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2016-137
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2016-137
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Last modified
9/16/2016 11:37:49 AM
Creation date
9/16/2016 11:37:46 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/13/2016
Control Number
2016-137
Agenda Item Number
8.V.
Entity Name
Johns Eastern Company Inc.
Subject
Third Party Administration Services
Self Funded Worker's Compensation and Liability
Project Number
UPC 3228
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17. Conduct adequate, timely and complete 24 hour contact in the investigation of lost-time claims <br /> and 48 hour contact in the investigation of medical-only claims. (24/48 hours from first notice to <br /> WC management organization, not 24/48 hours from when adjuster received). <br /> 18. Pay vendor bills (attorneys, surveillance, etc.) within 30 days. <br /> 19. Develop and follow appropriate written policies when(i)the injured employee requests a second <br /> opinion, (ii) medical evaluation is questioned, or (iii) grievance report is filed. <br /> 20. Assist, as appropriate, in the scheduling of independent medical examinations. <br /> 21. Monitor the purchase of items deemed to be medically necessary for the accommodation of an <br /> injured employee and obtain approval from the Risk Manager for those items with a cost greater <br /> than $10,000. <br /> 22. Follow all provisions of Florida Statute in regard to medical benefit entitlement and <br /> administration. <br /> FIRST NOTICE OF INJURY SERVICES <br /> TPA will provide the following administrative services: <br /> 1. Provide internet based claim reporting and intake capabilities. Send First Notice of Injury to the <br /> State of Florida in a timely manner. TPA must accept responsibility for penalties for late notice <br /> to the State of Florida when caused by other than the delay of IRC. <br /> 2. Receive and examine on behalf of IRC all reports of employee injury claims. Refer injured <br /> workers to appropriate medical services, and as appropriate and based upon pre-established <br /> criteria agreed upon by IRC. Provide immediate referral to network specialty medical providers <br /> for injuries. <br /> 3. Coordinate data between first report of injury and claims administration system. <br /> 4. The on-line claim security shall permit on-line input of accident reports by IRC. <br /> TELEPHONIC MEDICAL MANAGEMENT <br /> TPA will provide the following services: <br /> 1. Telephonic Nurse Case Management services will be provided by TPA staff for all lost time and <br /> select medical only claims. <br /> 2. Pre-Certification of Hospital Admissions. <br /> Page 16 <br /> i <br />
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