INTERMEDIARY OBLIGATIONS Clause Samples

INTERMEDIARY OBLIGATIONS. 25 A. INTERMEDIARY shall perform as fiscal intermediary on behalf of All Providers, Out-of- 26 Network Providers, and COUNTY. INTERMEDIARY shall reimburse All Providers and Out-of- 27 Network Providers in accordance with the Agreement and all other agreements for the MSI Program in 28 which INTERMEDIARY is defined. ADMINISTRATOR shall provide copies of all such agreements 29 to INTERMEDIARY. 30 B. During the term of the Agreement, and for such time thereafter as required by the Agreement, 31 INTERMEDIARY shall perform the services herein including, but not limited to, the following: 32 1. Receiving, compiling, preserving, and reporting information and data. 33 2. Receiving eligibility data by direct on-line input provided by ADMINISTRATOR’s 34 eligibility system provider, performing utilization review, and processing, denying, approving all claims 35 submitted in accordance with Exhibit B. 36 3. Providing a process for All Provider and patient appeals of denied services. 37 4. Receiving, maintaining, collecting, and accounting for Funds. 1 5. Reimbursing claims and making other required payments. 2 6. Sanction screening All Providers for the MSI Program to ensure that they are not 3 designated as Ineligible Persons.

INTERMEDIARY OBLIGATIONS. 17 A. CONTRACTOR shall perform as fiscal intermediary on behalf of Physicians and COUNTY. 18 B. During the term of the Agreement, and for such time thereafter as required by the Agreement, 19 CONTRACTOR shall continuously provide sufficient staffing including production, supervisory and 20 management staff to ensure timely and efficient performance of the services herein. 21 1. CONTRACTOR agrees to provide the resources necessary to address any backlog claims 22 processing or an increased influx of claims within the time periods specified herein. 23 2. CONTRACTOR agrees that staff providing claims adjudication services shall, to the extent 24 possible and practical, be dedicated to the performance of the duties herein for the EMSF program. 25 3. CONTRACTOR shall ensure that a designated point of contact and alternate, when 26 necessary, is available at all times during regular business hours to respond to requests from 27 ADMINISTRATOR. 28 4. CONTRACTOR agrees that all services provided pursuant to the Agreement shall be 29 provided at CONTRACTOR’s primary place of business and that no services may be outsourced outside 30 the contiguous United States of America without prior written consent of ADMINISTRATOR. 31 C. During the term of the Agreement, and for such time thereafter as required by the Agreement, 32 CONTRACTOR shall continuously provide fiscal intermediary services including, but not limited to, 33 the following: 34 1. Receiving, compiling, preserving, and reporting information and data. 35 2. Processing, denying, approving all Claims submitted. 36 3. Receiving, maintaining, collecting, and accounting for Funds. 37 4. Reimbursing Claims and making other required payments. 1 5. Establishing and maintaining all necessary policies and procedures pertaining to 2 CONTRACTOR’s responsibilities pursuant to the Agreement. 3 6. Routine storage and destruction of records. 4 7. Special retrieval of records.

INTERMEDIARY OBLIGATIONS. Once commissioned by both parties, the agent is responsible for actively finding suitable properties or clients for both parties and facilitating a successful lease. Upon the completion of the transaction between Party A and Party B, the agent’s responsibilities are considered fulfilled once the agent’s fee is collected. If a dispute arises between Party A and Party B during the lease period, the agent may intervene to mediate the dispute. If mediation fails, the parties may apply for mediation with the People’s Mediation Committee, and if that also fails, they may file a lawsuit with the local People’s Court.

INTERMEDIARY OBLIGATIONS. 34 35 A. 36 37 1 Manual as approved by the Medical Policy Committee (MPC).

INTERMEDIARY OBLIGATIONS. The Intermediary undertakes to the Provider: 8.4.1 that where any part of a Message generated by, or on behalf of, the Provider is disclosed to a Customer, such disclosure will be made subject to any notes from the Provider which are contained within the Message relating to the presentation or disclosure of that Message; 8.4.2 to ensure that any Message, or Data contained within a Message, received by the Intermediary is not disclosed to any person not authorised to access and / or view it; and 8.4.3 to ensure that a User who receives or is able to access a Message in error will: (a) not use or disclose the Message for any purpose whatsoever; and (b) promptly notify the Provider; and 8.4.4 not to use, or permit the use of, the Message for any purposes other than those specified in Schedule 2 (Technical Schedule) or, if none are specified, not to use, or permit the use of, the Message for any purposes other than as may be required by the Intermediary in order to carry out its legitimate business.

INTERMEDIARY OBLIGATIONS. 5.1 The Intermediary shall submit hard copy of policy documents, including signed Proposal Form and other deliverables as may be specified by RS from time to time for all new and renewal business processed, together with a list of all the transactions, as provided by the Online Intermediary Interface Service issued during the previous day duly signed by the authorised signatory on the following day. 5.2 The Intermediary shall provide and maintain at its own expense any device needed to access the Service 5.3 All costs incurred by the Intermediary in accessing and utilising the Service including the cost of online access shall be at the Intermediary’s own expense. 5.4 All security incident should be reported to Royal Sundaram' at the earliest possible time. 5.5 The Intermediary shall indemnify and keep RS fully indemnified for the entire amount of any direct or indirect loss suffered by RS arising from, traceable or attributable to any unauthorised, wrongful or improper use of the Service including the misuse of authority in pursuance hereof or the breach of this Agreement either by the Intermediary or its Staff Members.

INTERMEDIARY OBLIGATIONS. 4.2.1 The Intermediary is responsible for ensuring that the Intermediary System is maintained and secured in accordance with the Security Standards. 4.2.2 The Intermediary will operate the Intermediary System in accordance with the Intermediary Standards. 4.2.3 The Intermediary will notify the Provider immediately on detecting any Defect in the Intermediary System and, where reasonably practicable, will put in place appropriate measures to minimise and to mitigate the effects of any Defect detected in the Intermediary System and for the correction of such Defect.

INTERMEDIARY OBLIGATIONS. INTERMEDIARY shall perform as fiscal intermediary on behalf of Provider, and COUNTY.

INTERMEDIARY OBLIGATIONS. 10 A. INTERMEDIARY shall perform as fiscal intermediary on behalf of All Providers and 11 COUNTY. INTERMEDIARY shall reimburse All Providers in accordance with this Agreement and all 12 other agreements for the MSI Program in which INTERMEDIARY is defined. ADMINISTRATOR 13 shall provide copies of all such agreements to INTERMEDIARY. 14 B. During the term of this Agreement, and for such time thereafter as required by this Agreement, 15 INTERMEDIARY shall perform the services herein including, but not limited to, the following: 16 1. Receiving, compiling, preserving, and reporting information and data. 17 2. Receiving eligibility data, performing utilization review, and processing, denying, 18 approving all claims submitted in accordance with Exhibit E. 19 3. Providing a process for patient appeals of denied services. 20 4. Receiving, maintaining, collecting, and accounting for Funds. 21 5. Reimbursing Claims and making other required payments. 22 C. INTERMEDIARY shall keep a copy of its current Operations Manual at its main facility which 23 shall include INTERMEDIARY’S policies and procedures relating to its operations, including, but not 24 limited to the activities specified herein.