Specifications include, but are not limited to: A. The Contractor shall have the ability to perform a full network evaluation and cost analysis to provide medical claims review for coding and billing inaccuracies in high claims and other claims as required by EBD. B. The Contractor shall provide an analysis of high claims cases. C. The Contractor shall advise EBD on plan design changes, as well as the impact on cost and quality of care related to such changes. D. The Contractor shall act as a liaison to develop reimbursement and collection strategies. E. The Contractor shall provide administrative reporting and claim management needs specific to EBD. F. The Contractor shall provide a detailed description of overall approach to the work. G. The Contractor shall have adequate staff capacity to effectively complete projects. H. The Contractor shall keep all EBD information strictly confidential unless disclosure is required by law. I. The Contractor shall notify EBD within thirty (30) days of the following: 1. Purchase, acquisition, and all other changes in ownership, partners, or control affecting ten percent (10%) or greater interest; 2. Any acquisition by of ten percent (10%) or greater interest in any subsidiary; and 3. Any new agreement with, by, or between any affiliates that is relevant to the resulting contract. J. During the Discussions phase, the Contractor shall disclose to EBD any relationships that may pose any potential conflicts of interest. K. The Contractor shall perform all work under a resulting contract within the contiguous United States.
