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TPA agrees that IRC shall have real-time access to all claim files, including all adjuster notes, supervisory notes, field case management notes, diary items, payment records, medical bills and expense bills in an electronic manner with internet based access available to IRC. NETWORK ACCESS & DEVELOPMENT SERVICES TPA will provide the following network access and development services: Provide IRC access to a provider network that contains appropriate providers. TPA must assure that high quality providers, particularly in key specialties, are encouraged to participate in the network. TPA will work with providers to develop contractual agreements which include preferred appointment setting criteria, reporting and standards to best address the medical and rehabilitative needs of IRC injured employees. Key specialties include internists, orthopedics, neurology, neurosurgery, occupational medicine specialties, pulmonology, infectious disease specialists, ear/nose/throat specialists, allergists, psychiatry and psychology. On an annual basis, the TPA and IRC will meet and agree upon discounts, types of specialists and key providers to be added to the network. MEDICAL BILL REVIEW AND AUDIT SERVICES TPA will provide the following medical bill review and audit services: 1. For Medical Bill Review: (a) Promptly review medical/surgical bills (in and out of network) for accuracy including, but not limited to, as they relate to the following: (i) Duplicate billings (ii) Unbundling of charges (iii) Upcoding of charges (iv) Approval and appropriate precertification. (b) Review all medical bills that: (i) Are not subject to fee schedule coding (ii) Are for services not specifically addressed in the fee schedule (iii) Need an in-depth medical interpretation of the rules and regulations (iv) In the exercise of professional judgment, specifically warrant review. (c) Process, pay and mail bills within 45 days of receipt. Reimburse IRC for any overpayments made in the bill review process within 30 days of identification of overpayment. Reimburse IRC for any penalties and/or interest associated with inaccurate payments. 3. For Medical Auditing Services: (a) Audit in -network and out -network hospital/provider bills Page 17