Medical Provider Network Services

provide medical and related services at pre-negotiated fees to the covered individuals of the FUND. The FUND will have access to those pre-negotiated fees for medical and related services delivered to such employees by Participating Providers in the network. The Preferred Provider Organization represents that it has thoroughly researched and developed the know-how and technology to comply with specific states’ laws to reimburse providers for fees and services as they relate to injuries sustained at work and that it has made provisions and it will obtain necessary updates on medical payments and make necessary changes in payments as outlined in specific sections of fee schedule regulations and usual, customary and reasonable fees in order to perform the services stated herein and agrees to provide the following services: 1) Establishment and maintenance of an adequate network of hospitals, physicians, laboratories and other appropriate facilities, available 24 hours a day, seven days a week. 2) Provide access, to individuals covered under the FUND, to the Preferred Provider Organization network of hospitals, physicians, laboratories, and other appropriate facilities for treatment of work related injuries and health conditions. 3) Perform Health care provider and facility credentialing in compliance with URAC/NCQA standards. 4) Require complete medical documentation of all provider bills. See attached file.