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INNOVATIVE CLAIM SOLUTIONS (ICS)
City of Pleasanton
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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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2. Audit and pay all medical expenses in a timely manner, and within <br />statutory guidelines. <br />3. Maintain close contact with physicians to ensure employees receive proper <br />medical treatment and are returned to full employment at the earliest date, <br />ensuring all appropriate documentation is received as soon as possible. <br />4. Arrange for medical-legal opinions in disputed cases, conferring with <br />medical examiners, CLIENT, and legal counsel where indicated and when <br />allowed outside of the QME process. <br />5. Consult as required with CLIENT on those cases where injury residual <br />might involve restriction and/or retirement potential. <br />E. Legal Administration. ICS shall adhere to the following legal administration <br />standards. <br />1. Refer litigated cases, when needed,to attorneys recommended by ICS and <br />approved by CLIENT for purposes of defending CLIENT'S interests before the <br />Workers' Compensation Appeals Board and the court. <br />2. Work closely with counsel in preparing defense of litigated cases. <br />3. Obtain CLIENT'S authorization on all settlements or stipulations when <br />required. <br />4. Work closely with applicant's attorney and legal counsel in informal <br />dispositions of litigated cases. <br />5. Attend, when required, Workers' Compensation Appeals Board hearings. <br />6. Discharge on behalf of CLIENT, all legal obligations to its injured <br />employees imposed by Workers' Compensation Appeals Board and higher courts. <br />7. Protect and preserve CLIENT'S interests in all potential subrogation <br />cases. <br />F. Medical Cost Containment Services. ICS shall adhere to the following medical <br />cost containment service standards: <br />1. Use and cooperate fully with the designated medical cost containment <br />vendor(bill review and utilization review service providers)to review the medical <br />bills for the CLIENT, including other medical charges and treatment relating to <br />the claims of industrial injury or illness, and provide necessary utilization review <br />services related to treatment requests on all claims of industrial injury or illness. <br />2. Unless otherwise directed, ICS will select the bill review service provider <br />to be utilized and the CLIENT will pay for such services. The rate of services for <br />bill review will be charged at $3.00 per header, $1.00 per line, 20%of savings for <br />81Page <br />DocuSign Envelope ID: 177B557A-79FB-4E9E-B338-6359A5FCBAB8
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