ATTACHMENT A
ADMINISTRATIVE SERVICES
HPHC shail perform the following administrative services for Purchaser with
. respect to the Plan.
- 4. Financial Systems and Services. HPHC shall establish, administer and
maintain accounting procedures and systems for the preparation of appropriate financial
reports for the efficient management and planning for the Plan. The foregoing shall
include, but not be limited to:
(a) Not later than ninety (90) days prior to the beginning of each annual
contract period, HPHC shail prepare and provide the Purchaser with
an annual operating budget setting forth an estimate of the Plan’s
operating expenses for the contractual year which shall be in
reasonable detail and shall contain an explanation of anticipated
changes, if any, in utilization, claims paid, and other factors which
may significantly affect the operating budget.
(b) HPHC shall assist Purchaser on Purchaser's request in preparing
and filing all financial reports required of Purchaser regarding the
Plan by any federal, state or other agency or authority.
(c) HPHC will provide the Purchaser monthiy accounting statement,
standard support reports, working fund billing services, and up to ten
(10) hours per year of personnel support for audits. Comprehensive
audits of claims data covering a multiple year period require a 45
day notice. HPHC will accommodate non standard report requests
subject to available staffing capacity and will reserve the right to
charge one hundred dollars ($100) per hour for labor costs, and a
set up fee of one hundred dollars ($100.00) per hour for
programming costs and seventy-five dollars ($75.00) per hour for
installation costs associated with each request. Audit support in
excess of ten (10) hours per year will be charged at one hundred
dollars ($100) per hour for each request.
2. Claims Processing and Administration. Subject to the restrictions in
Section 2(c) below, HPHC shall design, implement and maintain such systems and
procedures as may be necessary for the appropriate adjudication and timely payment of
all claims for payment submitted to Purchaser (including Member and provider claims)
and to assure the availability of appropriate and accurate information for the
administration of the Plan's programs. HPHC's services shall include, but not be limited
to the following:
FORM# PS_AO1 05/17/2002
