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DocuSign Envelope ID:06CEAA47-F11 F-421 A-B8CE-390F42C61208 <br /> (ii) for states not having a state mandated Standard Fee Schedule: (A) the medical <br /> provider's original bill amount;less(B)the bill amount resulting from the nurse review <br /> services. <br /> (iii)for states having a state mandated Standard Fee schedule (A)the medical provider's <br /> original bill amount; less(B)the bill amount resulting from technical review services. <br /> (iv)for states not having a state mandated Standard Fee Schedule: (A) the medical <br /> provider's original bill amount; less (B) the bill amount resulting from the technical <br /> review services. <br /> (c) Customer Responsibilities <br /> (i) Customer shall pay bills reviewed by CorVel in a timely manner in accordance with <br /> all state guidelines, and agrees to waive any bill audit and/or other retrospective <br /> reviews regarding all bills for which CorVel has secured a reduction from the original <br /> billed charges. <br /> (ii)If a medical provider submits an appeal,the bill will be reviewed again and, if any adjustment <br /> is necessary, CorVel will provide that information on the Explanation of Review(EOR). <br /> SCHEDULE 4 <br /> Preferred Provider Network Access Services (PPO) <br /> Terms and Conditions <br /> I. DESCRIPTION OF SERVICES <br /> (a) CorVel's preferred provider organization is a network of hospitals, physicians and other <br /> providers ("Participating Providers") that offer services at pre-negotiated Provider rates <br /> ("PPO Network"). CorVel also provides state certified preferred provider organization <br /> networks in states that maintain such networks. <br /> II. DELIVERY OF SERVICES <br /> (a) CorVel will provide Customer with access to its PPO Network provided it is the exclusive <br /> preferred provider organization utilized by Customer. CorVel may at any time and in its <br /> sole discretion add and/or terminate any provider to or from the PPO Network. <br /> (b) CorVel will provide Customer with a web-based directory of its PPO Network providers. <br /> (c) Customer agrees that, during the Term of this Agreement Customer will not contract <br /> directly or indirectly with Participating Providers made known to Customer under this <br /> Agreement. <br /> (d) Customer will make reasonable effort to channel all Covered Persons to the Participating <br /> Providers as are allowed under the laws of that service area or state. <br /> City of Everett,WA—CorVel EC Amendment 3 7-25-2022 <br />