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Consulting Services Agreement between June 1, 2014 <br />City of San Leandro and JT2 Integrated Resources -Exhibit A Page 2of 4 <br />m.Arrange for and supervise all necessaryinvestigations to determine eligibility for compensation <br />benefits and liability of negligent third parties. <br />n.Establish procedures to support the payment of all benefits and allocated expenses together with <br />appropriate documentation necessary to reconcile a trust fund checking account provided by the <br />City of San Leandro. <br />o.Report all excess claims to excess reinsurance carrier. <br />p.Host quarterly claim reviews for the City of San Leandro, with participation of the claim adjuster(s) <br />and as needed, defense attorneys. <br />q.Coordinate an annual stewardship meeting to present service performance metrics, benchmarking <br />and claim trending/loss analysis reports. <br />Bill Review <br />a.Review all bills in a timely manner for compliance with applicable fee schedules and reduce <br />accordingly. <br />b.Identify and reduce all duplicate billings. <br />c.Deny charges for all items not required for injury described. <br />d.Identify all unauthorized charges to insure billing does not exceed parameters of injured workers’ <br />treatment plan. <br />e.Provide reports on a monthly and annual basis outlining bill review activity, savings and costs. <br />Provide ad hoc reports as requested. <br />f.Handle all provider inquiries regarding bill reductions. <br />Medical management <br />a.Provide medical management of all cases to assure cost-effectiveand appropriate treatment, <br />including assurance that treatment is related to the compensable injury or illness. <br />b.Approve or disallow service requests within the applicable time standards and provide medical <br />advice as warranted. <br />c.Provide timely reports to the City of San Leandro outlining utilization review requests, approvals, <br />denials and costs/savings. <br />d.Arrange for medical/legal opinions in disputed cases, conferring with medical examiners, <br />professional personnel, City of San Leandro and legal counsel where indicated.