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2009-267
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2009-267
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Last modified
3/15/2016 12:17:27 PM
Creation date
10/1/2015 3:55:11 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
10/13/2009
Control Number
2009-267
Agenda Item Number
8.G.
Entity Name
Johns Eastern Company
Subject
Service Contract multiple lines claims handling
Alternate Name
JEC
Supplemental fields
SmeadsoftID
10837
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g . Fees for over- night or special mail service for various documents , <br /> h . Fees for examining and reducing hospital and medical bills as appropriate , <br /> i . Photocopying and/or CD- ROM copies and review of relevant documentation . <br /> j . Fees for Pre - Certification of Hospital Admissions , On - Site Case <br /> Management, Peer Review , Medical Care Audits , and Hospital Bill Audits . <br /> k . Medical Management - Telephonic case management would be provided on all <br /> cases at a rate of: <br /> • $ 525 . 00 per lost time exposure <br /> • $ 125 . 00 per medical only exposure <br /> I . Provider Bill Review/Cost Containment Services - Fees for these services are : <br /> • $ 5 . 95 per bill <br /> • 30 % of all savings over and above Fee Schedule reductions <br /> • 35 % out- of- network and hospital audits <br /> M , Medicare Set- Aside ( MSA ) services to include ; recommendation for <br /> MSA submission , MSA cost projection , MSA submission , liability <br /> MSA services , comprehensive drug utilization review , lien search , <br /> conditional lien dispute, projection update . <br /> 5 . Compensation for the Service Agent. For performing its services under this <br /> Agreement, the Service Agent shall be entitled to the following compensation : <br /> a. Fees for workers ' compensation exposures whose dates of loss fall between <br /> October 1 , 2009 and September 30 , 2010 will be a minimum and deposit of <br /> $ 625350 . 00 . <br /> This fee contemplates handling 150 workers ' compensation exposures . <br /> If the number of exposures exceeds 150 , then the fees will be increased <br /> proportionately . All years are subject to audit . <br /> b . Fees for non - workers ' compensation exposures whose dates of loss fall <br /> between October 1 , 2009 and September 30 , 2010 will be a minimum and <br /> deposit of $ 13 , 400 . 00 . <br /> This fee contemplates handling 22 non- workers ' compensation exposures . <br /> If the number of exposures exceeds 22 , then the fees will be increased <br /> proportionately . All years are subject to audit. <br /> C , Fees for workers ' compensation exposures whose dates of loss fall between <br /> October 1 , 2010 and September 30 , 20 ; 1 will be a minimum and deposit of <br /> $ 62 , 350 . 00 . <br />
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