(a)
(b)
(c)
(d)
HPHC shall assist Purchaser in preparing and distributing to
Members appropriate Member identification cards, instructional
brochures, booklets, announcements, and disclosure statements as
may be reasonably necessary and/or required by law, to assure the
availability of accurate and appropriate information regarding the
healih care services to be provided and the administration and
operations of the Pian’s programs. Upon request of the Purchaser,
customized member materials will be charged to the Purchaser at
cost.
HPHC shall develop and provide information for distribution to
Contracting Providers as may be reasonably necessary and/or
required by law to fully describe billing procedures, payment for
services, and the schedule of Covered Services. Such costs, as
well as all costs associated with the development and maintenance
of a network that meets Purchaser’s requirements as specified
herein shail be borne by HPHC:
HPHC shail develop and maintain Member and provider files to
permit eligibility verification, rate and provider compensation
computations, claims adjudication and efficient and timely response
to inquiries from Members and providers. HPHC shall be
responsible for informing Members in a timely fashion of the lapse
or termination of their eligibility to receive Covered Services. tn
accordance with Section 2.6 and 2.7 of the Purchaser Service
Agreement, HPHC may rely on information regarding the eligibility
of Members provided by Purchaser.
HPHC shall provide to the Purchaser a monthly administration bill
with membership roster. HPHC will accommodate billing.
reconciliation requests subject to availiable staffing capacity and will
reserve the right to charge one hundred dollars ($100) per hour for
labor costs.
5, Information Systems. HPHC shall employ an information system
appropriate for the purposes of claims processing, provider compensation computation,
utilization review, quality assessment, eligibility of Members, billing and making required
reports to regulatory agencies. HPHC shail bear all reasonable costs associated with the
acquisition and maintenance of the information system, including purchase or lease of
equipment, hardware and software development, installation, maintenance and
modification, and computer time- sharing and all personnet costs. The system, including
all software programs related thereto, shall be proprietary to HPHC or its contractor,
FORM# PS_A01
08/17/2002
