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INNOVATIVE CLAIM SOLUTIONS (ICS)
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INNOVATIVE CLAIM SOLUTIONS (ICS)
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Last modified
12/13/2024 2:30:05 PM
Creation date
6/28/2024 8:55:02 AM
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CONTRACTS
Description Type
Professional Services
Contract Type
Amendment
NAME
INNOVATIVE CLAIM SOLUTIONS (ICS)
Contract Record Series
704-05
Munis Contract #
2022107
Contract Expiration
6/30/2025
NOTES
WORKER'S COMPENSATION ADMINISTRATIVE SERVICES
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6. Determine nature and extent of permanent disability and arrange for <br />informal disability rating whenever possible to avoid Workers' Compensation <br />Appeals Board litigation. <br />7. Explain to and assist employee in completing necessary forms for <br />permanent disability ratings. <br />8. Review, compute and pay all informal ratings, findings and awards, life <br />pensions or compromise and release settlements. <br />9. Maintain and establish reserve estimates for each reported claim. <br />10. Arrange for and supervise all necessary investigations to determine <br />eligibility for compensation benefits and/or liability of negligent third parties. <br />11. Identify, recommend and obtain special fraud investigations after <br />obtaining advance authority from the CLIENT. <br />12. Report all excess claims to the CLIENT'S excess pool and/or reinsurance <br />carrier. <br />13. Arrange and supervise rehabilitation services where indicated. <br />14. Arrange for and set up system for payment of benefits and allocated <br />expenses in accordance with CLIENT'S needs. <br />15. Prepare, 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 <br />and will report to the Index Bureau on each and every indemnity claim. The per <br />claim cost of service shall be posted as an allocated expense to the CLIENT. <br />17. On behalf of the CLIENT, ICS will perform all worker's compensation <br />claim reporting services required by the Medicare, Medicaid and SCHIP <br />Extension Act(MMSEA) Section I 1 1 Mandatory Reporting to the Centers for <br />Medicare & Medicaid Services (CMS) for the periods identified in this contract. <br />18. ICS will comply with the performance standards as required by the <br />CLIENT'S excess carrier. ICS will advise if there are any exceptions, or when <br />compliance with new standards may impact the CLIENT'S annual fee. <br />D. 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 />7IPage <br />DocuSign Envelope ID: 177B557A-79FB-4E9E-B338-6359A5FCBAB8
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