Common use of Expert Services Clause in Contracts

Expert Services. a. At the request of the DEPARTMENT, the CONTRACTOR must make available qualified medical consultants to assist the DEPARTMENT in its reviews of questionable claims, claims recommended for denial for medical reasons, reconsiderations, and appealed claim determinations. b. The CONTRACTOR must have legal and technical staff available to the DEPARTMENT for consultation as needed for program administration, and for assistance with any appeals processes. c. The CONTRACTOR must monitor the development of and provide notification and information to the DEPARTMENT in a timely manner concerning state or federal regulations or legislation that may affect the HEALTH BENEFITS PROGRAM.

Expert Services. ‌ a. At the request of the DEPARTMENT, the CONTRACTOR must make available qualified medical consultants to assist the DEPARTMENT in its reviews of questionable claims, claims recommended for denial for medical reasons, reconsiderations, and appealed claim determinations. b. The CONTRACTOR must have legal and technical staff available to the DEPARTMENT for consultation as needed for program administration, and for assistance with any appeals processes. c. The CONTRACTOR must monitor the development of and provide notification and information to the DEPARTMENT in a timely manner concerning state or federal regulations or legislation that may affect the HEALTH BENEFITS PROGRAM.

Expert Services. a. ‌ a) At the request of the DEPARTMENT, the CONTRACTOR must shall make available qualified medical consultants to assist the DEPARTMENT in its reviews of questionable claims, claims recommended for denial for medical reasons, reconsiderations, reconsiderations and appealed claim determinations. b. b) The CONTRACTOR must shall also have legal and technical staff available to the DEPARTMENT for consultation as needed for program administration, and for assistance with any appeals processes. c. . The CONTRACTOR must shall monitor the development of and provide notification and information to the DEPARTMENT in a timely manner concerning state or federal regulations or legislation that may affect the HEALTH BENEFITS PROGRAM.