ATTACHMENT D
FUNDING OF COVERED SERVICES
OVERVIEW: HPHC shali from time to time, generally at weekly intervals, issue
payment to Contracting Providers for Covered Services. HPHC makes such
payments from a master claims paying account. This Attachment describes the
manner in which the Purchaser provides sufficient funds to HPHC to cover such
payments. Purchaser understands that failure to make sufficient funds available
in accordance with this Attachment shall cause HPHC to suspend further claims.
payments.
WEEKLY TRANSFER WITH PURCHASER AS ORIGINATOR: Purchaser has
agreed to reimbursement through weekly wire transfer with Purchaser as the
originator, HPHC will invoice Purchaser each week by Friday. Unless otherwise
agreed, the invoice will be in the form of a fax. Each invoice will include all claims
that were paid on Tuesday of that week from the HPHC master claims paying
account. Purchaser shall wire the amount due to HPHC by the third business day
following notification. This form of reimbursement requires that Purchaser make
an initial working deposit equal to one half of a month’s anticipated claims
expense as calculated by HPHC. The working deposit shall be kept in a
segregated sub-account specific to Purchaser maintained by HPHC at Citizens
Bank. HPHC acts as the custodian of the sub-account. A “W-9 Form” must be
filled out by Purchaser to establish the sub-account. Interest earned at the
current bank interest rate will be added to the working deposit. Each plan year,
HPHC will recalculate the working deposit required based on current utilization
and membership.
MONTHLY STATEMENT: Each month, HPHC shail provide a statement to the
Purchaser, which will include all claims paid and all payments received within the
month. This report will include detailed reports that support the claims charges on
the monthly billing statement.
DUTIES ON TERMINATION: Pursuant to section 3.8 of the Agreement, HPHC
shall process and pay all eligible claims incurred during the term of this
Agreement for a period up to twelve (12) months after termination of the
Agreement, and Purchaser shall continue to provide funding for such claims
payments in accordance with this Attachment.
Form# PS_4D01 05/17/2002
