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Service Comments <br />Medical claim review of specific health care claims to <br />promote coding accuracy, benefit interpretation, and apply <br />reimbursement policv. <br />Standard coordination of benefits for all claims with <br />automated investigation once eve 12 months. <br />. . . .. . ........................................ . . . . . . . . ... g ........... . ................. . . .......................... ' . . ............................................... . . . . . . . ............................................ <br />Production and distribution of monthly Health <br />Statements. <br />....... . ................ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................. <br />Processing of run -out claims (meaning claims incurred prior <br />to the termination date) for six (6) months following <br />termination. <br />Application of subrogation services. <br />Fraud and Abuse Management Recovery Program. <br />Hospital Bill Audit Program. <br />. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . ..... . ... .. . . ... .. .... . . . . . . . . . . . . . . . . . . . .. .. ... . ... .. ... .. .. .. . . . . ... . . . . .... .. .. .. . .. . . ... . ... . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />Credit Balance Recovery Program. <br />.................. . .... . ......................... . ..................................... . . . . . . . . . . . . . . . . . ................................................ <br />.......... . ........... <br />Advanced Analytics and Recovery Services <br />20 <br />If the Agreement terminates because Customer fails to pay <br />United fees due, fails to provide the funding for the payment of <br />benefits, or United terminates for any other material breach, <br />run -out will not apply. <br />The fees associated with providing run -out claims processing <br />are included in United's monthly administrative fees as <br />described in Exhibit A. No additional fee will apply to run -out <br />claims processing, provided, however, if the Agreement is <br />terminated prior to the end of the initial year of the contract <br />(prior to December 31, 2017) for any reason, there will be an <br />additional fee, mutually agreed upon by the parties, for the <br />remaining months of the run -out claims processing term. <br />Suspension of Run -out Processing <br />If Customer does not pay the run -out fees it owes United when <br />due as set forth above, United will notify Customer. If Customer <br />does not make the required payment within five (5) business <br />days of United's notice to Customer, United may stop issuing <br />checks and non -draft payments and suspend its run -out claims <br />processing under this Agreement, such suspension to apply to <br />all claims regardless of dates of service and shall remain in effect <br />until such date when Customer makes the required payment. <br />Termination of Run -out Processing <br />Run -out claims processing will terminate if Customer fails to <br />provide the required funds for payment of benefits under the <br />terns of this Agreement. Such termination shall apply to all <br />claims regardless of dates of service. <br />The fee includes all work to identify recovery opportunities, <br />research, conduct data analysis, investigate, negotiate <br />settlements without the use of outside counsel, and draft legal <br />documents. <br />If outside counsel is retained for a group of payers seeking the <br />recovery, a proportionate amount of the outside legal fees, <br />equal to the payer's exposure in the case to the total exposure <br />in the case, will be deducted from the gross recovery amount, <br />after the fee has been deducted. Customer will be given the <br />option to participate or decline participation in the settlement. <br />United or its affiliate will use a combination of large scale <br />analytics, information and analysis to identify post - <br />adjudication claims for additional overpayment opportunil <br />