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Reso 1998-066 to 070
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Reso 1998-066 to 070
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CM City Clerk-City Council
CM City Clerk-City Council - Document Type
Resolution
Document Date (6)
12/31/1998
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information that will assist the physician in making an objective evaluation. Copies medical <br />evaluations will be provided to the City. <br />8. Any medical bill received will be reviewed prior to payment with regard to causal <br />relationship to the accident/work-related injury. <br />9. Where needed, rehabilitation and/or retraining will be recommended and the progress will be <br />closely monitored and controlled. The first evaluation as to the appropriateness of rehab will <br />take place according to Workers' Compensation State requirements. <br />10. Subrogation will be promptly recognized and investigated. <br />11. All reserves will be evaluated for accuracy, based on information at hand, every time the case <br />is handled and/or reviewed. <br />12. All "medical only" cases will be reviewed for closing at least every ninety (90) days. <br />13. Settlement evaluation will be made promptly, based on information included in the file, as <br />well as other criteria by which a value may be based. <br />14. Where warranted, settlement will be pursued in a timely and aggressive manner, and all <br />negotiations will be handled or managed internally by the claims person assigned to the case <br />or qualified attorney under direction of the Claims Administrator. <br />15. Settlement authority will be granted in accordance with the policy established by the City. <br />Medical Control: <br />1. Recommend the composition of medical facilities and panels in conjunction with the City. <br />2. Maintain close liaison with doctors and assure maximum efficiency in the management of <br />claims and compliance with State laws regarding provision of job descriptions to determine <br />return to work possibilities. <br />3. Review every Doctor's First Report and initiate proper procedure in each claim. <br />4. Audit all medical bills. <br />5. The City will be provided with copies of medical evaluations, treatment records, and other <br />medical reports. <br />City of San Leandro <br />Standard Contractual Services Agreement <br />5/29/97 <br />AGRE\STANDARD.DOC <br />249 <br />
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