ABSTRACT
A fledgling Management Services Organization with immature software and systems engineering of a sophisticated information systems nature would not be able to undertake a task this grand without some expert help that might cost more than the job would pay. Group shall administer claims for covered services rendered by represented providers in accordance with this exhibit and the terms of the agreement. Group shall administer all claims for covered services in accordance with payor’s claim administration standards and any other standards set forth in applicable law, including but not limited to Employee Retirement Income Security Act. With reasonable notice, group agrees to allow payor representatives to conduct on-site reviews of group’s claims administration facilities. Such reviews shall be for the sole purpose of evaluating group’s performance of its claims administration responsibilities under this agreement, including, but not limited to, ascertaining the quality and timeliness of group’s claims processing.
