Healthcare Management Administrators (HMA) 2/20/2025

Proving What’s Possible in Healthcare This document contains important terms and conditions which are incorporated by reference into and becomes part of the terms of your contract with us. ©2024, Healthcare Management Administrators, Inc. Disclosures Product/Service Description of Disclosures Payment Integrity Program We retain the following shared savings fees on our Payment Integrity Program: 30% of savings –Medical bill audit and claim review, out-of-network claim re-pricing services, claims negotiation and medication and condition steerage programs. 30% of savings –Electronic review of claims for code edits prior to payment. Data Mining and Overpayment Recovery 15% for current claims and 17% for aged claims retained by Cotiviti on all recoveries. On post-payment COB and Code Edit recoveries identified by Cotiviti, we retain an additional 13-15%. Subrogation services The plan will receive 73% of recovered funds. Of the remaining, 22% is retained by The Phia Group, and 5% is retained by HMA.* *In the event of litigation to enforce the Plan’s right of recovery, The Phia Group fee will increase to 33.3% and HMA shall not retain any compensation. 9.5% of recovered funds –credit balance premier health services partner on site with providers across the country. 30% of savings –fraud, waste, and abuse •17.5% of savings retained by Optum •12.5% administrative allowance 37 Please Note: the content in this and the accompanying Client Insights document is intended to be informational only and cannot be relied upon as legal advice. The Plan Sponsor is ultimately responsible for the compliance of the Plan design and the benefits offered. HRIS Vendor Changes HRIS vendor change requests within 3 years of initial set-up incur a charge of $5,000