AUDIT PREREQUISITES Clause Samples
AUDIT PREREQUISITES. A. There are four components of your arrangement with ESI eligible for audit on an annual basis from February through October: • Retrospective Claims • Rebates • Performance Guarantees • Compliance with Regulatory Requirements (i.e., Medicare Part D) Balancing the need to adequately support the audit process for all ESI clients, with an efficient allocation of resources, we encourage clients to audit all four components, as applicable, through a single annual audit. If you choose to audit the above components separately throughout the year, rather than combining all components into a single annual audit, you will be subject to ESI’s standard charges for each additional audit. All such fees shall be reasonable and based on ESI’s costs for supporting such additional audits.
B. ESI will provide all data reasonably necessary for Sponsor to determine that ESI has performed in accordance with contractual terms. ESI will use commercially reasonable best efforts to provide the retrospective claims and benefit information in no more than fifteen (15) days from the audit kickoff call and having an executed confidentiality agreement. ESI’s pledge to respond within the foregoing timeframe is predicated on a good faith and cooperative effort between Sponsor and/or its Auditor and ESI.
C. ESI engages a national accounting firm, at its sole cost and expense, to conduct a SSAE 16 audit on behalf of its clients. Upon request, ESI will provide the results of its most recent SSAE 16 audit. Testing of the areas covered by the SSAE 16 is not within the scope of Sponsor’s audit rights (i.e., to confirm the financial aspects of the Agreement) and is therefore not permitted. However, if requested, ESI will explain the SSAE 16 audit process and findings to Sponsor in order for Sponsor to gain an understanding of the SSAE 16.
AUDIT PREREQUISITES. A. There are four components of your arrangement with ESI eligible for audit on an annual basis from February through October:
A. Retrospective Claims
B. Rebates
C. Performance Guarantees
D. Compliance with Regulatory Requirements (i.e., Medicare Part D)
B. ESI will provide all data reasonably necessary for Sponsor to determine that ESI has performed in accordance with contractual terms. ESI will use commercially reasonable best efforts to provide the retrospective claims and benefit information in no more than fifteen (15) days from audit kickoff call and having an executed confidentiality agreement. Our pledge to respond within the foregoing timeframe is predicated on a good faith and cooperative effort between Sponsor and/or its Auditor and ESI.
C. ESI engages a national accounting firm, at its sole cost and expense, to conduct a SSAE 16 audit on behalf of its clients. Upon request, ESI will provide the results of its most recent SSAE 16 audit. Testing of the areas covered by the SSAE 16 is not within the scope of Sponsor’s audit rights (i.e., to confirm the financial aspects of the Agreement) and is therefore not permitted. However, if requested, ESI will explain the SSAE 16 audit process and findings to Sponsor in order for Sponsor to gain an understanding of the SSAE 16.
AUDIT PREREQUISITES. A. The financial aspects of the Agreement can be broken down into the following two main components. Sponsor has the right to audit any or all of these components, if applicable: • Claims
AUDIT PREREQUISITES. A. The financial aspects of the Agreement can be broken down into the following three main components. Sponsor has the right to audit any or all three of these components, if applicable: • Claims • Rebates • Performance Guarantees At Sponsor’s discretion, Sponsor may conduct an audit of each component separately, or may combine all three components in one audit. In addition to the above audit rights, Sponsor may address general claim inquiries, which do not require an audit, by contacting Sponsor’s ESI Account Management team at any time.
B. ESI will provide all data reasonably necessary for Sponsor to determine that ESI has performed in accordance with contractual terms.
C. ESI engages a national accounting firm, at its sole cost and expense, to conduct a SAS 70 audit on behalf of its clients. Upon request, ESI will provide the results of its most recent SAS 70 audit. Testing of the areas covered by the SAS 70 is not within the scope of Sponsor’s audit rights (i.e., to confirm the financial aspects of the Agreement) and is therefore not permitted. However, if requested, ESI will explain the SAS 70 audit process and findings to Sponsor in order for Sponsor to gain an understanding of the SAS 70.
AUDIT PREREQUISITES. A. There are five components of your arrangement with ESI eligible for audit on an annual basis, which must be initiated from February through October: Plan Design Administration Retrospective Claims Rebates Performance Guarantees Compliance with Regulatory Requirements (i.e., Medicare Part D) Sponsor is allowed one annual audit at no cost. If you choose to audit the above components separately throughout the year, rather than combining all components into a single annual audit, you will be subject to ESI’s standard charges for each additional audit. All such fees shall be reasonable and based on ESI’s costs for supporting such additional audits.
B. ESI will provide all data reasonably necessary for Sponsor to determine that ESI has performed in accordance with contractual terms. ESI will use commercially reasonable best efforts to provide the retrospective claims and benefit information in no more than fifteen (15) days from audit kickoff call and having an executed confidentiality agreement. Our pledge to respond within the foregoing timeframe is predicated on a good faith and cooperative effort between Sponsor and/or its Auditor and ESI.
C. ESI engages a national accounting firm, at its sole cost and expense, to conduct a SSAE 16 audit on behalf of its clients. Upon request, ESI will provide the results of its most recent SSAE 16 audit. Testing of the areas covered by the SSAE 16 is not within the scope of Sponsor’s audit rights (i.e., to confirm the financial aspects of the Agreement) and is therefore not permitted. However, if requested, ESI will explain the SSAE 16 audit process and findings to Sponsor in order for Sponsor to gain an understanding of the SSAE 16.
AUDIT PREREQUISITES. A. The financial aspects of the Agreement can be broken down into the following two main components. Client has the right to audit any or all of these components, if applicable: • Claims