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10
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2021
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061521
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6/9/2021 3:52:38 PM
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6/9/2021 3:52:34 PM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
6/15/2021
DESTRUCT DATE
15Y
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all PPO savings, 20% of savings on all non PPO inpatient hospital bill savings <br /> and 16%of all non PPO outpatient bill savings, unless otherwise negotiated. <br /> 3. Use and cooperate fully with the designated Utilization Review vendor to <br /> refer all cases that meet the requirements of this service, for purposes of <br /> controlling treatment parameters and duration in accordance with all legislative <br /> changes. <br /> 4. Unless otherwise directed, ICS will select the Utilization Review service <br /> provider to be utilized and the CLIENT will pay for such services. The rate for <br /> utilization review services will be charged at$100 per RN determination, $220 <br /> per hour(billed in 1/4 hour increments) for all Physician Adviser Reviews, $310 <br /> per hour(billed in 1/4 hour increments) for all Specialty Physician Reviews on <br /> appeal and all Peer Reviews. <br /> G. Information Systems - ICS will provide a computer system with appropriate data <br /> base management capabilities to maintain records related to the administration of the <br /> CLIENT'S workers' compensation program. ICS shall coordinate data entry for employees <br /> in the program and for services supplied by ICS. The CLIENT shall have access to the <br /> computer system during normal working hours and access to the database through its own <br /> computers at its own expense. ICS shall provide computer-generated reports that are <br /> reasonably requested on a regular basis as detailed in section H below. <br /> H. Statistical. ICS will adhere to the following statistical report production <br /> obligations and provide all required reports to the CLIENT at agreed to intervals: <br /> 1. Report to CLIENT,monthly status of claim payments and reserves on an <br /> individual claim basis and in the aggregate. <br /> 2. Report to CLIENT, quarterly loss analysis of claims filed by frequency <br /> and severity. <br /> 3. Assist in the preparation of all reports required by the State of California <br /> or other Governmental agencies relating to Workers' Compensation claims. <br /> 4. ICS will prepare the federal information return (Form 1099)by the <br /> statutory deadline for all payments subject to 1099 reporting made by ICS on <br /> behalf of the CLIENT during the term of this Agreement. <br /> 5. Additional ad-hoc reports will be provided to CLIENT at their request at <br /> no additional cost. Special report requests that require programming time will be <br /> charged to CLIENT at $150 per hour,which is the direct cost of ICS. Our system <br /> is capable of generating standardized reports as follows: <br /> • Claim Logs <br /> • Claim Activity <br /> • Claim Cost Detail <br /> • Claim Cost Summary <br /> • Claim Cost Summary by Year <br /> 9IPage <br />
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