Laserfiche WebLink
SCHEDULE 7 <br />Peer Review/Medical Records Review Program <br />Terms and Conditions <br />I. DESCRIPTION OF SERVICES. <br />(a) CorVel shall provide access, and deliver the services described in this Schedule 7 in <br />connection with such access, to a panel of medical professionals who have been <br />credentialed by CorVel as "Credentialed Providers" and who will perform Peer Review <br />("Peer Reviews") and Medical Record Reviews ("MRRs"). <br />(b) Peer Review/Medical Records Review is defined as the process of reviewing and <br />commenting on the work, decisions and/or recommendations by one's equal (peer) to <br />ensure that it meets specific criteria such as federal and state regulations, and nationally <br />accepted standards of care in rendering medical services. <br />II. DELIVERY OF SERVICES. <br />(a) CorVel shall work only with Credentialed Providers under this Agreement. "Credentialed <br />Providers" are medical professionals with respect to whom CorVel has performed its <br />standard credentialing process. CorVel shall also verify that the medical professionals who <br />are Credentialed Providers meet all applicable statutory and/or legal requirements <br />regarding who can conduct a Peer Review or MRR. <br />(b) Customer shall have the right to nominate medical professionals as candidates for addition <br />to the panel of Credentialed Providers provided by CorVel for access by Customer <br />("Credentialed Panel"), subject to such medical professionals being credentialed by CorVel <br />as Credentialed Providers. <br />(c) Customer shall have the right, with written notice to CorVel, to request that CorVel cease <br />using a specific medical professional from the Credentialed Panel for Customer's <br />claimants. Upon receipt of such notice from Customer, Supplier shall promptly cease using <br />the specified medical professional as requested by Customer in such notice. <br />(d) Customer may submit a request for a Peer Review or a MRR via phone, fax, or <br />electronically via CorVel's CareMC website, if applicable. <br />(e) CorVel shall ensure that the MRR is assigned to a provider within 2 business days of <br />receipt of request or in accordance with applicable State law. <br />(f) CorVel will copy required medical records for the Peer Review or MRR as provided by <br />the Customer's file handler or legal office. CorVel will obtain additional medical records <br />as requested. <br />CorVel shall deliver to Customer completed Peer Review and MRR reports within 7 <br />business days of assignment to the Credentialed Provider. Prior to such delivery to <br />Customer, CorVel shall complete its quality review of such report. <br />(h) CorVel shall provide Customer quarterly activity reports within twenty (20) business days <br />following the applicable quarter. <br />(g) <br />City of Everett, WA — CorVel EC Amendment 3 7-25-2022 <br />