Specifications include, but are not limited to: 1. The TPA will provide a paperless administration for the WCP. The WCP has specific Claim/RTW/Safety guidelines/best practices for claim handling that shall be utilized; the guidelines are attached; 2. The TPA shall provide real time, immediate web access to claims and management reporting at no charge to the WCP. All claims will have available location codes to accept up to a minimum of 20 characters; 3. All paper and electronic claims file/medical management files, including but not limited to all imaged documents, will be the property of the WCP in the event of a change in the TPA and shall be electronically transferred to the new TPA at no charge to the WCP. Confirm that you will comply with a reasonable transition period, which shall be designated by the WCP; 4. No contact by the TPA shall be made with individual agencies except to complete the investigation of a claim. All personnel information (i.e., wage statements) must be obtained from a designated employee within the WCP; 5. Adjusters shall secure appropriate information to justify all continuing Temporary Total Disability (TTD) payments; 6. Payments of TTD are to be made consistent with the Commonwealth of Kentucky’s payroll unless otherwise directed by a designee of the WCP; 7. Assigned adjusters are responsible for authorizing all services and approving all payments; 8. The Workers’ Compensation Administrator (WCA), or designee, will approve all workers’ compensation settlements, agreements relating to subrogation recovery, and/or filing of all Medical Fee Disputes; 9. No charge shall be made for telephonic or secure e-mail updates to the WCP by the TPA or other parties to the claim; 10. Outside services (surveillance, medical/vocational case management, etc.) will be used when beneficial and on a limited basis with the WCP’s approval; 11. The WCP reserves the right to select the company providing onsite case management; 12. The TPA will manage excess insurance carriers, per individual past excess insurance contract at no cost to the WCP; 13. Reimbursement of any errors, including but not limited to duplicate payments, overpayments of any benefit, and/or payments to incorrect payee, or any electronic transmission errors or omissions to the Department of Workers’ Claims or any other State or Federal agency will be the responsibility of the TPA. All reimbursements of errors should be made within thirty (30) days of acknowledgement unless otherwise agreed upon by the WCP; 14. There will be no additional cost to the WCP for the TPA’s attendance at any meeting or hearing; 15. The TPA shall file all required state reporting requirements (i.e., Simulated Premium) and assist with any audits and/or questions posed by the Kentucky Workers’ Compensation Funding Commission, the Department of Insurance, the Department of Workers’ Claims or any other administrative/regulatory entity at no additional cost to the WCP
