Provider Agreement - 2004
+. tf. BlueCross
i.? ~ ~ BlueShield
~ ~ of Kansas"
1133 SW Topeka Boulevard
Topeka, Kansas 66629-0001
In Topeka - (785) 291-7000
In Kansas - (800) 432-0216
Web site: www.bcbsks.com
March 24, 2004
Dear Provider:
Tr-!
1J
- C C~ r -e.-
Blue Cross and Blue Shield of Kansas is pleased to announce that on August 22, 2003 the Department of
Defense (DO D) awarded the contract for the TRICARE West Region to TriWest Healthcare Alliance
(TriWest). TriWest has contracted with the DoD since 1997 to arrange for the health care ofTRICARE
(formerly known as CHAMPUS) beneficiaries in the Central Region ofthe United States. The awarding of
the West Region contract more than doubles TriWest's size, both in geographic area and in the number of
beneficiaries served. BCBSKS is the network subcontractor for TriWest and is responsible for the provider
network that delivers services to TRICARE beneficiaries in Kansas except Johnson and Wyandotte
counties.
Based on your current TRICARE contract for the TRICARE Central Region, BCBSKS and TriWest invite
you to continue serving America's military family by participating in the TRICARE program for the new
TRICARE West Region. In order to become a network provider for the West Region, you. must sign the
enclosed contract, update and complete the TRICARE Provider Data Sheet. Language specific to the
TRICARE West Region have been included in the agreement. The effective date of the amended contract
will be October 1, 2004. Enclosed is information for your review and completion which includes:
~
.
TRICARE provider contract amendment - Sign, initial and return by April 30. 2004
TRICARE Provider Data Sheet - Review and make corrections as needed. Each
field must be completed. If a field is not applicable, indicate N/A in the field.
Return the completed data sheet with the signed contract amendment in the envelope
provided.
Electronic claims submission information
¡/
.
.
TriWest intends to build on our success in the Central Region and continue to focus on providing superior
customer service to our provider network, and they in turn to our beneficiaries. TriWest is focusing on
many enhancements in the West Region including a new claims processor, Wisconsin Physician Services,
greater availability and easier access to information on TriWest website.
Please review, sign and initial the amendment where indicated, attach the supporting documentation and
return in the enclosed envelope by April 30, 2004. If you do not return the signed amendment, your current
TRICARE contract will terminate on September 30, 2004. By signing the enclosed amendment, you will
continue to deliver health care to your TRICARE beneficiaries.
Your participation in this network serving the men and women of America's military family is encouraged
and appreciated. More information regarding TriWest is available to you at www.triwest.com and
additional information about the TRICARE program is available at www.tricare.osd.mii.
If you have any questions; please contact any of the following:
Pat Toda, Provider Relations Specialist
Sherri Woodall, Administrative Assistant
Cathy Holmes, Manager, Internal Operations
785-291-7507 or 1-800-432-0216 x7507
785-291-8591 or 1-800-432-0216 x8591
785-291-8709 or 1-800-432-0216 x8709
Þ~L
Fred Boston, Director
Professional Relations
Blue Cross and Blue Shield of Kansas
"An Independent Licensee of the Blue Cross and Blue Shield Association.
...V RlueCroM
... . lßueShieid
,. , arKansas
TriCare Datasheet for
City of Salina EMS
The following information is in the Blue Cross Blue Shield of Kansas, Inc., provider database which was taken from the previous
application you submitted.
Instructions:
Review the following information. Please provide missing information and/or note corrections by crossing out
incorrect data and entering correct information in the space provided. Use an addditional page if necessary.
Institutional Information
Provider 10 #: 0000005536
Institution Name: City of Salina EMS
Address: PO Box 736
Phone: (785) 309-5737
Fax: (785) 309-5738
DCN:
Internal Use Only
Salina, KS 67402-0736
Contact Person: Rod Franz
EIN: i.-} 8(, ð( ,2 ¿..~
License
Hospital License
State License
License #
Date Awarded
Licensing Agency/Institution
Kansas Board of Emergency Medical Services
1700
5 .- f -ó L.{
Certification and Accreditation
Medicare Certification:
Accreditation:
0 Yes 0 No
0 Yes 0 No
Original Certification Date
Accrediting Organization
^/.'JI,
'J/f-
.~y,/+
0 No
Certification #:
Does your facility participate in the National Disaster Medical System?
0 Yes
tJ/.4-
Beds
Bed Type
0 Acute Care:
0 Psychiatric Unit:
0 Partial-Day Psychiatric Unit:
0 Certified Substance Abuse Unit
0 Intensive Care Unit:
0 Cardiac Care Unit:
Number of Beds
Certification #:
Certifying Organization:
N/4-
I .
Trauma level
Trauma level Care Provided
I
1 = All complex injuries
2 = Severe trauma patients
3 = Common trauma without specìfllized care
4 = Routine care
5 = Routine care -- may not be 24/7
0 = No trauma care
Staff
Type
Interns:
Residents:
Number
Pet ~-,,\. vV\. -<e.d \e:. ~
Em T is
;)- c¡
:5/
Insurance
Carrier
St Paul Insurance Co
Effective Date
Expiration Date
06f30/20ß3"""
¿'-30-0L(
Per Claim limit
0
Aggregate limit
0
TriCare Datasheet Institution
1/15/2004
TRICARE PROVIDER PROFILE SHEET
Ancillary Provider
SERVICE ADDRESS
CITY
Ambulance Companies
City Of Salina EMS
PO Box 736
SPECIALTY:
PROVIDER
Salina
STATE
KS
PERSON
. ..
Qn:?l-ð~""
-61
BILLING NAME
C-
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FED TAX ID #
486017228
C I 4.41- - 0 7 f
PHONE
ADDRESS
CITY
STATE
ZIP CODE
COUNTY <
CONTACT PERSON .1£<;Y1.[1". l.J-)J>IJ'~ .
HONE/FAX/EMAIL ~?ßf~~("t7}Z.J~)tÇ::3ðt-S'.7 '
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EFFECTIVE DATE
(Note: the effective date above
agreement shall be determined.)
1.. v ¿..; l.- /
the date upon which the duration of this
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TRICARE ANCILLARY PROVIDER CONTRACT
PARTIES
Blue Cross Blue Shield of Kansas ("SHAREHOLDER"), a Kansas nonprofit corporation, and City Of
Salina EMS ("Provider").
EFFECTIVE DA TE
This contract (the "Agreement") shall be effective (the "Effective Date") on
RECITALS
A. SHAREHOLDER has subcontracted with TriWest Healthcare Alliance Corp. ("TriWest") to establish
a provider network for TriWest in conjunction with TriWest's contract with the Department of
Defense to provide managed health care services to TRICARE Beneficiaries.
B. Provider is a health care provider licensed by and in good standing with the State of Kansas, and
desires to participate in SHAREHOLDER's network for TRICARE Beneficiaries.
Therefore, the Parties agree as follows:
AGREEMENT
1. DEFINITIONS
Active Duty - Full-time duty in the Unifonned Services of the United States. It includes duty on the
active list, full-time training duty, annual training duty, and attendance while in the active Military
Service, at a school designated as a Service school by law or by the Secretary of the Military
Department concerned.
Authorization - Approval for requested services, procedures or admission that is obtained prior to
services being rendered.
Clean Claim - A claim which does not require a pre-existing condition investigation, coordination of
benefits infonnation, accident infonnation and/or subrogation infonnation, medical records or any other
infonnation to adjudicate the claim.
Copayments - Deductibles, copayments and/or cost sharing amounts payable by a TRICARE
Beneficiary, as set forth in the TRICARE Provider Handbook.
Covered Services - Services for which benefits are available to TRICARE Beneficiaries in accordance
with the rules, regulations, policies and instructions of the TRICARE Management Activity.
Emergency Care ~ TRICARE considers an emergency medical condition a condition manifesting itself
by "acute symptoms of sufficient severity, including severe pain, such that a prudent layperson could
reasonably expect the absence of medical attention to result in placing the beneficiary's health in
serious jeopardy, serious impainnent to bodily function, or serious dysfunction of any bodily organ or
part. "
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Health Care Coordinators (HCC) - Medical professionals employed by TriWest to assist in finding
medical care for TRICARE Beneficiaries in the military or civilian system. Health Care Coordinators
are responsible for facilitating referrals/authorizations.
Hospital-based Provider - TMA defines Hospital-based Providers as professional providers (except
Interns, Residents, and Fellows), either directly employed or under contract to a hospital who provide
services under a hospital owned Tax Identification Number for either inpatient or outpatient care,
where the hospital is not acting as a billing agent for the provider.
Institution - a general, acute-care hospital, a specialty hospital such as a behavioral health hospital, or a
skilled nursing facility.
Medically Necessary - The appropriate and necessary treatment of the patient's illness or injury
according to accepted standards of medical practice and TRICARE policy.
MTF - Military Treatment Facility.
Network Provider - A provider who has contracted to render Covered Services. to TRICARE
Beneficiaries.
Primary Care Manager (PCM) - A provider who is designated as a Primary Care Manager and is
selected by a TRICARE Prime beneficiary or assigned by an MTF commander to provide primary care
services. PCMs may be an individual, group, or MTF. PCMs include: Internists, Family
Practitioners, Pediatricians, General Practitioners, Obstetricians/Gynecologists, Physician Assistants,
Nurse Practitioners, or Certified Nurse Midwives.
Reimbursement Rates - The rates set forth in Exhibit 1.
RFP - The Department of Defense's Request for Proposal No. MDA906-02-R-OOO6, as amended, for
the managed care support services under the TRICARE program. Definitions included in the RFP are
incorporated herein by reference, except as otherwise provided.
Tail Insurance - When a provider has professional liability insurance on a claims.made basis (as
opposed to an occurrence-based policy), Tail Insurance provides coverage after the tennination of the
claims-made insurance policy for losses resulting from claims that are filed after the expiration of the
claims-made insurance policy.
TRICARE (fonnerly CHAMPUS) - A program established to provide health coverage for family
members of Active Duty military personnel, for retirees and their families, and for other TRICARE
Beneficiaries.
TRICARE Beneficiary - Any person eligible to receive Covered Services under the rules, regulations,
policies and instructions of TMA. TRICARE Beneficiaries may include, but are not limited to, Active
Duty members of the Anned Forces of the United States of America and their dependents, retired
members of the Anned Forces of the United States of America and their dependents, JI1on-Department
of Defense Unifonned Services (the Public Health Service, the United States Coast Guard, and the
National Oceanic & Atmospheric Administration) and certain North Atlantic Treaty Organization
beneficiaries.
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TRICARE/CHAMPUS Maximum Allowable Charge (CMAC) - The reimbursement methodology for
services rendered to TRICARE Beneficiaries. CMAC is updated by the federal government on an
annual basis.
TRICARE Extra - The Preferred Provider Option (PPO) under the TRICARE program in which
benefits are provided through Network Providers reducing the TRICARE Beneficiary's cost share.
TRICARE Management Activity (TMA) - fonnerly known as OCHAMPUS and TRICARE Support
Office - Area within Department of Defense responsible for overseeing the TRICARE program.
TRICARE Prime - A health maintenance organization (HMO)-type option under the TRICARE
program in which TRICARE Beneficiaries enroll and receive enhanced primary and preventive
benefits at a reduced cost share. Medical care is coordinated by a PCM.
TRICARE Provider Handbook - Manual of operational policies and protocols for TRICARE that will
be furnished to Provider.
TRICARE Standard - Standard benefits available under CHAMPUS. Similar ,to a traditional
indemnity plan, with an annual deductible, cost-share, and annual out-of-pocket catastrophic cap.
TriWest - TriWest Healthcare Alliance Corp. and, as applicable, its subcontractors.
IL
TERM; TERMINA TION
A. Tenn - This Agreement shall commence upon the Effective Date and continue for an initial two
year tenn. Thereafter, both Parties agree that the tenn of this Agreement shall automatically be
extended for one-year periods until TriWest no longer has a contract with TRICARE Management
Activity (TMA) or unless tenninated by either Party as pennitted in this Agreement.
B. Tennination without Cause - Either Party may tenninate this Agreement without cause upon at
least ninety-(90) days prior written notice to the other Party.
C. Immediate Tennination - SHAREHOLDER shall have the right to immediately tenninate this
Agreement upon written notice to Provider upon the occurrence of any of the following events:
1. Provider's Kansas license or another state or federal license or authorization to do business is
reduced, restricted, suspended, or tenninated (either voluntarily or involuntarily), or Provider's
other applicable license or accreditation necessary to perfonn any services contemplated by
this Agreement is reduced, restricted, suspended, or tenninated (either voluntarily or
involuntarily); or'
2. Provider's professional liability coverage as required under this Agreement is reduced below
required amounts or is no longer in effect; or
3. Provider fails to meet SHAREHOLDER's or TriWest's recredentialing, quality management
or utilization management criteria, or fails to comply with quality management or utilization
management processes; or
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4. Provider fails to provide material infonnation or provides erroneous infonnation on Provider's
credentialing application or recredentialing application.
D. Material Breach - Either Party may tenninate this Agreement for any material breach of this
Agreement by the other Party, but only if that breach is not cured within thirty (30) days after
written notice to the breaching Party.
E. After termination of this Agreement, Provider shall use reasonable efforts to notifY any TRICARE
Beneficiaries that Provider is no longer a TRICARE provider when TRICARE Beneficiaries seek
care from Provider. In addition, Provider shall cooperate with SHAREHOLDER to ensure a
smooth transition for TRICARE Beneficiaries from Provider to another Network Provider.
F. Tennination of this Agreement shall not relieve either Party of any obligation to the other Party in
accordance with the tenns of this Agreement with respect to services furnished prior to such
tennination and shall not relieve Provider of the obligation to cooperate with TriWest in arranging
for the transfer of care of TRICARE Beneficiaries then receiving treatment.
III. PROVIDER'S RESPONSIBILITIES
A. Provider agrees to treat TRICARE Beneficiaries according to the tenns and conditions of this
Agreement. Provider shall accept the Reimbursement Rates (less the amount of any Copayments
payable by the TRICARE Beneficiary) as the only payment expected from TriWest and TRICARE
Beneficiaries for Covered Services, and for all services paid for by the TRICARE program.
TRICARE Beneficiaries are responsible only for Copayments. The Reimbursement Rates shall
apply to Active Duty and civilian claims, to enrollees and to non-enrollees, and to all TRICARE
Beneficiaries whose care is reimbursed by the Department of Defense, regardless of their
residence. In no event will Provider be paid for such services more than the
TRICARE/CHAMPUS Maximum Allowable Charge (CMAC) or what is permissible under
federal law or TRICARE policy.
B. Provider shall collect applicable Copayments from TRICARE Beneficiaries. The Copayments
depend upon the sponsor's grade and military status. Except as otherwise provided in this
Paragraph 8., Provider may not bill TRICARE Beneficiaries or Active Duty personnel for any
service that is non-covered or disallowed. Provider shall not routinely waive Copayments. Except
for Copayments, Provider agrees that in no event (including, but not limited to, nonpayment or
breach of this Agreement by TriWest or TriWest's insolvency) shall Provider bill or collect for
Covered Services from a TRICARE Beneficiary or Active Duty member, and this provision shall
survive tennination of this Agreement. Provider shall not require payment from a TRICARE
Beneficiary for any excluded or excludable service that the TRICARE Beneficiary received unless
the TRICARE Beneficiary has been properly infonned that the services are excludable and has
agreed in advance of receiving the services, in writing, to pay for such services. A TRICARE
Beneficiary who is infonned that care is potentially excludable and proceeds with receiving the
potentially excludable service shall not, by receiving such care, be construed to have entered into
an agreement to pay. Provider acknowledges that payment shall not be allowed for a non-Covered
Service unless the TRICARE Beneficiary or Active Duty member is properly informed and agrees
in a separate writing. Any waivers must be specific as to the details of the excluded or non-
Covered Service. General agreements to pay, such as those signed by the TRICARE Beneficiary
at the time of service, are not evidence that the TRICARE Beneficiary knew specific services were
excluded or excludable or that the TRICARE Beneficiary agreed to pay.
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C. Provider shall submit claims for Covered Services on behalf of TRICARE Beneficiaries and
Active Duty personnel. Provider shall use best efforts to submit claims within thirty (30) days
after the provision of the services. All claims shall be submitted electronically. No payment shall
be made for a claim submitted more than one (1) year after the provision of the Covered Service.
D. Provider shall participate in Medicare (accept assignment) and submit claims on behalf of all
TRICARE and Medicare beneficiaries.
E. Provider agrees to being reported to the Department of Veterans Affairs (DV A) as a TRICARE
Network Provider. DV A shall have the right to directly contact Provider and request that he/she
provide care to Veteran Administration (V A) patients on a case by case basis. Provider is never
obligated to see the V A patient, however if seen, any documentation of the care rendered to the
V A patient and reimbursement for the care is a matter between the referring V A Medical Center
(V AMC) and Provider. The referral and instructions for seeking reimbursement from the V AMC
will be provided by the patient at the time of the appointment. If Provider has initialed "Yes" on
Section A. of Exhibit 3, Provider has agreed to accept requests from the DV A to provide care to
veterans.
F. Provider agrees to being reported to the Civilian Health and Medical Program of the Department
of Veterans Affairs (CHAMPV A) as a TRICARE Network Provider. If Provider has initialed
"Yes" on Section B. of Exhibit 3, Provider agrees to accept assignment for CHAMPV A
beneficiaries.
G. Provider shall comply with all policies and procedures set forth in the TRICARE Provider
Handbook, including without limitation credentialing, peer review, refen-als, utilization
review/management and quality assurance programs and procedures established by TriWest or
TRICARE including submission of infonnation concerning Provider and compliance with
preauthorization requirements, care approvals, concurrent reviews, retrospective reviews,
discharge planning for inpatient admissions and prior authorization of referrals. Such
requirements may concern Active Duty personnel as well as TRICARE Beneficiaries.
H. Provider shall provide and maintain policies of general and professional liability (malpractice)
insurance to insure Provider against any claim for damages arising by reason of personal injury or
death resulting directly or indirectly from the perfonnance of this Agreement. Such insurance
shall be subject to the approval of SHAREHOLDER, but shall not be less than one million dollars
($1,000,000) per claim and three million dollars ($3,000,000) in the aggregate per year for each
professional perfonning service. Provider shall provide SHAREHOLDER with a certificate of
such insurance upon execution of this Agreement, entitling SHAREHOLDER to receive thirty
(30) days' prior notice of any change in coverage or tennination or expiration of coverage. If the
insurance is on a claims-made basis, Provider shall obtain Tail Insurance satisfactory to
SHAREHOLDER uþon any tennination of coverage and containing an extended reporting
endorsement for a period of not less than three (3) years after the tennination of this Agreement.
L
If Provider offers behavioral health services, and the TRICARE Beneficiary authorizes release of
the infonnation, Provider shall submit, to the TRICARE Beneficiary's PCM, a copy of the record
of the treatment provided.
J.
Provider or designee shall attend an initial educational seminar (and periodic update seminars) in
order to obtain an understanding of the requirements ofTRICARE.
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K. Provider's facilities shall be accessible to handicapped individuals as required by applicable federal
and state and/or local laws and regulations.
L. Provider shall comply with federal and any applicable state laws and regulations concerning the
confidentiality and security of the medical records ofTRICARE Beneficiaries.
M. As soon as it is aware of them, Provider must notify SHAREHOLDER of any actions, policies,
detenninations or internal or external developments that may have a direct impact on Provider's
ability to perfonn its obligations under this Agreement.
Actions requiring notifications by Provider include, but are not limited to:
1. Any change in ownership, specialty services provided or location of facility(s);
2. Action against or lapse of Provider's license, certification, accreditation or certificate of
authority;
3. Loss of hospital privileges; and
4. Reduction in insurance coverage below the required limits or tennination of insurance
coverage.
N. Providers shall participate in and cooperate with TriWest's case management and/or utilization
management plans described in the TRICARE Provider Handbook, and developed in accordance
with the policies, rules, and regulations of TriWest and TRICARE.
O. Provider agrees to provide a TRICARE Beneficiary with a copy of his or her medical record at no
charge, to include a narrative summary and other documentation of care within two (2) business
days of the request when the TRICARE Beneficiary or TRICARE Beneficiary's guardian presents
(i) a copy of official change of station orders or orders changing the TRICARE Beneficiary's or
sponsor's status from Active Duty to retired or separated from service and (ii) a properly executed
medical release.
P. Provider agrees to provide copies of medical records to TriWest within two (2) business days of
TriWest's request, to pennit TriWest to conduct peer review, quality assurance and utilization
review. At the Provider's request TriWest will reimburse Provider for the cost of photocopying
and postage. The reimbursement rate for photocopies is currently set at $.07 per page.
Q. Provider acknowledges and agrees that the National Quality Monitoring Contractor (NQMC) shall
be responsible for reviewing requests from TRICARE Beneficiaries and providers for an appeal or
reconsideration of certain denials of coverage by TriWest and Provider will cooperate with the
NQMC in such appeal process. Provider agrees the NQMC may release all review data obtained
by the NQMC to TriWest.
R. Provider understands and agrees that all Covered Services provided for TRICARE Prime
enrollees, except emergency services, outpatient mental health services, and services provided
under a Point of Service option, must be referred from the PCM to a Network Provider or an MTF
provider, and authorized by the applicable Health Care Coordinator or other designee of TriWest.
S. Provider agrees that TriWest and its designee shall have access, upon demand and at reasonable
times, to the books, records and papers of Provider relating to the health care services provided to
TRICARE Beneficiaries and Active Duty personnel, to the costs thereof, and to Copayments
received by Provider from TRICARE Beneficiaries for Covered Services. TriWest and its
designee shall have the right to inspect, at reasonable times, Provider's facilities upon five (5) days'
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prior notice to Provider. Provider will provide adequate space to TriWest and its designee for the
conduct of on-site inspections and reviews and shall cooperate in the conduct of such review
activity. Provider will photocopy and deliver to TriWest or its designee all information required
for off-site review by TriWest of Provider's perfonllance under this Agreement within thirty (30)
days of a request by TriWest. This section shall survive tenllination of this Agreement.
T. Provider acknowledges and understands that the MTF has a first right of refusal to provide
medical services to TRICARE Prime beneficiaries who are referred for any services by their PCM.
U. Provider shall comply with additional responsibilities, if any, set forth in Exhibit 2.
V. Provider acknowledges that this is not an exclusive agreement, and that neither TriWest nor
SHAREHOLDER represents, warrants, or guarantees that Provider will be utilized at all by any
TRICARE Beneficiary, Active Duty member or by any number of TRICARE Beneficiaries or
Active Duty personnel.
W. Provider agrees that Provider will not discriminate in providing Covered Services under this
Agreement against any TRICARE Beneficiary or Active Duty member on the basis of hislher
enrollment or non-enrollment in TRICARE Prime, source of payment, sex, age, race, color,
religion, national origin, health status, or disability.
X. Provider shall comply with all final HIP AA ASC X 12N Transaction standards as promulgated by
the Secretary, Department of Health and Human Services for implementation effective October
2003.
Iv. PROVIDER DIRECTORY
TriWest will periodically include Provider's name, location, and specialty in a directory of Network
Providers. Provider is responsible for notifying SHAREHOLDER of any changes of address or specialty
within ten (IO) business days.
V. PAYMENT TO PROVIDER
A. TriWest will use best efforts to process Clean Claims within thirty (30) days of receipt and will
make payment directly to Provider for Covered Services rendered by Provider to TRICARE
Beneficiaries or Active Duty personnel in accordance with the Reimbursement Rates set forth in
Exhibit 1. Provider understands and agrees that SHAREHOLDER is not the insurer, payer,
guarantor or underwriter of the payment of benefits to Provider and agrees that SHAREHOLDER
shall not be responsible for payment of any claims submitted by Provider for Covered Services
provided to TRICARE Beneficiaries.
I
B. TriWest may deny payment for services or supplies deemed by TriWest to be not Medically
Necessary or at an inappropriate level under definitions and detenninations of TRICARE.
TriWest will utilize a standard industry code review system in adjudicating claims and detenllining
appropriate levels of coding.
C. Payments to Provider may be disallowed or reduced for noncompliance with required utilization
review/management programs and procedures, including without limitation failure to obtain a
required preauthorization or continued stay approval even if the services are not denied on
necessity or appropriateness grounds. In this case, the reduction shall be at least ten percent (I 0%)
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of the Reimbursement Rate as set forth in Exhibit 1. Amounts that are disallowed or reduced may
not be billed to TRICARE Beneficiaries or Active Duty personnel.
D. Provider understands and agrees that there may be payment adjustments through the remittance or
return of underpayments, overpayments, and adjustments for retroactive tenninations or denials of
coverage.
VI.
GENERAL PROVISIONS
A. Amendment
SHAREHOLDER may modifY this Agreement by providing Provider with sixty (60) days prior
written notice. Provider shall have thirty (30) days after receipt of such notice to object in writing
to a proposed amendment. If Provider objects timely and in writing to the proposed amendment,
SHAREHOLDER may tenninate this Agreement upon thirty (30) days' prior written notice to
Provider. JfProvider fails to object timely and in writing to a proposed amendment, Provider shall
be deemed to have accepted such proposed amendment.
Except as specified above and unless specified elsewhere in this Agreement or allowed/prohibited
by applicable law, this Agreement may be amended or modified only in writing signed by the
authorized personnel of each Party.Applicable Law; Jurisdiction; Venue
B. Applicable Law; Jurisdiction; Venue
This Agreement is governed by the laws of the State of Kansas and applicable federal law. The
Parties consent to the jurisdiction of and to venue for any dispute involving this Agreement in the
state courts of the State of Kansas or the United States District Court for the District of Kansas.
C. Assignment
Except as pennitted in this Agreement, neither Party may assign or transfer any right, benefit,
obligation or duty under the tenus of this Agreement to any third party without the prior written
consent of the other Party.
D. Authority
Each person signing this Agreement certifies that he/she has the appropriate authority to bind the
respective Party.
E. SHAREHOLDER's Relationship to the Blue Cross and Blue Shield Association
I
Provider expressly acknowledges his/herlits understanding that this Agreement constitutes an
agreement between Provider and SHAREHOLDER, that SHAREHOLDER is an independent
corporation operating under a license from the Blue Cross and Blue Shield Association (the
"Association"), an association of independent Blue Cross and Blue Shield Plans, pennitting
SHAREHOLDER to use the Blue Cross and Blue Shield Service Marks in the State of Kansas,
and that SHAREHOLDER is not contracting as the agent of the Association.
Provider further acknowledges and agrees that he/she/it has not entered into this Agreement based
upon representations by any person, entity or organization other than SHAREHOLDER and that
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no person, entity or organization other than SHAREHOLDER shall be held accountable or liable
to Provider for any of SHAREHOLDER's obligations to Provider created under this Agreement.
This Paragraph shall not create any additional obligations whatsoever on the part of
SHAREHOLDER other than those obligations created under other provisions of this Agreement.
F. Compliance
Provider warrants and certifies that he/she/it is in compliance with all local and federal laws
applicable to provider's business of providing health care services, including but not limited to, the
provisions of the Americans with Disabilities Act and the Health Insurance Portability and
Accountability Act as they may apply to Provider.
G. Coordination of Benefits/Third-Party Liability
Provider agrees to make inquiries of TRICARE Beneficiaries regarding other health insurance
coverage. If there is another entity providing coverage for the TRICARE BeneJì.ciary, Provider
shall bill that entity first and provide infonnation regarding that carrier to TriWest when it submits
the claim to TriWest for Covered Services provided to the TRICARE Beneficiaries. TRICARE
coverage shall always be secondary, except when TRICARE Beneficiaries have coverage with
Indian Health Services or Medicaid. Provider further agrees to cooperate in subrogation, Workers'
Compensation and other third-party recovery programs to the extent pennitted or required by
applicable law.
H. Dispute Resolution
1.
If Provider believes that TriWest incorrectly denied all or part of a claim and desires to obtain
a review of the benefit detennination, Provider shall, within ninety (90) days of initial
detennination:
a.
submit a written request for review to TriWest, A TTN: Provider Services; and
b. include in the written request the items of concern regarding TriWest's de:tennination and
all additional infonnation (including medical infonnation) supporting Provider's belief that
the denial was incorrect.
On the basis of the infonnation supplied with the request for review, together with any other
infonnation available to it, TriWest will review its prior detennination. Provider will be
notified in writing of TriWest's decision and the reasons for the detennination within sixty
(60) days ofTriWest's receipt of the request for review.
If Provider still lJelieves that TriWest's detennination of payment or non-payment is incorrect
and/or has infonnation that was not previously available for review when submitted to
TriWest, Provider may direct a second request for review in writing to TriWest within sixty
(60) days of receipt of the prior detennination. The TriWest reviewer will follow the
procedures outlined in the TRICARE Provider Handbook for processing second reviews.
2. In the event that any claim or controversy arising out of or relating to this Agreement, or any
claimed breach thereof, cannot be resolved by the Parties as provided in Section VI Paragraph
H. Subsection 1 above or in the nonnal course of business, each Party shall designate a
member of its senior management to meet in an attempt to resolve the dispute.
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A dispute that cannot be resolved to the satisfaction of the Parties in this manner shall be
referred for binding arbitration in accordance with the commercial dispute arbitration rules of
the American Arbitration Association or such other rules as may be agreed to by the Parties.
Judgment upon an award in arbitration may be entered in any court of competent jurisdiction,
or application may be made to such court for a judicial acceptance of the award and
enforcement, as the law of the state having jurisdiction may require or allow.
I.
Entire Agreement
This Agreement, including referenced exhibits, contains the entire understanding of the Parties and
supersedes all prior agreements between the Parties with respect to the same subject matter.
J.
Mutual Indemnification
Provider shall hold hannless and indemnify SHAREHOLDER and TriWest for, from, and against
any Provider-related claims, losses, damages, liabilities, costs, expenses or obligaÜons arising out
of or resulting from Provider's wrongful or negligent conduct in the perfonnance of this
Agreement including, but not limited to, the provision of health care services by Provider.
SHAREHOLDER shall hold hannless and indemnify Provider for, from, and against any losses,
damages, liabilities, costs, expenses or obligations arising out of or resulting from
SHAREHOLDER's wrongful or negligent conduct in the perfonnance of this Agreement.
K. Notice
All notices and other communications to a Party must be in writing, hand delivered, delivered by
prepaid commercial courier service with tracking capabilities, faxed, or delivered by the U.S. mail
to the address listed on the signature page. The Parties may change the address of record by
notifying the other Party of the new address. Notice shall be complete upon the earlier of actual
receipt or five (5) days after being deposited into the U.S. mail. Notices and other
communications in writing need not be mailed either by registered or certified mail, although a
signed return receipt received through the U.S. Post Office shall be conclusive proof as between
the Parties of delivery of any notice or communication and of the date of such delivery.
L. Paragraph Headings
The paragraph headings used in this Agreement have been inserted for convenience of reference
only and do not in any way modify or restrict the meaning of any of the tenns or provisions of this
Agreement.
M. Regulatory Requirements
Those portions of the Federal Acquisition Regulations (the "FAR," 48 c.F.R. Ch. 1.) and the
Department of Defense Supplement to the FAR (the "DFARS," 48 C.F.R. Ch. 2.) mentioned in
Section I of the RFP are incorporated into this Agreement with the same force and effect as if they
were given in full text, and for such purposes, Provider shall be deemed the "Contractor" or
"Offeror." Upon request, their full text will be made available.
N. Relationship of the Parties
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The relationship of the Parties is not and shall not be construed or interpreted to be a partnership,
joint venture or agency. The relationship between the Parties is an independent contractor
relationship.
O. Release
PROVIDER ACKNOWLEDGES THAT A NUMBER OF FUNCTIONS UNDER THIS
AGREEMENT WILL BE PERFORMED BY TRIWEST AS SET FORTH IN THIS
AGREEMENT, INCLUDING, BUT NOT LIMITED TO, CLAIMS PAYMENT AND
UTILIZATION REVIEW. PROVIDER AGREES TO THIS DELEGATION OF FUNCTIONS
TO TRIWEST AND FURTHER AGREES THAT SHAREHOLDER SHALL NOT BE LIABLE
FOR PAYMENTS UNDER THIS AGREEMENT OR FOR NEGLIGENT OR JNTENTIONAL
WRONGDOING OR BREACH OF THIS AGREEMENT BY TRIWEST. TR][WEST SHALL
BE SOLELY LIABLE FOR ITS ACTIONS AND INACTIONS AND FOR ALL PAYMENTS
DUE TO PROVIDER UNDER THIS AGREEMENT.
P. Third-Party Beneficiary
TriWest shall be a third-party beneficiary of this Agreement and shall be entitled to enforce
Provider's obligations under this Agreement, and Provider shall be entitled to enforce TriWest's
obligations under this Agreement.
Q. Trade Name Ownership
The Parties acknowledge that SHAREHOLDER has the sole right to use, in Kansas, the "Blue
Cross" and "Blue Shield" trade names and service marks.
R. Waiver
There shall be no waiver of any tenn, provision or condition of this Agreement unless in writing
and signed by both Parties.
S. Severability
If any provision of this Agreement is deemed illegal, unenforceable or in conflict with any law of a
federal, state or local government having jurisdiction over this AgTeement, the validity of the
remaining sections shall not be affected. In addition, the illegal, unenforceable or invalid
provision shall be replaced by a mutually acceptable provision, which, being valid, legal and
enforceable, comes closest to the intention of the parties concerning the illegal, unenforceable or
invalid provision. I
T. Survivability
The obligations of Sections III. A., III. B., III. C., III. H., VI. J. and VI. O. shall survive the
tennination of this Agreement.
Signatures appear on next page
cœnm \Ah1«£
~
1111111111111111111111111111111111
OW1>17JtJSlN
Intending to be legally bound, the Parties have executed this Agreement as of its Effective Date.
SHAREHOLDER
Blue Cross Blue Shield, a Kansas corporation
Provider
By:
Signature
C~'I ~ <;h L~~
(
Name
~~I
Andrew Corbin
Vice President, External Sales and
Affairs
Provider
E v1A (f't<: Jo-'-'(
Specialty
l:'JJt <. ~ fC4 (
5" <.ruv¡
Date:
4RG 0 I J ¿ 7-Ó
Tax ill
1133 SW Topeka Blvd
Topeka, Kansas 66629-0001
Date:
ar
'2--e>ô ~(
Whose main address is:
Whose main address is:
Fax # (785) 291-7990
Accepted by TriWest:
F~. [)ð~' ~Jt
5 ~ (~r-=< i Ie <; & "7 '7., (
Fax # ì g ç- ~ ") tfi- )--- 7 ? ¡j'
TriWest Healthcare Alliance Corp.
Signature
Lisa D. Stevens
Vice President, Provider Services
Whose main address is:
P.O. Box 42049
Phoenix, AZ 85053
Fax # {602) 564-2456
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0257135
Exhibit 1
Ancillary Reimbursement Rates
PROVIDER NAME: C(\t f ~
TIN: 4- O¿'D I ì 2-- kf;
s~ ( ("'<-
P~5
Provider agrees to accept the lesser of a ten percent (10%) discount off the TRICARE/CHAMPUS
Maximum Allowable Charge (CMAC) or a twenty percent (20%) discount off Provider's billed charge as
the Reimbursement Rate. Provider acknowledges that, as set forth in Section III Paragraph A. of the
Agreement, this is the exclusive reimbursement he/she will receive for the provision of Covered Services
except for applicable Copayments.
In no event will Provider be paid more than what is pennissible under federal law or TRIC\RE policy.
p~
(Provider initial)
(SHAREHOLDER initial)
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Exhibit 2
Additional Re!Jponsibilities
There are no additional responsibilities at this time.
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A. Provider agrees to accept requests from the Department of Veterans Affairs to provide care to veterans.
Yes r:;( L (initial)
B. Provider agrees to accept assignment for Civilian Health and Medical Program of the Department of
Veterans Affairs (CHAMPV A) claims.
Yes d L (initial)
Exhibit 3
Participation in Department of Veterans Affairs and
Civilian Health and Medical Program of the Veterans Affairs
No 0
(initial)
No 0
(initial)
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