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Claim Wady Date <br /> Ready to pay electronic claims by the later of the effective date or within the designated number of days <br /> following the completion of key implementation tasks: (i)Account structure and benefit plan details are <br /> Definition defined and written approval has been provided by the customer,(ii)final eligibility has been received and <br /> successfully tested by United;and(iii)if so negotiated,deductibles and lifetime maximums from the <br /> revious carrier received in a mutually agreed upon format,accurate,and loaded electronically. <br /> Measurement Electronic claim ready by effective date or the later of business days or less business days IS <br /> If any additional changes are received or requested after written approval is received, 10 additional business <br /> Criteria days will be required for changes affecting up to ten benefit plans(sets);20 additional days will be required <br /> for than es affecting ten or more benefit plans(sets). <br /> Level Customerspecific <br /> Period Initial implementation timefi-ame <br /> Payment Period Annually <br /> Fees at Risk Total Dollars at Risk for this metric $3,900 <br /> Payment Amount Of the Fees at Risk for this metric,percentage at risk for each gradient N/A <br /> Gradients Not applicable <br /> Eli ibli Loading <br /> Definition Initial implementation electronic eligibility files will be loaded within the timeframe set forth following <br /> receipt of clean eligibility file. <br /> Measurement Files loaded,in business days or less business da s 3 <br /> Clean eligibility file once approved by Customer and/or its designee and United,which must be:a)error <br /> Criteria free;b)formatted per United's standards;and c)received by 12:00 p.m.,EST on the scheduled date,or the <br /> arantee period starts the following business day. <br /> Level Customerspecific <br /> Period Initial implementation timeframe <br /> Payment Period Annually <br /> Fees at Risk Total Dollars at Risk for this metric $3,900 <br /> Pavinent Amount Of the Fees at Risk for this metric,percentage at risk for each gradient N/A <br /> Gradients Not a plicable <br /> Time to Process in'10 Days <br /> Definiti on The percentage of all claims United receives will be processed within the designated number of business <br /> days of receipt. <br /> Measurement Percentage of claims processed 94°l0 <br /> Time to rocess,in business days or less after receipt of claim business days 10 <br /> Criteri a Standard claim operations reports <br /> Level Site Level <br /> Period Annually <br /> Payment Period Annually <br /> Fees at Risk Total Dollars at Risk for this metric $3,900 <br /> . .............. ....... . ...._ ._.. <br /> Payment Amount Of the Fees at Risk for this metric,percentage at risk for each gradient 20% <br /> Gradients 11 business days <br /> 12 business days <br /> 13 business days <br /> 14 business days <br /> 15 business days or more <br /> 24 <br />