Common use of Contractor Payments Clause in Contracts

Contractor Payments. Physician Reimbursement: 7 1. All funds received by CONTRACTOR in accordance with this subparagraph C. shall be 8 used by CONTRACTOR to reimburse Physician Claims. 9 2. COUNTY shall pay CONTRACTOR, upon receipt of an appropriate claim funding invoice, 10 an initial provisional payment of one-million one-hundred twenty-five thousand dollars ($1,125,000) for 11 each Period which shall be paid immediately by COUNTY. Such funds, upon receipt by 12 CONTRACTOR, shall be immediately deposited by CONTRACTOR into an interest-bearing EMSF 13 Account (Account) for reimbursement of EMSF Physician Claims received by CONTRACTOR for 14 dates of service within July 1st and June 30th of each Period. 15 3. Following the initial claim funding payment for each Period, COUNTY shall pay 16 CONTRACTOR, upon receipt of an appropriate claim funding invoice, a monthly claim funding 17 amount of $400,000 beginning August 15th of each Period. 18 4. CONTRACTOR’s invoice shall be on a form approved or supplied by ADMINISTRATOR 19 and provide such information as is required by ADMINISTRATOR. Invoices are due as specified in 20 subparagraphs V.C.2. and V.C.3. above, and payments to CONTRACTOR should be released by 21 COUNTY no later than twenty-one (21) days after receipt of the correctly completed invoice form. 22 5. Invoices received from CONTRACTOR after the tenth (10th) working day of the month 23 may not be paid within the same month. Payments to CONTRACTOR should be released by COUNTY 24 no later than thirty (30) business days after receipt of the correctly completed billing form; provided, 25 however that the aggregate of all payments for physician claims shall not exceed all deposits to and 26 appropriations for the Physicians’ Allocation for each Period, less administrative costs described in 27 subparagraph V.B. above; and provided further, the balance of the Account does not exceed 28 $2,000,000 unless otherwise authorized by ADMINISTRATOR in accordance with subparagraph 29 V.C.7. below. 30 6. Upon determination by CONTRACTOR that the Account requires additional funds for 31 reimbursement of claims authorized in accordance with the Contract, CONTRACTOR shall submit a 32 supplemental invoice to COUNTY, together with any documentation that may be required by 33 ADMINISTRATOR. 34 7. Except as otherwise provided herein, the Account shall not exceed a maximum of two 35 million dollars ($2,000,000), unless otherwise approved by ADMINISTRATOR at its sole discretion, 36 and shall be managed so as to maximize the interest earned upon Funds in the Account. 37 14 of 16 EXHIBIT A ADVAMCED MEDICAL MANAGEMENT, INC. MA 042-24010971 1 8. If CONTRACTOR determines that the fees to maintain an interest-bearing Account is more 2 than projected interest to be earned, CONTRACTOR shall recommend to ADMINISTRATOR that such 3 funds be maintained in a non-interest-bearing Account. Approval of the recommendation shall be at the 5 9. All ▇▇▇▇▇▇▇▇ to COUNTY shall be supported, at CONTRACTOR’s facility, by source 7 canceled checks, and records of services paid. In support of the monthly billing, CONTRACTOR shall 8 submit a Claims Processed Report on a form, or in an electronic format, approved or provided by 9 ADMINISTRATOR. 10 a. For Emergency Services and/or Care provided within the first twenty-four (24)-hours 11 of the hospital visit, reimbursement of Claims shall be through use of TSR Funds. 12 b. For Emergency Services and/or Care provided after twenty-four (24) hours, but not 13 more than the immediately following two (2) calendar days after the date services are first provided, 14 reimbursement of Claims shall be through use of all other Funds in accordance with all applicable laws 15 and regulations governing their use. 16 c. Notwithstanding subparagraph V.C.9.b., if it is necessary to transfer a patient to a 17 second facility providing a higher level of care for the treatment of the emergency condition, 18 reimbursement of these Claims for the calendar day of transfer and on the immediately following two

Contractor Payments. Physician Reimbursement: 7 35 1. All funds received by CONTRACTOR in accordance with this subparagraph C. shall be 8 36 used by CONTRACTOR to reimburse Physician Claims.. 37 // 9 1 2. COUNTY shall pay CONTRACTOR, upon receipt of an appropriate claim funding invoice, 10 2 an initial provisional payment of one-million one-hundred twenty-five thousand dollars ($1,125,000) for 11 3 each Period which shall be paid immediately by COUNTY. Such funds, upon receipt by 12 4 CONTRACTOR, shall be immediately deposited by CONTRACTOR into an interest-bearing EMSF 13 5 Account (Account) for reimbursement of EMSF Physician Claims received by CONTRACTOR for 14 6 dates of service within July 1st and June 30th of each Period. 15 7 3. Following the initial claim funding payment for each Period, COUNTY shall pay 16 8 CONTRACTOR, upon receipt of an appropriate claim funding invoice, a monthly claim funding 17 9 amount of $400,000 beginning August July 15th of each Period. 18 10 4. CONTRACTOR’s invoice shall be on a form approved or supplied by ADMINISTRATOR 19 11 and provide such information as is required by ADMINISTRATOR. Invoices are due as specified in 20 12 subparagraphs V.C.2. and V.C.3. above, and payments to CONTRACTOR should be released by 21 13 COUNTY no later than twenty-one (21) days after receipt of the correctly completed invoice form. 22 14 5. Invoices received from CONTRACTOR after the tenth (10th) working day of the month 23 15 may not be paid within the same month. Payments to CONTRACTOR should be released by COUNTY 24 16 no later than thirty twenty-one (3021) business days after receipt of the correctly completed billing form; provided, 25 17 however that the aggregate of all payments for physician claims shall not exceed all deposits to and 26 18 appropriations for the Physicians’ Allocation for each Period, less administrative costs described in 27 19 subparagraph V.B. above; and provided further, the balance of the Account does not exceed 28 $2,000,000 20 unless otherwise authorized by ADMINISTRATOR in accordance with subparagraph 29 V.C.7. below. 30 21 6. Upon determination by CONTRACTOR that the Account requires additional funds for 31 22 reimbursement of claims authorized in accordance with the ContractAgreement, CONTRACTOR shall submit a 32 23 supplemental invoice to COUNTY, together with any documentation that may be required by 33 24 ADMINISTRATOR. 34 25 7. Except as otherwise provided herein, the Account shall not exceed a maximum of two 35 26 million dollars ($2,000,000), unless otherwise approved by ADMINISTRATOR at its sole discretion, 36 27 and shall be managed so as to maximize the interest earned upon Funds in the Account. 37 14 of 16 EXHIBIT A ADVAMCED MEDICAL MANAGEMENT, INC. MA 042-24010971. 1 28 8. If CONTRACTOR determines that the fees to maintain an interest-bearing Account is more 2 29 than projected interest to be earned, CONTRACTOR shall recommend to ADMINISTRATOR that such 3 30 funds be maintained in a non-interest-bearing Account. Approval of the recommendation shall be at thethe 31 sole discretion of ADMINISTRATOR. 5 32 9. All ▇▇▇▇▇▇▇▇ to COUNTY shall be supported, at CONTRACTOR’s facility, by source 7 33 documentation including, but not limited to, provider claims, ledgers, journals, bank statements, 34 canceled checks, and records of services paid. In support of the monthly billing, CONTRACTOR shall 8 35 submit a Claims Processed Report on a form, or in an electronic format, approved or provided by 9 36 ADMINISTRATOR.. 37 // 10 1 a. For Emergency Services and/or Care provided within the first twenty-four (24)-hours 11 2 of the hospital visit, reimbursement of Claims shall be through use of TSR Funds. 12 3 b. For Emergency Services and/or Care provided after twenty-four (24) hours, but not 13 4 more than the immediately following two (2) calendar days after the date services are first provided, 14 5 reimbursement of Claims shall be through use of all other Funds in accordance with all applicable laws 15 6 and regulations governing their use. 16 7 c. Notwithstanding subparagraph V.C.9.b., if it is necessary to transfer a patient to a 17 8 second facility providing a higher level of care for the treatment of the emergency condition, 18 reimbursement of these Claims for the calendar day of transfer and on the immediately following two,