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and will be billed directly to the client by the carrier or by CorVel should CorVel be invoiced for such fees. <br />Intake and Immediate Intervention Services <br />Description <br />Pricing <br />Claim Intake (includes one FNOL distribution) - Per Intake <br />$31.44 <br />Incident Only Reporting - Per Incident <br />I <br />$31.44 <br />Advocacy 24/7 - Per Ca11 <br />I <br />$91.00 <br />Telehealth Services <br />Fee Schedule or U&C value by CPT code <br />Allocated Expense Fees <br />Le. al Services <br />Description <br />Pricing <br />Subrogation <br />Legal Bill Auditing 1 <br />25% of Recoveries <br />2.5% of gross legal charges <br />reviewed <br />Indexing and OFAC Compliance - Per Index <br />$15.72 <br />' Fees will never exceed the savings generated <br />Bill Review Services <br />Description <br />Pricing <br />Bill Review: Includes Standard Fee Schedule and UCR - Per Bill 1,2 <br />+ Network Solutions Includes: 2 <br />Clinical Review, Implant Analysis, Line Item Bill Review, <br />Negotiations, PPO Network Access, <br />Substantive Denials, Technical Evaluation <br />$9.43 <br />27% of Savings <br />Minimum Transaction Fee 2 $6.95 <br />State EDI, Scanning/OCR, Initial 1099 Provider Notification Letter Included <br />' Includes bill intake, document imaging, file upload, state EDI's, and initial 1099 provider notification letters. <br />2 Minimum transaction fee (MTF) per bill transaction. Applied per transaction if all other applicable fees do not meet <br />the minimum transaction fee. Applies to all transactions, including but not limited to, Specialty Bills, Duplicate Bills <br />and bills sent for Re -consideration or Re-evaluation. There is a maximum bill review transaction fee of $15,000. <br />Patient Management <br />Description <br />Pricin <br />Telephonic Case Management, Field Case Management <br />and Return to Work Coordinator - Per Hour1,2 <br />Vocational Rehabilitation - Per Hour 2 <br />$121.57 <br />$172.92 <br />Specialty Services (Catastrophic, Life Care Plan, Medicare <br />Conditional Payments, Medicare Set Asides, Bilingual) - Per Hour <br />$228.46 <br />Nurse Utilization Review - Per Review <br />$149.86 <br />Physician Utilization Review - Per Review <br />Care Advocate - Per Claim <br />$275.00 <br />$50.00 <br />PeerWell App Access - Per Claim (One -Time Fee) <br />$500.00 <br />'Fee applies to all States with the exception of premium states (CA, HI, AK, and NY). <br />2 Statutory rates supersede if applicable. <br />Prevailing IRS Mileage Rate applies. <br />Each invoice for Case Management Services shall have an additional professional service fee of $39.00 billed to <br />Customer. <br />City of Everett, WA — CorVel EC Amendment 3 7-25-2022 <br />