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01
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2011
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062111
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01
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6/17/2011 3:20:33 PM
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6/16/2011 3:20:55 PM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
6/21/2011
DESTRUCT DATE
15Y
DOCUMENT NO
01
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12. As a service to the CLIENT, ICS will report all excess claims to excess reinsurance <br /> carrier, although the final responsibility for reporting such claims is that of the <br /> CLIENT's. <br /> 13. Arrange and supervise rehabilitation services where indicated. <br /> 14. Arrange for and set up system for payment of benefits and allocated expenses in <br /> accordance with CLIENT's needs. <br /> 15. ICS shall prepared with the assistance of the CLIENT all reports, which are now, or <br /> will be required by the State of California or other government agencies with <br /> respect to self-funded programs. <br /> 16. ICS shall subscribe to and pay for enrollment in the Index Bureau System and will <br /> report to the Index Bureau on each and every indemnity claim. The per claim cost <br /> of this service shall be posted as an allocated expense to the CLIENT. <br /> 17. On behalf of the Client, ICS will perform all workers compensation claim reporting <br /> services required by the Medicare, Medicaid and SCRIP Extension Act <br /> (MMSEA) Section 111 Mandatory Reporting to the Centers for Medicare & <br /> Medicaid Services (CMS) for the periods identified in this contract. <br /> 18. ICS will comply with the performance standards as required by the City's excess <br /> carrier. ICS will advise if there are any exceptions, or when compliance with new <br /> standards may impact our annual fee. <br /> B. Medical Administration. ICS shall adhere to the following medical <br /> administration standards: <br /> 1. Authorize, review and monitor all medical treatment required on injury or <br /> illness claims. <br /> 2. Audit and pay all medical expenses in a timely manner, and within statutory <br /> guidelines. <br /> 3. Maintain close contact with treating physicians to ensure employees receive <br /> proper medical treatment and are returned to full employment at earliest date. <br /> 4. Arrange for medical-legal opinions in disputed cases, conferring with medical <br /> examiners, CLIENT, and legal counsel where indicated. <br /> 5. Consult as required with CLIENT on those cases where injury residual might <br /> involve restriction and/or retirement potential. <br /> C. Legal Administration. ICS shall adhere to the following legal administration <br /> standards: <br />
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