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01
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2007
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082107
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01
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8/16/2007 4:31:45 PM
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8/16/2007 4:31:45 PM
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CITY CLERK
CITY CLERK - TYPE
STAFF REPORTS
DOCUMENT DATE
8/21/2007
DESTRUCT DATE
15 Y
DOCUMENT NO
01
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6. Discharge on behalf of CLIENT, all legal obligations to its injured employees <br />imposed by Workers' Compensation Appeals Board and higher courts. <br />7. Protect and preserve CLIENT'S interests in all potential subrogation cases. <br />D. Medical Cost Containment Services. ICS shall adhere to the following medical cost <br />containment services standards: <br />ICS shall use and cooperate fully with the designated medical cost containment <br />vendor (bill review and utilization review service provider) to review the medical <br />bills for the CLIENT and other medical charges and provide necessary utilization <br />review services relating to treatment requests on all claims of industrial injury or <br />illness. <br />2. Unless otherwise directed, ICS will select the service provider to be utilized and <br />CLIENT will pay for such services. The rate of services for bill review will be <br />charged at $3.50 per header, $1.15 per line, 24% of savings for all PPO savings, 20% <br />of savings on all non PPO inpatient hospital bill savings and 16% of all non PPO <br />outpatient bill savings, unless otherwise negotiated. The rate for utilization review <br />services will be charged at $100 per RN determination, $220 per hour (billed in '/4 <br />hour increments) for all Physician Adviser Reviews, $310 per hour (billed in'/4 hour <br />increments) for all Specialty Physician Reviews on appeal and all Peer Reviews. <br />E. Information Systems. ICS will provide a computer system with appropriate data <br />base management capabilities to maintain records related to the administration of the Client's <br />workers' compensation program. ICS shall coordinate data entry for employees in the program <br />and for services supplied by ICS. The CLIENT shall have access to the computer system during <br />normal working hours and access to the database through its own computers at its own expense. <br />ICS shall provide computer-generated reports that are reasonably requested on a regular basis as <br />detailed in section F below. <br />F. Statistical. ICS will adhere to the following statistical report production obligations <br />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 individual <br />claim basis and in the aggregate. <br />2. Report to CLIENT, quarterly loss analysis of claims filed by frequency and severity. <br />3. Assist in the preparation of all reports required by the State of California or other <br />Governmental agencies relating to Workers' Compensation claims. <br />4. ICS will prepare the federal information return (Form 1099) by the statutory deadline <br />for all payments subject to 1099 reporting made by ICS on behalf of the CLIENT <br />during the term of this Agreement. <br />
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