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Agmt96 Lipman
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Agmt96 Lipman
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Last modified
7/5/2005 2:32:51 PM
Creation date
11/4/2004 1:58:24 PM
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Template:
Agreement
Contractor Name
Lipman
PROJECT NAME
TLC Dental
RMP File Number
304
Date
11/14/1996
Reso Ref
12938
Box
5858
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<br /> Administrators Self-Funded Quote <br />mE <br />LIPMAN <br />COMPANY, INe. <br /> REPORTS: Billin1! and Eli1!ihilitv {Continued} <br /> 4. BILLING AND RECONCILIATION. Lists the previous month's receipts and <br /> distributions of premiums, fees and expenses., along with the amount to be remitted <br /> for the new month. <br /> 5. PREMIUM STATEMENT. A billing for premium, administration fees and any other <br /> fixed costs. <br /> REPORTS: Claims Administration <br /> 1. ADJUSTER REPORT. Prints a report of adjuster activity during the month and <br /> includes total charges, line items and claim checks processed for each adjuster. It <br /> also includes the average charge, average number of line items and average <br /> amount paid per claim. <br /> 2. MONTHLY PAID CLAIM REGISTER. Shows all claims processed during the <br /> current processing month. <br /> 3. MONTHL Y CHECK REGISTER. Summarizes the total number of checks printed <br /> during the month and the amount of each. <br /> 4. BENEFIT ANAL YSIS. Prints various information on claims processed during the <br /> month, including: dependent type, number of service days, total charge, <br /> coinsurance deductible, benefit deductible, COB savings, ineligible amounts and <br /> total dollars paid. <br /> 5. COVERAGE ANALYSIS. Compares claim payment information for selected <br /> coverage analysis codes from one month to the activity within the same code in <br /> another month. The comparisons include the number of service days, total charge <br /> amount, total amount paid and average amount paid. <br /> 6. PROCEDURE ANAL YSIS. Compares payment information for selected procedure <br /> codes from one month to the activity within the same code in another month. These <br /> comparisons include the number of claims, total charges, total amount paid and <br /> average amount paid. <br /> 7. PAID CLAIMS ANALYSIS. Prints claim information accumulated during the month <br /> and includes claim incurred dates, total charges, total ineligible charges, total benefit <br /> deductible, total coinsurance deductible, total basic coinsurance, total COB <br /> reimbursed, total COB savings and total amount paid. <br /> 7 <br /> >r <br />
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