The Vendor is required to provide for third part administration of dental benefits.
- Provider will be responsible for informing agency staff of all newly introduced regulations/laws and modification to existing regulations/laws with the intent being to maintain compliance with regulations and to benefit financially from government directed programs.
- Shall initiate and conduct all necessary and timely investigation of all claims and/or invoices for which reports are furnished by agency personnel.
- Shall issue appropriate instrument(s) to effect and satisfy claim settlement.
- Responsible to answer all inquiries from claimants and assume the responsibility for the adjustment of all claims so that these activities are diverted from agency personnel.
- Required to collect, receive, store agency claim exposure and other necessary data and will organize such data in reports to provide risk management information.
- Computer data files must be copied and placed in a location remote from the control processing unit at least once a week.
- All financial reports and activities relating to transfer, payment and recordkeeping of agency transactions must be conducted in a manner acceptable to the agency VP of Finance.
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