Renewal Amendment
Keenan & Associates – License #0451271
Confidential Information – For Client Use Only
(Rev. 1/10) Page 1 of 2
RENEWAL AMENDMENT No 3
This Amendment hereby amends the Self-Insured Claims Administration Agreement (“Agreement”) dated July 1, 2016 by and between Keenan & Associates and City of Commerce (hereinafter referred to collectively as the “Parties”) as follows:
WHEREAS, the current term of the Agreement shall expire on June 30, 2023; and WHEREAS, the Parties desire to continue their relationship subject to the terms and conditions outlined in the Agreement;
NOW, THEREFORE, the Parties agree as follows:
1. The parties agree to exercise the Optional Renewal Term 2 to renew the Agreement for an additional one-year term beginning on July 1, 2023 and ending June 30, 2024 (“Renewal Term”) at the rate of $40,547 payable in full on July 1, 2023.
2. The PRIME Fee Schedule, effective July 1, 2023 and attached hereto as Exhibit C, hereby replaces the previous Prime Fee Schedule as of the effective date of this agreement.
3. All the remaining terms and conditions of the Agreement shall remain unchanged and in full force and effect, and shall govern the conduct of the Parties during the Renewal Term.
4. The effective date of this Amendment is July 1, 2023.
5. Each person signing this Amendment to the Agreement on behalf of a Party represents and warrants that he or she has the necessary authority to bind such Party and that this Amendment is binding on and enforceable against such Party.
City of Commerce Keenan & Associates
Signature: Signature:
By: By: Tara Schilling
Title: Title: President, Claims Operations
Address: 2535 Commerce Way,
Commerce, CA 90040
Address: 2355 Crenshaw Blvd., Suite 200
Torrance, CA 90505
Email: [email protected] Email: [email protected] Attention: Ela Pappo Attention: Monica Mojarro
Renewal Amendment
Keenan & Associates – License #0451271
Confidential Information – For Client Use Only
(Rev. 1/10) Page 2 of 2
EXHIBIT C
MANAGED CARE
Early Intervention Initial Assessment / Triage .......... $50 / Hour Case Management (TCM/FCM) ……..................... $115 / Hour • PPO Channeling
• 4 PT Contact
• Initial Evaluation
• RTW Plan
• Medical Care Evaluation
• Written/Case Management Action Plan
Utilization Review .............................................. $135 / Referral • Up to 8 items per referral
Physician Advisor .............................................. $285 / Referral • Up to 8 items per referral
• Medical Necessity Determination
• Physician-to-Physician Contact
Specialty Physician Review ................................... $395 / Hour • Specialty match required
• Appeals
STOP (Pharmacy Review)..................................... $325 / Hour • Peer-to-Peer Contact by Physician
• Management of Opioid Use
• Written Treatment Plan / Recommendations
BILL REVIEW
Price bills to State Fee Schedules .................. 15% of Savings PPO Network Access (Anthem) ...................... 26% of Savings • Retrospective Network Capture
• Preferred Vendor Pricing (Ancillary Services)
Minimum Processing Fee ………………………... $13.00 per bill
MPN Access ............................................... $8.00 per MPN bill • Care Concierge™ Medical Access Assistant
• Network Management
• Physician Based Outcome Analytics
Pharmacy Benefit Management ....................... 20% of Savings • Additional $3.00 per prescription administrative fee
Negotiations .................................................... 24% of Savings Negotiated Medical Bill Liens ……………………….. $95 / Hour
• Excludes Travel & Expenses
Complex Bill Review by Physician ................... 24% of Savings eBill Access .................................................... $1.20 per e-bill State Reporting Administrative Fee .................. $1.35 per bill Fee Schedule – Effective July 1, 2023 (Subject to change upon notice)