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Service Comments <br /> (MNRP for non-emergency non-network claims. <br /> Shared Savings Program The services under this program provide access to provider <br /> Application of the Shared Savings Program provides discounts only and do not include credentialing of providers or <br /> additional savings on select non-Network facility and other Network services.United is not responsible for the <br /> physician claims not eligible for standard network discounts. medical outcomes or the quality or competence of any provider <br /> Program provides access to discounted charges made or facility rendering services under the Shared Savings <br /> available to United from health care providers who contract Program. <br /> or will negotiate with,a third party to provide such <br /> discounted charges. Either party can terminate the Shared Savings Program at any <br /> time for any reason with written notice. <br /> Access to Extended Networks(leased networks) Available at an additional charge. <br /> I. CARE MANAGEMENT AND OUTREACH SERVICES <br /> Service Comments <br /> Personal Health Support,an integrated personal health Coordination with external vendors is subject to an additional <br /> management program using a designated team of nurses and fee. <br /> incorporating elements of care management core activities <br /> such as case management and support around specific <br /> treatment decisions. A pregnancy program,consumer <br /> engagement notification program including gaps in care <br /> messaging,and a predictive model specific to Customer are <br /> also included. <br /> Medica olicy functions,as guided by a medical director. Standard on all managed plans. _ <br /> Disease Management Programs Coordination with external vendors is subject to an additional <br /> fee. <br /> Complex Medical Conditions: <br /> • Cancer Resource Services <br /> 9 Congenital Heart Disease Resource Services <br /> • Healthy Pregnancy <br /> • Kidney Resource Services <br /> • Maternity Support Program <br /> • Neonatal Resource Services <br /> Alternate Care Proposals(ACP)which provide appropriate ? Customer consents to United's use and administration of the <br /> and cost effective health care services and supplies I ACP program and delegate to United the discretion and <br /> alternatives that would otherwise not be covered by the Plan. i authority to develop and revise ACPs. __ ^ <br /> Activation programs to engage Participants including, <br /> monthly health statements member call services,and access <br /> to member ortal with consumer messaging <br /> Predictive modeling,using data from a proprietary system, Standard on all managed plans. Additional charges apply for <br /> to identify individuals at risk and offer proactive programs to integrating an outside vendor's pharmacy data <br /> improve their health status. <br /> 20 <br />