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Service Comments <br /> regardless of dates of service. _ <br /> Application of subrogation services. <br /> Abuse and Fraud Management Recovery Program. The fee includes all work to identify recovery opportunities, <br /> research,conduct data analysis,investigate,negotiate <br /> settlements without the use of outside counsel,and draft legal <br /> documents. <br /> If outside counsel is retained for a group of payers seeking the <br /> recovery,a proportionate amount of the outside legal fees, <br /> equal to the payer's exposure in the case to the total exposure <br /> in the case,will be deducted from the gross recovery amount, <br /> after the fee has been deducted Customer will be given the <br /> _ option to participate or decline participation in the settlement. <br /> Hospital Bill Audit Program. <br /> Credit Balance Recovery Program. <br /> Advanced Analytics and Recovery Services United or its affiliate will use a combination of large scale <br /> analytics,information and analysis to identify post- <br /> adjudication claims for additional overpayment o ortunities. <br /> F. MEMBER SERVICES <br /> Service Comments <br /> Toll-free access to a customer care unit using a dedicated <br /> number <br /> Employee access to a member website enabling Participants <br /> to: <br /> • Check claim status. <br /> • Check eligibility information. <br /> • Search for providers and online health information. <br /> G. MEDICARE SERVICES <br /> Service Comments <br /> Medicare Secondary Payer Reporting. United shall Customer agrees to provide to United in a timely manner and <br /> provide to applicable parties the applicable reports in a time in an agreed upon format any and all data that United requires <br /> and manner as required according to the Medicare Secondary to comply with the Reporting Requirements. <br /> Payer Mandatory Reporting Provisions ("Reporting <br /> Requirements") in Section 111 of the Medicare, Medicaid, <br /> and SCHIP Extension Act of 2007. United shall not be <br /> responsible for any noncompliance penalties in connection <br /> with the Reporting Requirements that are related to <br /> Customer's failure to provide the required data. <br /> H. NETWORK SERVICES <br /> Service Comments <br /> Network access, management and administrative Standard on all network plans. <br /> activities _ <br /> UnitedHealth PremiumsM Designation Program Available_ in designated markets. _ <br /> Network access to chiropractic and complementary <br /> alternative medicine providers <br /> Physical Health Clinical Support Program for Chiropractic <br /> and Complementary Alternative providers. <br /> Transplant Solutions(TS)Services <br /> • Transplant Network via Centers of Excellence(COE) <br /> • Transplant Access Program(TAP)Network <br /> • Extra-Contractual Services-contracting on a case-by <br /> case basis for transplant care outside of the COE or TAP <br /> Networks for a standard negotiating <br /> Reasonable and customary charge guidelines for out of <br /> network surgical,medical,lab and x-ray claims. <br /> Maximum Non-Network Reimbursement Program <br /> 19 <br />