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Agmt12 Athens Administrators
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Agmt12 Athens Administrators
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Last modified
8/28/2012 2:17:00 PM
Creation date
8/28/2012 2:17:00 PM
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Template:
Agreement
Contractor Name
Athens Administrators
PROJECT NAME
Workers' Compensation Service Agreement
RMP File Number
304
Date
6/25/2012
MO Ref
12-128
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a <br /> S r <br /> o. Make all disability payments and send ail notices in a timely manner,abiding by all applicable <br /> provisions of the California Labor Code and California Workers'Compensation Laws, Rules <br /> and Regulations. <br /> p. Make payments of bills within thirty (30) days of receipt, and assure timely review and <br /> payment of all medical bilis in accordance with statutory deadlines and requirements. <br /> q. Acknowledge to Employer all claims reported to Administrator within three(3)working days <br /> of receipt of the notice of claim and to notify Employer and injured workers within five(5) <br /> working days of the notice of claim to Employer, whether the claim has been accepted, <br /> delayed for further investigation,or denied. <br /> r. Convert all Medical Only Claims to Indemnity Claims status when the paid amount reaches <br /> two-thousand-five-hundred($2,500)dollars orwhen the claim remains open in excess of one <br /> (1)year. <br /> s. Recognize and where appropriate investigate all subrogation and/or contribution possibilities, <br /> preserving evidence and utilizing appropriate investigators and experts,as needed,after first <br /> obtaining Employers permission to engage such investigators/experts. As respects <br /> subrogation and contribution cases, any compromise settlements or lien reductions will be <br /> discussed with the Employer. <br /> t. SCHIP Reporting-Administrator has contracted with Gould & Lamb, LLP as our preferred <br /> provider for Medicare Set Aside Allocations. Gould&Lamb,LLP is also our preferred partner <br /> in all SCHIP reporting efforts. Unless specifically approved in advance by Employer, <br /> Administrator wili exclusively utilize the services of Gould&Lamb,LLP to satisfy and comply <br /> with all SCHIP reporting requirements. <br /> 4.03 Administrator agrees to monitor relevancy of inedical treatment by the following: <br /> a. Maintain continual contact with medical practitioners in orderto monitor claimanttreatment <br /> process and a timely return to work.Administrator shall make a good faith effort to establish <br /> contact with attending physician within twenty-four(24)hours of receipt of injury report and <br /> shaii make contact with attending physician's office within forty-eight(48)hours of receipt of <br /> injury report and shall document such contact in the claim file. <br /> b. Review and discuss Vocational Rehabilitation Program(s)with Employer priorto its initiation <br /> for an individual claimant. <br /> c. Monitor individual vocational rehabilitation programs to determine appropriateness and <br /> progress. <br /> 4.04. Administrator agrees to the following record keeping and reporting requirements: <br /> a. Provide Employer with monthly reports consisting of: <br /> (1) Check Registers including all claim disbursements made on behalf of <br /> Employer. <br /> The City of Redwood City- Claim Service Agreement- 2012-2014 <br /> 5 <br />
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