issue,  or rights to
          convert any obligations into or exchange any securities for, shares of
          capital   stock  of  or   ownership   interests  in  the  Company  are
          outstanding;

               (f)  There  is no  franchise,  contract  or other  document  of a
          character  required to be described in the  Registration  Statement or
          Prospectus,  or to be  filed  as an  exhibit  thereto,  which  is  not
          described or filed as required;  and the  statements in the Prospectus
          under  the  headings  "Risk  Factors  --  Proposed   Healthcare   Data
          Confidentiality  Legislation," "Business -- Government Regulation" and
          "Business -- Legal  Proceedings"  fairly summarize the matters therein
          described.

               (g)  This  Agreement  has  been  duly  authorized,  executed  and
          delivered  by  the  Company  and   constitutes  a  valid  and  binding
          obligation of the Company enforceable in accordance with its terms.

               (h) The Company is not and,  after giving  effect to the offering
          and sale of the Securities and the application of the proceeds thereof
          as described in the Prospectus, will not be an "investment company" as
          defined in the Investment Company Act of 1940, as amended.

               (i) No consent, approval, authorization,  filing with or order of
          any court or  governmental  agency or body is required  in  connection
          with the

                                       3

          transactions  contemplated  herein,  except such as have been obtained
          under the Act and such as may be  required  under the blue sky laws of
          any  jurisdiction in connection with the purchase and  distribution of
          the Securities by the Underwriters in the manner  contemplated  herein
          and in the Prospectus.

               (j)  Neither  the  issue  and  sale  of the  Securities  nor  the
          consummation of any other of the transactions  herein contemplated nor
          the  fulfillment of the terms hereof will conflict  with,  result in a
          breach  or  violation  of or the  imposition  of any  lien,  charge or
          encumbrance  upon  any  property  or  assets  of  the  Company  or the
          Subsidiaries pursuant to, (i) the charter or by-laws of the Company or
          the Subsidiaries,  (ii) the terms of any indenture,  contract,  lease,
          mortgage,  deed of trust,  note  agreement,  loan  agreement  or other
          agreement, obligation,  condition, covenant or instrument to which the
          Company  or the  Subsidiaries  are a party or bound or to which its or
          their  property  is  subject,   or  (iii)  any  statute,   law,  rule,
          regulation, judgment, order or decree applicable to the Company or the
          Subsidiaries,  of any court,  regulatory body,  administrative agency,
          governmental body,  arbitrator or other authority having  jurisdiction
          over  the  Company  or  the  Subsidiaries  or  any  of  its  or  their
          properties.

               (k) No holders of  securities  of the Company  have rights to the
          registration  of such  securities  under  the  Registration  Statement
          except for such rights of WCAS Capital  Partners II, L.P. as have been
          effectively waived.

               (l)  The  consolidated   historical   financial   statements  and
          schedules of the Company and its consolidated Subsidiaries included in
          the Prospectus and the  Registration  Statement  present fairly in all
          material respects the financial  condition,  results of operations and
          cash  flows  of the  Company  as of the  dates  and  for  the  periods
          indicated,   comply  as  to  form  with  the   applicable   accounting
          requirements  of the Act and have been  prepared  in  conformity  with
          generally accepted accounting principles applied on a consistent basis
          throughout the periods  involved  (except as otherwise noted therein).
          The  selected  financial  data set forth under the  caption  "Selected
          Consolidated  Financial  Data"  in  the  Prospectus  and  Registration
          Statement  fairly  present,  on the basis stated in the Prospectus and
          the Registration Statement,  the information included therein. The pro
          forma  financial   statements  included  in  the  Prospectus  and  the
          Registration  Statement include  assumptions that provide a reasonable
          basis for presenting the significant effects directly  attributable to
          the transactions and events described  therein,  the related pro forma
          adjustments give appropriate effect to those assumptions,  and the pro
          forma adjustments  reflect the proper application of those adjustments
          to  the  historical  financial  statement  amounts  in the  pro  forma
          financial  statements  included in the Prospectus and the Registration
          Statement.   The  pro  forma  financial  statements  included  in  the
          Prospectus  and the  Registration  Statement  comply as to form in all
          material  respects  with the  applicable  accounting  requirements  of
          Regulation S-X under the Act and the pro forma  adjustments  have been
          properly applied to the historical amounts in the compilation of those
          statements.

                                       4


               (m) No  action,  suit or  proceeding  by or  before  any court or
          governmental agency, authority or body or any arbitrator involving the
          Company or the Subsidiaries or its or their property is pending or, to
          the  best  knowledge  of  the  Company,   threatened  that  (i)  could
          reasonably  be  expected  to have a  material  adverse  effect  on the
          performance  of  this  Agreement  or  the  consummation  of any of the
          transactions  contemplated hereby or (ii) could reasonably be expected
          to have a  material  adverse  effect on the  condition  (financial  or
          otherwise), prospects, earnings, business or properties of the Company
          and the  Subsidiaries,  taken as a whole,  whether or not arising from
          transactions in the ordinary  course of business,  except as set forth
          in or  contemplated  in the  Prospectus  (exclusive of any  supplement
          thereto) (a "Material Adverse Effect").

               (n) Each of the Company and the  Subsidiaries  owns or leases all
          such  properties as are necessary to the conduct of its  operations as
          presently conducted.

               (o) Neither the Company nor the  Subsidiaries  is in violation or
          default of (i) any provision of its charter or bylaws,  (ii) the terms
          of any  indenture,  contract,  lease,  mortgage,  deed of trust,  note
          agreement, loan agreement or other agreement,  obligation,  condition,
          covenant or instrument to which it is a party or bound or to which its
          property is subject,  or (iii) any  statute,  law,  rule,  regulation,
          judgment,   order  or   decree   of  any   court,   regulatory   body,
          administrative   agency,   governmental  body,   arbitrator  or  other
          authority having  jurisdiction over the Company or the Subsidiaries or
          any of its or their properties, as applicable.

               (p) Deloitte and Touche LLP, who have certified certain financial
          statements  of the  Company  and  its  consolidated  Subsidiaries  and
          delivered  their  report  with  respect  to the  audited  consolidated
          financial  statements and schedules  included in the  Prospectus,  are
          independent  public accountants with respect to the Company within the
          meaning of the Act and the applicable  published rules and regulations
          thereunder.

               (q) There are no transfer  taxes or other similar fees or charges
          under  Federal  law  or  the  laws  of any  state,  or  any  political
          subdivision  thereof,  required  to be paid  in  connection  with  the
          execution  and  delivery  of this  Agreement  or the  issuance  by the
          Company or sale by the Company of the Securities.

               (r) The Company has filed all foreign,  federal,  state and local
          tax returns that are required to be filed or has requested  extensions
          thereof  (except in any case in which the failure so to file would not
          have a Material  Adverse Effect) and has paid all taxes required to be
          paid by it and any other  assessment,  fine or penalty  levied against
          it, to the extent that any of the foregoing is due and payable, except
          for any such  assessment,  fine or  penalty  that is  currently  being
          contested  in good  faith or as  would  not  have a  Material  Adverse
          Effect.

               (s) No labor problem or dispute with the employees of the Company
          or the  Subsidiaries  exists or is  threatened  or  imminent,  and the
          Company is not aware of any existing or imminent labor  disturbance by
          the employees of any of 

                                       5

          its  or  the  Subsidiaries'   principal   suppliers,   contractors  or
          customers, that could have a Material Adverse Effect.

               (t) The Company and the  Subsidiaries  are insured by insurers of
          recognized financial  responsibility against such losses and risks and
          in such  amounts as are prudent and  customary  in the  businesses  in
          which they are  engaged;  all  policies of  insurance  and fidelity or
          surety  bonds  insuring  the  Company  or the  Subsidiaries  or  their
          respective businesses,  assets, employees,  officers and directors are
          in full force and  effect;  the Company  and the  Subsidiaries  are in
          compliance  with the terms of such  policies  and  instruments  in all
          material  respects;  and there are no  claims  by the  Company  or the
          Subsidiaries  under  any such  policy  or  instrument  as to which any
          insurance   company  is  denying   liability  or  defending   under  a
          reservation of rights clause; neither the Company nor the Subsidiaries
          have been refused any  insurance  coverage  sought or applied for; and
          neither the Company  nor the  Subsidiaries  have any reason to believe
          that it will not be able to renew its existing  insurance  coverage as
          and when such  coverage  expires or to obtain  similar  coverage  from
          similar  insurers as may be  necessary  to continue  its business at a
          cost that would not have a Material Adverse Effect.

               (u) The  Subsidiaries are not currently  prohibited,  directly or
          indirectly,  from paying any dividends to the Company, from making any
          other  distribution on the Subsidiaries'  capital stock, from repaying
          to the  Company any loans or  advances  to the  Subsidiaries  from the
          Company or from  transferring  any of the  Subsidiaries'  property  or
          assets to the Company,  except as described in or  contemplated by the
          Prospectus.

               (v)  The  Company  and the  Subsidiaries  possess  all  licenses,
          certificates,   permits  and  other   authorizations   issued  by  the
          appropriate federal, state or foreign regulatory authorities necessary
          to conduct their  respective  businesses,  and neither the Company nor
          the Subsidiaries  have received any notice of proceedings  relating to
          the revocation or modification of any such certificate,  authorization
          or permit  which,  singly or in the  aggregate,  if the  subject of an
          unfavorable decision, ruling or finding, would have a Material Adverse
          Effect.

               (w) The  Company  and  the  Subsidiaries  maintain  a  system  of
          internal   accounting   controls   sufficient  to  provide  reasonable
          assurance  that (i)  transactions  are  executed  in  accordance  with
          management's general or specific authorizations; (ii) transactions are
          recorded as necessary to permit preparation of financial statements in
          conformity  with  generally  accepted  accounting  principles  and  to
          maintain  asset  accountability;  (iii)  access to assets is permitted
          only   in   accordance   with   management's   general   or   specific
          authorization;  and (iv) the  recorded  accountability  for  assets is
          compared  with  the  existing  assets  at  reasonable   intervals  and
          appropriate action is taken with respect to any differences.

                                       6

               (x) The Company has not taken, directly or indirectly, any action
          designed  to or which has  constituted  or which might  reasonably  be
          expected to cause or result,  under the Exchange Act or otherwise,  in
          stabilization  or  manipulation  of the price of any  security  of the
          Company to facilitate the sale or resale of the Securities.

               (y) The Company and the  Subsidiaries  are (i) in compliance with
          any and all  applicable  foreign,  federal,  state and local  laws and
          regulations relating to the protection of human health and safety, the
          environment or hazardous or toxic substances or wastes,  pollutants or
          contaminants  ("Environmental  Laws"),  (ii) have  received and are in
          compliance with all permits,  licenses or other approvals  required of
          them under applicable  Environmental  Laws to conduct their respective
          businesses  and  (iii)  have not  received  notice  of any  actual  or
          potential  liability  for  the  investigation  or  remediation  of any
          disposal  or  release  of  hazardous  or toxic  substances  or wastes,
          pollutants  or  contaminants,  except where such  non-compliance  with
          Environmental  Laws, failure to receive required permits,  licenses or
          other  approvals,  or  liability  would  not,  individually  or in the
          aggregate,  have a Material Adverse Effect. Except as set forth in the
          Prospectus,  neither the Company nor the Subsidiaries  have been named
          as  a  "potentially   responsible   party"  under  the   Comprehensive
          Environmental  Response,  Compensation,  and Liability Act of 1980, as
          amended.

               (z)  In  the  ordinary  course  of  its  business,   the  Company
          periodically reviews the effect of Environmental Laws on the business,
          operations and properties of the Company and the Subsidiaries,  in the
          course  of which it  identifies  and  evaluates  associated  costs and
          liabilities (including,  without limitation,  any capital or operating
          expenditures   required  for   clean-up,   closure  of  properties  or
          compliance  with  Environmental  Laws,  or  any  permit,   license  or
          approval,  any related  constraints  on operating  activities  and any
          potential  liabilities to third parties). On the basis of such review,
          the Company has reasonably  concluded that such  associated  costs and
          liabilities  would not,  singly or in the  aggregate,  have a Material
          Adverse Effect.

               (aa) Each of the Company and the  Subsidiaries  has fulfilled its
          obligations,  if any, under the minimum  funding  standards of Section
          302 of the United States  Employee  Retirement  Income Security Act of
          1974  ("ERISA")  and the  regulations  and  published  interpretations
          thereunder  with respect to each "plan" (as defined in Section 3(3) of
          ERISA and such  regulations  and published  interpretations)  in which
          employees  of  the  Company  and  the  Subsidiaries  are  eligible  to
          participate  and  each  such  plan is in  compliance  in all  material
          respects  with the presently  applicable  provisions of ERISA and such
          regulations  and  published  interpretations.   The  Company  and  the
          Subsidiaries  have not  incurred  any unpaid  liability to the Pension
          Benefit Guaranty  Corporation  (other than for the payment of premiums
          in the ordinary course) or to any such plan under Title IV of ERISA.

                                       7


               (ab) MedE America of Ohio,  an Ohio  corporation,  and  Wellmark,
          Incorporated, a Delaware corporation, are the only subsidiaries of the
          Company (the "Subsidiaries").

               (ac) The Company and the Subsidiaries  own,  possess,  license or
          have other rights to use, on  reasonable  terms,  all patents,  patent
          applications,   trade  and  service  marks,  trade  and  service  mark
          registrations,  trade names, copyrights,  licenses,  inventions, trade
          secrets,   technology,   know-how  and  other  intellectual   property
          (collectively,  the "Intellectual Property") necessary for the conduct
          of the  Company's  business  as now  conducted  or as  proposed in the
          Prospectus  to be  conducted.  Except as set  forth in the  Prospectus
          under the caption "Business--Intellectual  Property," (a) there are no
          rights of third parties to any such Intellectual  Property;  (b) there
          is no material  infringement by third parties of any such Intellectual
          Property;  (c)  there  is  no  pending  or  threatened  action,  suit,
          proceeding or claim by others  challenging the Company's  rights in or
          to any such Intellectual  Property,  and the Company is unaware of any
          facts which  would form a  reasonable  basis for any such  claim;  (d)
          there is no pending or threatened action, suit, proceeding or claim by
          others  challenging  the  validity  or scope of any such  Intellectual
          Property,  and the  Company is unaware of any facts which would form a
          reasonable  basis  for  any  such  claim;  (e)  there  is  no  pending
          threatened  action,  suit,  proceeding  or  claim by  others  that the
          Company  infringes  or  otherwise  violates  any  patent,   trademark,
          copyright, trade secret or other proprietary rights of others, and the
          Company is unaware  of any other  fact which  would form a  reasonable
          basis for any such  claim;  (f) there is no U.S.  patent or  published
          U.S.  patent  application  which contains  claims that dominate or may
          dominate any  Intellectual  Property  described in the  Prospectus  as
          being owned by or licensed to the Company or that  interferes with the
          issued or pending claims of any such  Intellectual  Property;  and (g)
          there is no prior art of which the  Company  is aware  that may render
          any  U.S.  patent  held by the  Company  invalid  or any  U.S.  patent
          application  held by the  Company  unpatentable  which  has  not  been
          disclosed to the U.S. Patent and Trademark Office.

               (ad)  The  statements  contained  in  the  Prospectus  under  the
          captions "Risk  Factors--Dependence on Intellectual Property;  Risk of
          Infringement,"  "Business--Intellectual  Property"  and  "Business  --
          Legal Proceedings" insofar as such statements summarize legal matters,
          agreements,  documents, or proceedings discussed therein, are accurate
          and fair  summaries of such legal  matters,  agreements,  documents or
          proceedings.

               (ae) Except as disclosed in the  Registration  Statement  and the
          Prospectus,  the  Company  (i) does not have any  material  lending or
          other   relationship   with  any  bank  or  lending  affiliate  of  an
          Underwriter  and (ii) does not intend to use any of the proceeds  from
          the sale of the  Securities  hereunder to repay any  outstanding  debt
          owed to any affiliate of an Underwriter.

               (af)  The  Company  and  the   Subsidiaries  are  implementing  a
          comprehensive,  detailed  program to analyze and address the risk that
          the 
                                       8


          computer hardware and software used by them may be unable to recognize
          and properly execute date-sensitive  functions involving certain dates
          prior to and any  dates  after  December  31,  1999  (the  "Year  2000
          Problem"),  and reasonably believes that such risk will be remedied on
          a timely basis without  material  expense and will not have a Material
          Adverse Effect; and the Company believes, after due inquiry, that each
          supplier,  vendor,  customer or financial service organization used or
          serviced  by the  Company and the  Subsidiaries  has  remedied or will
          remedy on a timely basis the Year 2000  Problem,  except to the extent
          that a failure to remedy by any such  supplier,  vendor,  customer  or
          financial  service  organization  would  not have a  Material  Adverse
          Effect.  The Company is in compliance with the Commissions staff legal
          bulletin No. 5 dated January 12, 1998 related to Year 2000 compliance.

               (ag) Any  certificate  signed by any  officer of the  Company and
          delivered to the  Representatives  or counsel for the  Underwriters in
          connection  with the  offering  of the  Securities  shall be  deemed a
          representation  and  warranty by the  Company,  as to matters  covered
          thereby, to each Underwriter.

               2. Purchase and Sale.

               (a) Subject to the terms and  conditions and in reliance upon the
          representations and warranties herein set forth, the Company agrees to
          sell to each Underwriter,  and each Underwriter agrees,  severally and
          not jointly,  to purchase from the Company,  at a purchase  price of $
          per  share,  the  amount  of the  Underwritten  Securities  set  forth
          opposite such Underwriter's name in Schedule I hereto.

               (b) Subject to the terms and  conditions and in reliance upon the
          representations  and warranties  herein set forth,  the Company hereby
          grants an option to the several  Underwriters  to purchase,  severally
          and not jointly,  up to 540,000 Option Securities at the same purchase
          price per  share as the  Underwriters  shall pay for the  Underwritten
          Securities. Said option may be exercised only to cover over-allotments
          in the sale of the Underwritten  Securities by the Underwriters.  Said
          option may be  exercised in whole or in part at any time (but not more
          than once) on or before the 30th day after the date of the  Prospectus
          upon  written  or  telegraphic  notice by the  Representatives  to the
          Company setting forth the number of shares of the Option Securities as
          to which the several  Underwriters  are  exercising the option and the
          settlement  date.  The number of Option  Securities to be purchased by
          each  Underwriter  shall be the same percentage of the total number of
          shares  of the  Option  Securities  to be  purchased  by  the  several
          Underwriters  as such  Underwriter  is purchasing of the  Underwritten
          Securities,  subject  to  such  adjustments  as you in  your  absolute
          discretion shall make to eliminate any fractional shares.

          3. Delivery and Payment.  Delivery of and payment for the Underwritten
Securities and the Option Securities (if the option provided for in Section 2(b)
hereof shall have been  exercised  on or before the third  Business Day prior to
the


                                       9

Closing  Date) shall be made at 10:00 AM, New York City time,  on , 1998,  or at
such  time on such  later  date not more  than  three  Business  Days  after the
foregoing date as the Representatives  shall designate,  which date and time may
be  postponed  by agreement  between the  Representatives  and the Company or as
provided in Section 9 hereof (such date and time of delivery and payment for the
Securities being herein called the "Closing  Date").  Delivery of the Securities
shall be made to the  Representatives for the respective accounts of the several
Underwriters   against   payment  by  the  several   Underwriters   through  the
Representatives  of the  purchase  price  thereof  to or upon  the  order of the
Company by wire transfer  payable in same-day  funds to an account  specified by
the Company.  Delivery of the Underwritten  Securities and the Option Securities
shall be made through the facilities of The Depository  Trust Company unless the
Representatives shall otherwise instruct.

          If the option  provided for in Section 2(b) hereof is exercised  after
the third  Business Day prior to the Closing Date,  the Company will deliver the
Option Securities (at the expense of the Company) to the  Representatives on the
date specified by the Representatives (which shall be within three Business Days
after  exercise  of said  option)  for the  respective  accounts  of the several
Underwriters,   against  payment  by  the  several   Underwriters   through  the
Representatives  of the  purchase  price  thereof  to or upon  the  order of the
Company by wire transfer  payable in same-day  funds to an account  specified by
the Company.  If settlement for the Option  Securities  occurs after the Closing
Date, the Company will deliver to the Representatives on the settlement date for
the Option  Securities,  and the obligation of the  Underwriters to purchase the
Option Securities shall be conditioned upon receipt of,  supplemental  opinions,
certificates and letters  confirming as of such date the opinions,  certificates
and letters delivered on the Closing Date pursuant to Section 6 hereof.

          4.  Offering  by  Underwriters.  It is  understood  that  the  several
Underwriters propose to offer the Securities for sale to the public as set forth
in the Prospectus.

          5. Agreements. The Company agrees with the several Underwriters that:

               (a)  The  Company   will  use  its  best  efforts  to  cause  the
          Registration  Statement,  if not effective at the Execution  Time, and
          any amendment thereof,  to become effective.  Prior to the termination
          of the  offering  of the  Securities,  the  Company  will not file any
          amendment  of  the   Registration   Statement  or  supplement  to  the
          Prospectus  or any  Rule  462(b)  Registration  Statement  unless  the
          Company has  furnished  you a copy for your review prior to filing and
          will not file any such  proposed  amendment or supplement to which you
          reasonably  object.   Subject  to  the  foregoing  sentence,   if  the
          Registration  Statement  has become or becomes  effective  pursuant to
          Rule 430A,  or filing of the  Prospectus is otherwise  required  under
          Rule  424(b),   the  Company  will  cause  the  Prospectus,   properly
          completed,  and any supplement thereto to be filed with the Commission
          pursuant to the  applicable  paragraph of Rule 424(b)  within the time
          period  prescribed  and  will  provide  evidence  satisfactory  to the
          Representatives  of such  timely  filing. 

                                       10


          The Company  will  promptly  advise the  Representatives  (1) when the
          Registration  Statement, if not effective at the Execution Time, shall
          have become  effective,  (2) when the  Prospectus,  and any supplement
          thereto,  shall  have been  filed (if  required)  with the  Commission
          pursuant to Rule 424(b) or when any Rule 462(b) Registration Statement
          shall  have  been  filed  with  the  Commission,  (3)  when,  prior to
          termination  of the offering of the  Securities,  any amendment to the
          Registration Statement shall have been filed or become effective,  (4)
          of any request by the Commission or its staff for any amendment of the
          Registration  Statement, or any Rule 462(b) Registration Statement, or
          for  any   supplement  to  the   Prospectus  or  for  any   additional
          information,  (5) of the issuance by the  Commission of any stop order
          suspending  the  effectiveness  of the  Registration  Statement or the
          institution  or threatening of any proceeding for that purpose and (6)
          of the receipt by the Company of any notification  with respect to the
          suspension  of the  qualification  of the  Securities  for sale in any
          jurisdiction  or the  institution or threatening of any proceeding for
          such  purpose.  The Company  will use its best  efforts to prevent the
          issuance  of any  such  stop  order  or  the  suspension  of any  such
          qualification  and,  if  issued,  to  obtain as soon as  possible  the
          withdrawal thereof.

               (b) If, at any time when a prospectus  relating to the Securities
          is  required  to be  delivered  under the Act,  any event  occurs as a
          result of which the Prospectus as then supplemented  would include any
          untrue statement of a material fact or omit to state any material fact
          necessary  to  make  the  statements  therein  in  the  light  of  the
          circumstances  under  which  they were made not  misleading,  or if it
          shall be necessary to amend the  Registration  Statement or supplement
          the  Prospectus  to comply with the Act or the rules  thereunder,  the
          Company  promptly  will (1)  notify  the  Representatives  of any such
          event; (2) prepare and file with the Commission, subject to the second
          sentence  of  paragraph  (a)  of  this  Section  5,  an  amendment  or
          supplement  which will  correct  such  statement or omission or effect
          such compliance;  and (3) supply any supplemented Prospectus to you in
          such  quantities  as  you  may  reasonably  request.

               (c) As soon as  practicable,  the  Company  will  make  generally
          available  to its  security  holders  and to  the  Representatives  an
          earnings  statement or statements of the Company and the  Subsidiaries
          which will satisfy the provisions of Section 11(a) of the Act and Rule
          158 under the Act.

               (d) The Company will furnish to the  Representatives  and counsel
          for the  Underwriters  signed  copies  of the  Registration  Statement
          (including  exhibits  thereto) and to each other Underwriter a copy of
          the Registration  Statement (without exhibits thereto) and, so long as
          delivery of a prospectus by an  Underwriter  or dealer may be required
          by the Act,  as many  copies of each  Preliminary  Prospectus  and the
          Prospectus  and any  supplement  thereto  as the  Representatives  may
          reasonably request.

               (e) The Company will arrange, if necessary, for the qualification
          of the Securities for sale under the laws of such jurisdictions as the
          Representatives may designate and will maintain such qualifications in
          effect so long as required  for

                                       11


          the  distribution of the  Securities;  provided that in no event shall
          the Company be obligated to qualify to do business in any jurisdiction
          where it is not now so  qualified  or to take any  action  that  would
          subject it to service  of process in suits,  other than those  arising
          out of the  offering or sale of the  Securities,  in any  jurisdiction
          where it is not now so subject.

               (f) The Company will not,  without the prior  written  consent of
          Salomon Smith Barney, for a period of 180 days following the Execution
          Time,  offer,  sell or contract to sell,  or otherwise  dispose of (or
          enter into any transaction  which is designed to, or might  reasonably
          be  expected  to,  result  in  the  disposition   (whether  by  actual
          disposition or effective  economic  disposition due to cash settlement
          or  otherwise)  by the Company or any  affiliate of the Company or any
          person in privity  with the Company or any  affiliate  of the Company)
          directly or indirectly,  or announce the offering of, any other shares
          of Common Stock or any securities  convertible  into, or  exchangeable
          for, shares of Common Stock;  provided,  however, that the Company may
          issue and sell Common  Stock  pursuant to any  employee  stock  option
          plan,  stock  ownership  plan  or  dividend  reinvestment  plan of the
          Company  in effect at the  Execution  Time and the  Company  may issue
          Common  Stock  issuable  upon  the  conversion  of  securities  or the
          exercise  of  warrants  outstanding  at the  Execution  Time.

               (g) The Company will not take, directly or indirectly, any action
          designed  to or which has  constituted  or which might  reasonably  be
          expected to cause or result,  under the Exchange Act or otherwise,  in
          stabilization  or  manipulation  of the price of any  security  of the
          Company to facilitate the sale or resale of the Securities.

               (h) The Company agrees to pay the costs and expenses  relating to
          the following matters:  (i) the preparation,  printing or reproduction
          and  filing  with  the  Commission  of  the   Registration   Statement
          (including   financial   statements   and  exhibits   thereto),   each
          Preliminary  Prospectus,   the  Prospectus,   and  each  amendment  or
          supplement  to any of them;  (ii) the printing (or  reproduction)  and
          delivery  (including  postage,  air  freight  charges  and charges for
          counting and packaging) of such copies of the Registration  Statement,
          each  Preliminary  Prospectus,  the Prospectus,  and all amendments or
          supplements  to any of  them,  as may,  in each  case,  be  reasonably
          requested  for use in  connection  with the  offering  and sale of the
          Securities; (iii) the preparation, printing, authentication,  issuance
          and delivery of certificates  for the Securities,  including any stamp
          or transfer taxes in connection with the original issuance and sale of
          the Securities;  (iv) the printing (or  reproduction)  and delivery of
          this  Agreement,  any blue sky memorandum and all other  agreements or
          documents printed (or reproduced) and delivered in connection with the
          offering of the  Securities;  (v) the  registration  of the Securities
          under the Exchange Act and the listing of the Securities on the Nasdaq
          National  Market;  (vi)  any  registration  or  qualification  of  the
          Securities for offer and sale under the securities or blue sky laws of
          the several states  (including filing fees and the reasonable fees and
          expenses of counsel for the Underwriters relating to such registration
          and  qualification);  (vii) any  filings  required to be

                                       12



          made  with  the  National  Association  of  Securities  Dealers,  Inc.
          (including filing fees and the reasonable fees and expenses of counsel
          for  the   Underwriters   relating  to  such   filings);   (viii)  the
          transportation  and other expenses incurred by or on behalf of Company
          representatives   in  connection  with  presentations  to  prospective
          purchasers  of the  Securities;  (ix)  the fees  and  expenses  of the
          Company's  accountants and the fees and expenses of counsel (including
          local and special  counsel) for the  Company;  and (x) all other costs
          and  expenses  incident  to  the  performance  by the  Company  of its
          obligations hereunder.

          6. Conditions to the Obligations of the Underwriters.  The obligations
of the  Underwriters  to purchase  the  Underwritten  Securities  and the Option
Securities,  as the  case  may be,  shall  be  subject  to the  accuracy  of the
representations and warranties on the part of the Company contained herein as of
the Execution Time, the Closing Date and any settlement date pursuant to Section
3  hereof,  to  the  accuracy  of the  statements  of the  Company  made  in any
certificates  pursuant  to the  provisions  hereof,  to the  performance  by the
Company of its obligations hereunder and to the following additional conditions:

               (a) If the Registration  Statement has not become effective prior
          to the Execution Time, unless the Representatives  agree in writing to
          a later time, the  Registration  Statement  will become  effective not
          later than (i) 6:00 PM New York City time on the date of determination
          of the public  offering price,  if such  determination  occurred at or
          prior to 3:00 PM New York  City  time on such  date or (ii) 9:30 AM on
          the Business Day following the day on which the public  offering price
          was determined,  if such determination occurred after 3:00 PM New York
          City time on such date; if filing of the Prospectus, or any supplement
          thereto, is required pursuant to Rule 424(b), the Prospectus,  and any
          such  supplement,  will be filed in the  manner  and  within  the time
          period  required  by Rule  424(b);  and no stop order  suspending  the
          effectiveness of the Registration Statement shall have been issued and
          no  proceedings  for  that  purpose  shall  have  been  instituted  or
          threatened.

               (b) The Company  shall have  caused  Reboul,  MacMurray,  Hewitt,
          Maynard & Kristol,  counsel for the Company,  to have furnished to the
          Representatives their opinion, dated the Closing Date and addressed to
          the  Representatives,  to the effect that:

                    (i) each of the Company and the  Subsidiaries  has been duly
               incorporated  and is validly  existing as a  corporation  in good
               standing  under  the  laws of the  jurisdiction  in  which  it is
               chartered or organized,  with full corporate  power and authority
               to  own or  lease,  as the  case  may  be,  and  to  operate  its
               properties   and  conduct  its   business  as  described  in  the
               Prospectus,  and is duly  qualified  to do  business as a foreign
               corporation  and is in  good  standing  under  the  laws  of each
               jurisdiction which requires such qualification.

                    (ii) all the outstanding  shares of capital stock of each of
               the Subsidiaries have been duly and validly authorized and issued
               and are


                                       13


               fully paid and nonassessable,  and, except as otherwise set forth
               in the Prospectus, all outstanding shares of capital stock of the
               Subsidiaries  are owned by the Company directly free and clear of
               any  perfected  security  interest  and, to the knowledge of such
               counsel,  after due inquiry, any other security interest,  claim,
               lien or encumbrance;

                    (iii) the Company's  authorized equity  capitalization is as
               set forth in the  Prospectus;  the  capital  stock of the Company
               conforms  in all  material  respects to the  description  thereof
               contained in the  Prospectus;  the  outstanding  shares of Common
               Stock have been duly and  validly  authorized  and issued and are
               fully paid and  nonassessable;  the Securities have been duly and
               validly  authorized,  and,  when issued and delivered to and paid
               for by the Underwriters pursuant to this Agreement, will be fully
               paid and  nonassessable;  the  Securities  are duly  listed,  and
               admitted and authorized for trading,  subject to official  notice
               of issuance and  evidence of  satisfactory  distribution,  on the
               Nasdaq National  Market;  the certificates for the Securities are
               in valid and sufficient  form; the holders of outstanding  shares
               of capital stock of the Company are not entitled to preemptive or
               other  rights to  subscribe  for the  Securities  except for such
               rights of WCAS Capital Partners II, L.P. as have been effectively
               waived;  and, except as set forth in the Prospectus,  no options,
               warrants  or  other  rights  to  purchase,  agreements  or  other
               obligations to issue, or rights to convert any  obligations  into
               or exchange any  securities  for,  shares of capital  stock of or
               ownership interests in the Company are outstanding;

                    (iv) to the knowledge of such  counsel,  there is no pending
               or threatened  action,  suit or proceeding by or before any court
               or  governmental  agency,  authority  or body  or any  arbitrator
               involving  the  Company  or the  Subsidiaries  or  its  or  their
               property  of  a  character   required  to  be  disclosed  in  the
               Registration  Statement which is not adequately  disclosed in the
               Prospectus, and there is no franchise, contract or other document
               of a  character  required  to be  described  in the  Registration
               Statement or  Prospectus,  or to be filed as an exhibit  thereto,
               which is not described or filed as required;  and the  statements
               included in the  Prospectus  under the headings  "Risk Factors --
               Proposed  Healthcare  Data  Confidentiality  Legislation,"  "Risk
               Factors--Dependence   on   Intellectual    Property;    Risk   of
               Infringement,"  "Business -- Government Regulation," "Business --
               Legal Proceedings" and  "Business--Intellectual  Property" fairly
               summarize the matters therein described;

                    (v) the  Registration  Statement has become  effective under
               the  Act;  any  required  filing  of  the  Prospectus,   and  any
               supplements thereto, pursuant to Rule 424(b) has been made in the
               manner and within the time period required by Rule 424(b); to the
               knowledge  of  such  counsel,   no  stop  order   suspending  the
               effectiveness of the Registration  Statement has been issued,  no
               proceedings  for that purpose have been  instituted or threatened
               and the Registration Statement and the Prospectus (other than the
               financial 

                                       14


               statements and other financial  information contained therein, as
               to which such counsel need express no opinion)  comply as to form
               in all material respects with the applicable  requirements of the
               Act and the rules  thereunder;  and such counsel has no reason to
               believe that on the Effective  Date or at the Execution  Time the
               Registration  Statement  contained  any  untrue  statement  of  a
               material  fact or omitted to state any material  fact required to
               be stated therein or necessary to make the statements therein not
               misleading  or that  the  Prospectus  as of its  date  and on the
               Closing  Date  included or  includes  any untrue  statement  of a
               material  fact or  omitted  or  omits to  state a  material  fact
               necessary  to make the  statements  therein,  in the light of the
               circumstances under which they were made, not misleading (in each
               case,  other than the financial  statements  and other  financial
               information  contained  therein,  as to which such  counsel  need
               express no opinion);

                    (vi) this Agreement has been duly  authorized,  executed and
               delivered by the Company;

                    (vii) the  Company is not and,  after  giving  effect to the
               offering and sale of the  Securities  and the  application of the
               proceeds thereof as described in the Prospectus,  will not be, an
               "investment  company" as defined in the Investment Company Act of
               1940, as amended;

                    (viii) no consent, approval,  authorization,  filing with or
               order of any court or governmental  agency or body is required in
               connection with the transactions contemplated herein, except such
               as have been  obtained  under the Act and such as may be required
               under the blue sky laws of any  jurisdiction  in connection  with
               the  purchase  and   distribution   of  the   Securities  by  the
               Underwriters in the manner  contemplated in this Agreement and in
               the  Prospectus  and  such  other  approvals  (specified  in such
               opinion) as have been  obtained;  

                    (ix) neither the issue and sale of the  Securities,  nor the
               consummation of any other of the transactions herein contemplated
               nor the  fulfillment  of the terms  hereof  will  conflict  with,
               result in a breach or  violation  of or  imposition  of any lien,
               charge or encumbrance  upon any property or assets of the Company
               or its  subsidiaries  pursuant  to, (i) the charter or by-laws of
               the Company or the Subsidiaries, (ii) the terms of any indenture,
               contract,  lease, mortgage,  deed of trust, note agreement,  loan
               agreement or other agreement, obligation,  condition, covenant or
               instrument to which the Company or the  Subsidiaries  are a party
               or bound or to which its or their  property is subject,  or (iii)
               any statute,  law, rule,  regulation,  judgment,  order or decree
               applicable  to the  Company  or the  Subsidiaries  of any  court,
               regulatory  body,   administrative  agency,   governmental  body,
               arbitrator  or  other  authority  having  jurisdiction  over  the
               Company or the Subsidiaries or any of their  properties;  and 

                                       15

                    (x) no holders of  securities  of the Company have rights to
               the  registration  of  such  securities  under  the  Registration
               Statement  except for such rights of WCAS  Capital  Partners  II,
               L.P. as have been effectively  waived. 

               In  rendering  such  opinion,  such  counsel  may  rely (A) as to
          matters  involving the application of laws of any  jurisdiction  other
          than the State of Delaware or the Federal  laws of the United  States,
          to the extent they deem proper and specified in such opinion, upon the
          opinion of other  counsel  of good  standing  whom they  believe to be
          reliable and who are  satisfactory to counsel for the Underwriters and
          (B) as to  matters  of  fact,  to the  extent  they  deem  proper,  on
          certificates  of  responsible  officers  of  the  Company  and  public
          officials.  References to the Prospectus in this paragraph (b) include
          any supplements thereto at the Closing Date.

               (c) The Representatives shall have received from Dewey Ballantine
          LLP, counsel for the Underwriters, such opinion or opinions, dated the
          Closing Date and addressed to the Representatives, with respect to the
          issuance and sale of the Securities,  the Registration Statement,  the
          Prospectus  (together with any  supplement  thereto) and other related
          matters as the Representatives may reasonably require, and the Company
          shall have  furnished to such  counsel such  documents as they request
          for the purpose of enabling them to pass upon such matters.

               (d) The Company  shall have  furnished to the  Representatives  a
          certificate of the Company, signed by the Chairman of the Board or the
          President  and the principal  financial or  accounting  officer of the
          Company,  dated the  Closing  Date,  to the effect that the signers of
          such certificate have carefully  examined the Registration  Statement,
          the  Prospectus,  any supplements to the Prospectus and this Agreement
          and that: 

                    (i) the  representations  and  warranties  of the Company in
               this  Agreement are true and correct in all material  respects on
               and as of the Closing Date with the same effect as if made on the
               Closing Date and the Company has complied with all the agreements
               and satisfied  all the  conditions on its part to be performed or
               satisfied at or prior to the Closing Date;

                    (ii) no  stop  order  suspending  the  effectiveness  of the
               Registration  Statement  has been issued and no  proceedings  for
               that purpose have been instituted or, to the Company's knowledge,
               threatened; and

                    (iii) since the date of the most recent financial statements
               included in the Prospectus (exclusive of any supplement thereto),
               there   has   been   no   Material   Adverse   Effect.  

                                       16

               (e) The Representatives  shall have received letters addressed to
          you dated the date  hereof  and the  Closing  date from  Deloitte  and
          Touche LLP and Carver Moquist Alagna, LLC, each independent  certified
          public accountants,  substantially in the forms heretofore approved by
          you.

               (f) Subsequent to the Execution Time or, if earlier, the dates as
          of which information is given in the Registration Statement (exclusive
          of  any  amendment  thereof)  and  the  Prospectus  (exclusive  of any
          supplement  thereto),  there  shall  not have  been (i) any  change or
          decrease  specified in the letter or letters  referred to in paragraph
          (e) of this Section 6 or (ii) any change, or any development involving
          a prospective  change,  in or affecting  the  condition  (financial or
          otherwise),  earnings,  business or  properties of the Company and the
          Subsidiaries   taken  as  a  whole,   whether  or  not  arising   from
          transactions in the ordinary  course of business,  except as set forth
          in or  contemplated  in the  Prospectus  (exclusive of any  supplement
          thereto) the effect of which, in any case referred to in clause (i) or
          (ii)  above,  is,  in the sole  judgment  of the  Representatives,  so
          material  and  adverse as to make it  impractical  or  inadvisable  to
          proceed   with  the  offering  or  delivery  of  the   Securities   as
          contemplated by the Registration Statement (exclusive of any amendment
          thereof) and the Prospectus (exclusive of any supplement thereto).

               (g) The  Securities  shall  have been  listed  and  admitted  and
          authorized for trading on the Nasdaq National Market, and satisfactory
          evidence   of  such   actions   shall  have  been   provided   to  the
          Representatives.

               (h) At or prior to the  Execution  Time,  the Company  shall have
          furnished to the Representatives a letter substantially in the form of
          Exhibit A hereto from each officer,  director and  stockholder  of the
          Company addressed to the Representatives.

               (i) The Company shall have provided evidence to the Underwriters,
          in form and substance  satisfactory to the Representatives and for the
          Underwriters,  that  concurrently  with  the  Closing  (i) the  Senior
          Subordinated  Note and the Credit  Facility (as such terms are defined
          in the  Prospectus)  will be repaid in full in the manner set forth in
          the  Prospectus  under  the  heading  "Use of  Proceeds"  and (ii) the
          Recapitalization (as defined in the Prospectus) will be completed.

               (j) [Amended Credit Facility]

               (k) The Company shall have provided evidence to the Underwriters,
          in form and substance  satisfactory to the Representatives and for the
          Underwriters, that the Company's Certificate of Incorporation has been
          amended to  provide  for the  issuance  of up to  5,000,000  shares of
          Preferred  Stock as set forth in the  Prospectus  under  the  headings
          "Risk Factors--Potential  Adverse Effect of Anti-Takeover Provisions,"
          "Description   of   Capital   Stock"  and   "Description   of  Capital
          Stock--Preferred Stock."


                                       17

               (l) Prior to the Closing Date,  the Company shall have  furnished
          to the  Representatives  such further  information,  certificates  and
          documents as the Representatives may reasonably request.

          If any of the  conditions  specified  in this Section 6 shall not have
been fulfilled in all material  respects when and as provided in this Agreement,
or if any of the opinions and certificates  mentioned above or elsewhere in this
Agreement shall not be in all material respects reasonably  satisfactory in form
and  substance to the  Representatives  and counsel for the  Underwriters,  this
Agreement and all obligations of the Underwriters  hereunder may be canceled at,
or at any time prior to, the Closing Date by the Representatives. Notice of such
cancelation  shall  be  given to the  Company  in  writing  or by  telephone  or
facsimile confirmed in writing.

          The  documents  required to be  delivered  by this  Section 6 shall be
delivered at the office of Dewey Ballantine LLP,  counsel for the  Underwriters,
at 1301 Avenue of the Americas, New York, New York, on the Closing Date.

          7.  Reimbursement  of  Underwriters'  Expenses.  If  the  sale  of the
Securities  provided for herein is not consummated  because any condition to the
obligations of the  Underwriters set forth in Section 6 hereof is not satisfied,
because  of any  termination  pursuant  to  Section  10 hereof or because of any
refusal,  inability  or  failure  on the  part of the  Company  to  perform  any
agreement  herein or comply with any provision  hereof other than by reason of a
default by any of the Underwriters,  the Company will reimburse the Underwriters
severally through Salomon Smith Barney on demand for all out-of-pocket  expenses
(including  reasonable fees and  disbursements  of counsel) that shall have been
incurred  by them in  connection  with  the  proposed  purchase  and sale of the
Securities.

          8. Indemnification and Contribution.

               (a) The  Company  agrees  to  indemnify  and hold  harmless  each
          Underwriter,  the  directors,  officers,  employees and agents of each
          Underwriter  and each person who controls any  Underwriter  within the
          meaning  of either the Act or the  Exchange  Act  against  any and all
          losses,  claims,  damages or liabilities,  joint or several,  to which
          they or any of them may become subject under the Act, the Exchange Act
          or other Federal or state  statutory law or regulation,  at common law
          or otherwise,  insofar as such losses,  claims, damages or liabilities
          (or  actions  in respect  thereof)  arise out of or are based upon any
          untrue  statement  or alleged  untrue  statement  of a  material  fact
          contained in the  registration  statement for the  registration of the
          Securities as originally filed or in any amendment thereof,  or in any
          Preliminary Prospectus or the Prospectus,  or in any amendment thereof
          or supplement  thereto, or arise out of or are based upon the omission
          or alleged  omission to state  therein a material  fact required to be
          stated  therein  or  necessary  to make  the  statements  therein  not
          misleading,  and agrees to reimburse each such  indemnified  party, as
          incurred,  for any legal or other expenses reasonably incurred by them
          in connection with  investigating  or defending any such loss,  claim,
          damage, liability or action; provided,  however, that the Company will
          not 

                                       18

          be liable in any such case to the extent  that any such  loss,  claim,
          damage or  liability  arises out of or is based  upon any such  untrue
          statement or alleged untrue  statement or omission or alleged omission
          made  therein  in  reliance  upon  and  in  conformity   with  written
          information   furnished  to  the  Company  by  or  on  behalf  of  any
          Underwriter  through the  Representatives  specifically  for inclusion
          therein. This indemnity agreement will be in addition to any liability
          which the Company may otherwise have.

               (b)  Each  Underwriter   severally  and  not  jointly  agrees  to
          indemnify and hold harmless the Company,  each of its directors,  each
          of its officers who signs the Registration Statement,  and each person
          who controls  the Company  within the meaning of either the Act or the
          Exchange Act, to the same extent as the foregoing  indemnity  from the
          Company  to each  Underwriter,  but only  with  reference  to  written
          information  relating to such Underwriter  furnished to the Company by
          or  on  behalf  of  such  Underwriter   through  the   Representatives
          specifically  for  inclusion  in  the  documents  referred  to in  the
          foregoing  indemnity.  This indemnity agreement will be in addition to
          any liability  which any  Underwriter  may otherwise have. The Company
          acknowledges  that the  statements  set forth in the last paragraph of
          the cover page  regarding  delivery of the  Securities,  the legend in
          block capital  letters on page 2 related to  stabilization,  syndicate
          covering   transactions  and  penalty  bids  and,  under  the  heading
          "Underwriting" or "Plan of Distribution," (i) the sentences related to
          concessions  and  reallowances  and  (ii)  the  paragraph  related  to
          stabilization, syndicate covering transactions and penalty bids in any
          Preliminary   Prospectus  and  the  Prospectus   constitute  the  only
          information  furnished  in  writing  by or on  behalf  of the  several
          Underwriters  for  inclusion  in  any  Preliminary  Prospectus  or the
          Prospectus.

               (c) The Company hereby  confirms that at its request Smith Barney
          Inc.  has  without   compensation  acted  as  "qualified   independent
          underwriter" (in such capacity,  the "QIU") within the meaning of Rule
          2720 of the Conduct  Rules of the National  Association  of Securities
          Dealers,   Inc.  in  connection  with  the  offering  of  the  Offered
          Securities. The Company agrees to indemnify and hold harmless the QIU,
          the  directors,  officers,  employees  and  agents of the QIU and each
          person who  controls  the QIU within the  meaning of either the Act or
          the  Exchange  Act  against  any and all  losses,  claims,  damages or
          liabilities, joint or several, to which they or any of them may become
          subject  under the Act,  the  Exchange  Act or other  Federal or state
          statutory law or  regulation,  at common law or otherwise,  insofar as
          such losses,  claims,  damages or  liabilities  (or actions in respect
          thereof)  arise  out of or are  based  upon any  untrue  statement  or
          alleged  untrue   statement  of  a  material  fact  contained  in  the
          registration  statement  for the  registration  of the  Securities  as
          originally  filed or in any amendment  thereof,  or in any Preliminary
          Prospectus  or  the  Prospectus,   or  in  any  amendment  thereof  or
          supplement  thereto, or arise out of or are based upon the omission or
          alleged  omission  to state  therein a material  fact  required  to be
          stated  therein  or  necessary  to make  the  statements  therein  not
          misleading,  and agrees to reimburse each such  indemnified  party, as
          incurred,  for any legal or other expenses reasonably incurred by them
          in connection with  investigating  or defending any such loss,  claim,
          damage, liability or action; provided,  however, that the Company will
          not be  liable  in any such  case to the  extent  that any such  loss,

                                       19

          claim,  damage or  liability  arises  out of or is based upon any such
          untrue  statement or alleged  untrue  statement or omission or alleged
          omission made therein in reliance upon and in conformity  with written
          information  furnished  to the  Company  by or on  behalf  of the  QIU
          through the Representatives  specifically for inclusion therein.  This
          indemnity  agreement  will be in addition to any  liability  which the
          Company may otherwise have.

               (d) Promptly  after  receipt by an  indemnified  party under this
          Section  8  of  notice  of  the  commencement  of  any  action,   such
          indemnified  party will,  if a claim in respect  thereof is to be made
          against  the  indemnifying  party  under this  Section  8,  notify the
          indemnifying  party in writing of the  commencement  thereof;  but the
          failure so to notify the  indemnifying  party (i) will not  relieve it
          from liability under paragraph (a), (b) or (c) above unless and to the
          extent it did not  otherwise  learn of such  action  and such  failure
          results in the  forfeiture by the  indemnifying  party of  substantial
          rights  and  defenses  and (ii) will not,  in any event,  relieve  the
          indemnifying party from any obligations to any indemnified party other
          than the indemnification  obligation provided in paragraph (a), (b) or
          (c) above. The indemnifying party shall be entitled to appoint counsel
          of the indemnifying party's choice at the indemnifying party's expense
          to  represent   the   indemnified   party  in  any  action  for  which
          indemnification  is sought (in which case the indemnifying party shall
          not  thereafter  be  responsible  for the  fees  and  expenses  of any
          separate counsel  retained by the indemnified  party or parties except
          as set forth  below);  provided,  however,  that such counsel shall be
          satisfactory   to   the   indemnified   party.   Notwithstanding   the
          indemnifying  party's  election to appoint  counsel to  represent  the
          indemnified  party in an action,  the indemnified party shall have the
          right to employ separate counsel  (including  local counsel),  and the
          indemnifying  party shall bear the reasonable fees, costs and expenses
          of such  separate  counsel  if (i) the use of  counsel  chosen  by the
          indemnifying  party to represent the  indemnified  party would present
          such counsel with a conflict of interest, (ii) the actual or potential
          defendants  in,  or  targets  of,  any such  action  include  both the
          indemnified party and the indemnifying party and the indemnified party
          shall  have  reasonably  concluded  that  there may be legal  defenses
          available to it and/or other  indemnified  parties which are different
          from or additional to those available to the indemnifying party, (iii)
          the indemnifying party shall not have employed counsel satisfactory to
          the  indemnified  party to represent  the  indemnified  party within a
          reasonable time after notice of the institution of such action or (iv)
          the indemnifying party shall authorize the indemnified party to employ
          separate  counsel  at  the  expense  of  the  indemnifying  party.  An
          indemnifying  party will not, without the prior written consent of the
          indemnified  parties,  settle or compromise or consent to the entry of
          any judgment with respect to any pending or threatened claim,  action,
          suit or proceeding in respect of which indemnification or contribution
          may be sought  hereunder  (whether or not the indemnified  parties are
          actual or  potential  parties  to such claim or  action)  unless  such
          settlement, compromise or consent includes an

                                       20


          unconditional  release of each  indemnified  party from all  liability
          arising out of such claim, action, suit or proceeding.

               (e) In the event that the indemnity  provided in paragraph (a) or
          (b) of  this  Section  8 is  unavailable  to or  insufficient  to hold
          harmless  an  indemnified  party for any  reason,  the Company and the
          Underwriters  severally  agree to contribute to the aggregate  losses,
          claims,  damages and  liabilities  (including  legal or other expenses
          reasonably  incurred in  connection  with  investigating  or defending
          same) (collectively  "Losses") to which the Company and one or more of
          the  Underwriters  may be subject in such proportion as is appropriate
          to reflect the  relative  benefits  received by the Company on the one
          hand and by the  Underwriters  on the other from the  offering  of the
          Securities;  provided,  however, that in no case shall any Underwriter
          (except  as  may  be  provided  in any  agreement  among  underwriters
          relating to the offering of the  Securities)  be  responsible  for any
          amount in excess of the underwriting discount or commission applicable
          to the  Securities  purchased by such  Underwriter  hereunder.  If the
          allocation   provided  by  the  immediately   preceding   sentence  is
          unavailable for any reason, the Company and the Underwriters severally
          shall  contribute in such  proportion as is appropriate to reflect not
          only such relative benefits but also the relative fault of the Company
          on the one hand and of the  Underwriters  on the  other in  connection
          with the statements or omissions which resulted in such Losses as well
          as any other relevant equitable  considerations.  Benefits received by
          the Company shall be deemed to be equal to the total net proceeds from
          the offering (before deducting  expenses) received by it, and benefits
          received by the Underwriters  shall be deemed to be equal to the total
          underwriting  discounts and commissions,  in each case as set forth on
          the cover page of the  Prospectus.  Relative fault shall be determined
          by reference to, among other things, whether any untrue or any alleged
          untrue  statement  of a  material  fact  or the  omission  or  alleged
          omission to state a material fact relates to  information  provided by
          the  Company on the one hand or the  Underwriters  on the  other,  the
          intent  of  the  parties  and  their  relative  knowledge,  access  to
          information   and  opportunity  to  correct  or  prevent  such  untrue
          statement or omission.  The Company and the Underwriters agree that it
          would not be just and equitable if contribution were determined by pro
          rata allocation or any other method of allocation  which does not take
          account   of  the   equitable   considerations   referred   to  above.
          Notwithstanding the provisions of this paragraph (e), no person guilty
          of fraudulent  misrepresentation  (within the meaning of Section 11(f)
          of the Act) shall be entitled to contribution  from any person who was
          not guilty of such fraudulent misrepresentation.  For purposes of this
          Section 8, each person who controls an Underwriter  within the meaning
          of either  the Act or the  Exchange  Act and each  director,  officer,
          employee  and agent of an  Underwriter  shall have the same  rights to
          contribution  as such  Underwriter,  and each person who  controls the
          Company within the meaning of either the Act or the Exchange Act, each
          officer  of  the  Company  who  shall  have  signed  the  Registration
          Statement  and each director of the Company shall have the same rights
          to contribution as the Company, subject in each case to the applicable
          terms and conditions of this paragraph (e).

                                       21


          9. Default by an Underwriter.  If any one or more  Underwriters  shall
fail to purchase  and pay for any of the  Securities  agreed to be  purchased by
such  Underwriter or  Underwriters  hereunder and such failure to purchase shall
constitute a default in the performance of its or their  obligations  under this
Agreement,  the remaining  Underwriters shall be obligated  severally to take up
and pay for (in the  respective  proportions  which the amount of Securities set
forth opposite their names in Schedule I hereto bears to the aggregate amount of
Securities set forth opposite the names of all the remaining  Underwriters)  the
Securities which the defaulting Underwriter or Underwriters agreed but failed to
purchase;  provided,  however,  that in the event that the  aggregate  amount of
Securities which the defaulting Underwriter or Underwriters agreed but failed to
purchase  shall exceed 10% of the aggregate  amount of  Securities  set forth in
Schedule I hereto,  the remaining  Underwriters shall have the right to purchase
all, but shall not be under any  obligation to purchase any, of the  Securities,
and if such nondefaulting Underwriters do not purchase all the Securities,  this
Agreement will terminate without  liability to any nondefaulting  Underwriter or
the Company.  In the event of a default by any  Underwriter as set forth in this
Section 9, the Closing Date shall be postponed  for such period,  not  exceeding
five Business  Days, as the  Representatives  shall  determine in order that the
required  changes in the  Registration  Statement  and the  Prospectus or in any
other  documents  or  arrangements  may be effected.  Nothing  contained in this
Agreement shall relieve any defaulting Underwriter of its liability,  if any, to
the Company and any  nondefaulting  Underwriter  for damages  occasioned  by its
default hereunder.

          10. Termination. This Agreement shall be subject to termination in the
absolute discretion of the Representatives, by notice given to the Company prior
to delivery of and payment for the Securities, if at any time prior to such time
(i)  trading in the  Company's  Common  Stock shall have been  suspended  by the
Commission or the Nasdaq National  Market or trading in securities  generally on
the New York  Stock  Exchange  or the  Nasdaq  National  Market  shall have been
suspended  or limited  or minimum  prices  shall have been  established  on such
Exchange or National Market,  (ii) a banking moratorium shall have been declared
either by  Federal  or New York  State  authorities  or (iii)  there  shall have
occurred any outbreak or escalation of  hostilities,  declaration  by the United
States of a national emergency or war, or other calamity or crisis the effect of
which on  financial  markets is such as to make it, in the sole  judgment of the
Representatives,  impractical  or  inadvisable  to proceed  with the offering or
delivery of the Securities as contemplated  by the Prospectus  (exclusive of any
supplement thereto).

          11.   Representations  and  Indemnities  to  Survive.  The  respective
agreements, representations, warranties, indemnities and other statements of the
Company or its officers and of the Underwriters set forth in or made pursuant to
this  Agreement  will  remain  in  full  force  and  effect,  regardless  of any
investigation  made by or on behalf of any  Underwriter or the Company or any of
the officers,  directors or controlling persons referred to in Section 8 hereof,
and will survive  delivery of and payment for the Securities.  The provisions of
Sections 7 and 8 hereof shall survive the  termination  or  cancelation  of this
Agreement.

                                       22

          12.  Notices.  All  communications  hereunder  will be in writing  and
effective only on receipt, and, if sent to the Representatives,  will be mailed,
delivered  or telefaxed to the Salomon  Smith Barney  General  Counsel (fax no.:
(212) 816-7912) and confirmed to the General Counsel,  Salomon Smith Barney,  at
388 Greenwich Street, New York, New York, , Attention:  General Counsel;  or, if
sent to the  Company,  will be mailed,  delivered  or  telefaxed  to  [FACSIMILE
NUMBER] and confirmed to it at , attention of the Legal Department.

          13.  Successors.  This  Agreement  will inure to the benefit of and be
binding upon the parties hereto and their respective successors and the officers
and directors and controlling  persons  referred to in Section 8 hereof,  and no
other person will have any right or obligation hereunder.

          14.  Applicable  Law. This Agreement will be governed by and construed
in  accordance  with the laws of the State of New York  applicable  to contracts
made and to be performed within the State of New York.

          15.  Counterparts.  This  Agreement  may be  signed  in  one  or  more
counterparts,  each of  which  shall  constitute  an  original  and all of which
together shall constitute one and the same agreement.

          16.  Headings.  The section  headings used herein are for  convenience
only and shall not affect the construction hereof.

          17. Definitions.  The terms which follow, when used in this Agreement,
shall have the meanings indicated.

                  "Act" shall mean the Securities  Act of 1933, as amended,  and
         the rules and regulations of the Commission promulgated thereunder.

                  "Business  Day" shall mean any day other  than a  Saturday,  a
         Sunday or a legal  holiday or a day on which  banking  institutions  or
         trust companies are authorized or obligated by law to close in New York
         City.

                  "Commission"   shall   mean  the   Securities   and   Exchange
         Commission.

                  "Effective  Date"  shall  mean  each  date and  time  that the
         Registration  Statement,  any  post-effective  amendment or  amendments
         thereto and any Rule  462(b)  Registration  Statement  became or become
         effective.

                  "Exchange Act" shall mean the Securities Exchange Act of 1934,
         as amended, and the rules and regulations of the Commission promulgated
         thereunder.

                  "Execution  Time"  shall  mean the date  and  time  that  this
         Agreement is executed and delivered by the parties hereto.

                                       23

                  "Preliminary Prospectus" shall mean any preliminary prospectus
         referred  to in  paragraph  1(a) above and any  preliminary  prospectus
         included in the Registration Statement at the Effective Date that omits
         Rule 430A Information.

                  "Prospectus"  shall  mean  the  prospectus   relating  to  the
         Securities  that is first  filed  pursuant  to Rule  424(b)  after  the
         Execution  Time or, if no filing  pursuant to Rule 424(b) is  required,
         shall  mean the form of final  prospectus  relating  to the  Securities
         included in the Registration Statement at the Effective Date.

                  "Registration Statement" shall mean the registration statement
         referred to in paragraph 1(a) above,  including  exhibits and financial
         statements,  as amended at the Execution  Time (or, if not effective at
         the  Execution  Time,  in the form in which it shall become  effective)
         and,  in the event any  post-effective  amendment  thereto  or any Rule
         462(b)  Registration  Statement  becomes effective prior to the Closing
         Date, shall also mean such registration statement as so amended or such
         Rule 462(b) Registration Statement, as the case may be. Such term shall
         include any Rule 430A Information  deemed to be included therein at the
         Effective Date as provided by Rule 430A.

                  "Rule  424",  "Rule  430A" and "Rule  462" refer to such rules
         under the Act.

                  "Rule 430A Information" shall mean information with respect to
         the  Securities and the offering  thereof  permitted to be omitted from
         the Registration  Statement when it becomes effective  pursuant to Rule
         430A.

                  "Rule 462(b) Registration Statement" shall mean a registration
         statement  and any  amendments  thereto  filed  pursuant to Rule 462(b)
         relating to the offering covered by the registration statement referred
         to in Section 1(a) hereof.

                  "Salomon Smith Barney" shall mean Smith Barney Inc. or Salomon
         Brothers Inc to the  extent that  either such  party is  a signatory to
         this Agreement.









                                       24

          If the  foregoing  is in  accordance  with your  understanding  of our
agreement, please sign and return to us the enclosed duplicate hereof, whereupon
this letter and your acceptance  shall  represent a binding  agreement among the
Company and the several Underwriters.

                                      Very truly yours,

                                      MedE America Corporation

                                      By: ______________________________________

                                          Name:

                                          Title:















                                       25

The  foregoing  Agreement is hereby 
confirmed and accepted as of the date
first above written.

Smith Barney Inc.
William Blair & Company, L.L.C.
Volpe Brown Whelan & Company, LLC

By:   Smith Barney Inc.


       By: _________________________
           Name:
           Title:

For  themselves  and the other
several  Underwriters  named in
Schedule I to the foregoing
Agreement.



                                   SCHEDULE I

                                                        Number of Underwritten
                                                            Securities To be
  Underwriters                                                 Purchased
  ------------                                          ----------------------

Smith Barney Inc....................................
William Blair & Company, L.L.C......................
Volpe Brown Whelan & Company, LLC...................
                                                            ---------------
                  Total.............................        
                                                            ================


[Form of Lock-Up Agreement]                                            EXHIBIT A


               [Letterhead of officer, director or shareholder of
                                  Corporation]

                            MEDE AMERICA CORPORATION
                     Initial Public Offering of Common Stock

                                                                  June ___, 1998

Smith Barney Inc.
William Blair & Company, L.L.C.
Volpe Brown Whelan & Company, LLC
  c/o Smith Barney Inc.
  388 Greenwich Street
  New York, New York 10013

Ladies and Gentlemen:

          This letter is being  delivered to you in connection with the proposed
Underwriting  Agreement  (the  "Underwriting  Agreement"),  between MEDE AMERICA
Corporation,  a  Delaware  corporation  (the  "Company"),  and  each  of  you as
Underwriters named therein,  relating to an underwritten initial public offering
of Common Stock, $.01 par value (the "Common Stock"), of the Company.

          In order to induce  you and the other  Underwriters  to enter into the
Underwriting  Agreement,  the  undersigned  will not,  without the prior written
consent of Smith Barney Inc., sell, offer to sell, solicit an offer to purchase,
contract to sell, grant any option to sell,  pledge or otherwise  dispose of, or
file  (or  participate  in the  filing  of) a  registration  statement  with the
Securities and Exchange Commission in respect of, or establish or increase a put
equivalent  position or liquidate or decrease a call equivalent  position within
the meaning of Section 16 of the  Securities  Exchange Act of 1934,  as amended,
and  the  rules  and  regulations  of the  Securities  and  Exchange  Commission
promulgated  thereunder  with  respect  to, any  shares of capital  stock of the
Company or any securities  convertible  into or exercisable or exchangeable  for
such  capital  stock,  or  publicly  announce  an  intention  to effect any such
transaction,  for a period of 180 days  after the date of the Final  Prospectus,
other than shares of Common  Stock  disposed  of as bona fide gifts  approved by
Smith Barney Inc.

          If for any reason the Underwriting Agreement shall be terminated prior
to the Closing Date (as defined in the  Underwriting  Agreement),  the agreement
set forth above shall likewise be terminated.

                                            Yours very truly,


                                            ----------------------------------
                                            Stockholder Name


                                            By: _______________________________
                                                Name:
                                                Title:
                                                Address:



                                      A-2