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T-1836
THIRD PARTY LIABILITY RECOVERY
SERVICES DEPT. OF HUMAN SERVICES

Vendor Information
By Vendor
RFP Documents
Email to SHANA FLETCHER

Downloadable NOA Documents
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NOAs By Number NOAs By Title Search NOAs
 
Index #:
T-1836
Contract #: 42344
Contract Period: FROM:   09/21/16   TO:   09/20/20
Applicable To: SELECTED STATE AGENCIES
Cooperative Purchasing: NOT APPLICABLE
Vendor Name & Address: HEALTH MANAGEMENT SYSTEMS INC
ACH ELECTRONIC PAYMENTS
5615 HIGH POINT DRIVE
IRVING, TX 75038
For Procurement Bureau Use:  
Solicitation #: 23249
Bid Open Date: 04/28/15
CID #: 1041637
Commodity Code: 946-11
Set-Aside: SMALL BUSINESS SUBCONTRACTING

CONDITIONS AND METHODS OF OPERATION

Multi-Source Contracts: State Agencies and Cooperative Purchasing partners should review each vendor's product/service and prices carefully and place orders in accordance with the terms and conditions of the contract. Note that

A. Delivery: All prices F.O.B. Destination
B. Method of Operation - State Agencies Only:
Issue an agency purchase order to the appropriate contract vendor(s).

In the event of an emergency, contact the following in the order listed:

SHANA FLETCHER PROCUREMENT SPECIALIST 609-292-4243
LINDA SPILDENER PROCUREMENT SPECIALIST SUPERVISOR 609-633-3906
PHILIP MICHAELS ASSISTANT DIRECTOR  
  PUB DATE: 10/28/16

VENDOR INFORMATION
Vendor Name & Address:
HEALTH MANAGEMENT SYSTEMS INC
ACH ELECTRONIC PAYMENTS
5615 HIGH POINT DRIVE
IRVING, TX 75038
Contact Person: WILLIAM C LUCIA
Contact Phone: 214-453-3140
Order Fax: 469-359-4413
Contract#: 42344
Expiration Date: 09/20/20
Terms: NONE
Delivery: SPECIFIED ELSEWHERE
Small Business Enterprise: NO
Minority Business Enterprise: NO
Women Business Enterprise: NO
Cooperative Purchasing *: NO
* WILL VENDOR EXTEND CONTRACT PRICES TO COOPERATIVE PURCHASING PARTICIPANTS?
 

CONTRACT ITEMS/SERVICES BY VENDOR
Vendor:  HEALTH MANAGEMENT SYSTEMS INC
ACH ELECTRONIC PAYMENTS
Contract Number:  42344
UNLESS SPECIFIED OTHERWISE BELOW:
SHIP TO: 547540 / S001
GENERAL SERVICES UNIT (DMAHS)
7 QUAKERBRIDGE PLAZA
TRENTON NJ 08625-0712
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00001 COMM CODE:  946-11-073510
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
COMPREHENSIVE MEDICAL COVERAGE
YEAR ONE (1)


1.000 EACH N/A $39.84000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00002 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
PRESCRIPTION COVERAGE
YEAR ONE (1)


1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00003 COMM CODE:  946-11-073668
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS: MINOR MEDICAL COVERAGE,
SUCH AS VISION ONLY; DENTAL ONLY;
MENTAL HEALTH ONLY; ETC.
YEAR ONE (1)

1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00004 COMM CODE:  946-11-073669
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
MEDICARE SUPPLEMENTAL
YEAR ONE (1)


1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00005 COMM CODE:  946-11-073670
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
COMPREHENSIVE MEDICAL COVERAGE
YEAR ONE (1)


1.000 EACH N/A $37.85000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00006 COMM CODE:  946-11-073671
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATION
PRESCRIPTION COVERAGE
YEAR ONE (1)

1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00007 COMM CODE:  946-11-073672
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
MINOR MEDICAL COVERAGE, SUCH AS
VISION ONLY; DENTAL ONLY; MENTAL HEALTH
ONLY, ETC.
YEAR ONE (1)

1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00008 COMM CODE:  946-11-073673
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
MEDICARE SUPPLEMENTAL
YEAR ONE (1)


1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00009 COMM CODE:  946-11-073674
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
COST AVOIDANCE:
NON-RESIDENT TERMINATIONS
FROM MEDICAID
YEAR ONE (1)
4.9 % CONTINGENCY PAID FOR EACH COST
AVOIDANCE DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00010 COMM CODE:  946-11-073675
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
RECOVERIES: ONSITE AUDITS; MEDICARE
PARTS A & B RECOVERIES; ALL TYPES OF
THIRD-PARTY-CARRIER RECOVERIES AND/OR
ADJUSTMENTS
YEAR ONE (1)
9.26 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00011 COMM CODE:  946-11-073676
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES-TORT
IDENTIFICATIONS ONLY
YEAR ONE (1)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION DOLLAR TO THE VENDOR


1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00012 COMM CODE:  946-11-073677
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES-TORT
RECOVERIES ONLY
YEAR ONE (1)
9.65 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00013 COMM CODE:  946-11-073678
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- TORT
IDENTIFICATION AND RECOVERY
YEAR ONE (1)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION AND RECOVERY
DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00014 COMM CODE:  946-11-073679
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
IDENTIFICATIONS ONLY
YEAR ONE (1)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00015 COMM CODE:  946-11-073680
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
RECOVERIES ONLY
YEAR ONE (1)
9.65 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00016 COMM CODE:  946-11-073681
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
IDENTIFICATION AND RECOVERY
YEAR ONE (1)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION AND RECOVERY
DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00017 COMM CODE:  946-11-073682
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
COMPREHENSIVE MEDICAL COVERAGE
YEAR TWO (2)



1.000 EACH N/A $39.84000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00018 COMM CODE:  946-11-073683
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
PRESCRIPTION COVERAGE
YEAR TWO (2)



1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00019 COMM CODE:  946-11-073684
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS: MINOR MEDICAL COVERAGE
SUCH AS VISION ONLY; DENTAL ONLY;
MENTAL HEALTH ONLY; ETC.
YEAR TWO (2)

1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00020 COMM CODE:  946-11-073685
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
MEDICARE SUPPLEMENTAL
YEAR TWO (2)





1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00021 COMM CODE:  946-11-073686
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
COMPREHENSIVE MEDICAL COVERAGE
YEAR TWO (2)





1.000 EACH N/A $37.85000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00022 COMM CODE:  946-11-073687
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATION
PRESCRIPTION COVERAGE
YEAR TWO (2)


1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00023 COMM CODE:  946-11-073688
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
MINOR MEDICAL COVERAGE, SUCH AS
VISION ONLY; DENTAL ONLY; MENTAL HEALTH
ONLY, ETC.
YEAR TWO (2)
1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00024 COMM CODE:  946-11-073689
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
MEDICARE SUPPLEMENTAL
YEAR TWO (2)


1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00025 COMM CODE:  946-11-073690
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
COST AVOIDANCE:
NON-RESIDENT TERMINATIONS
FROM MEDICAID
YEAR TWO (2)
4.9 % CONTINGENCY PAID FOR EACH
COST AVOIDANCE DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00026 COMM CODE:  946-11-073691
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
RECOVERIES: ONSITE AUDITS; MEDICARE
PARTS A & B RECOVERIES; ALL TYPES OF
THIRD-PARTY-CARRIER RECOVERIES AND/OR
ADJUSTMENTS
YEAR TWO (2)
9.26 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00027 COMM CODE:  946-11-073692
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES-TORT
IDENTIFICATIONS ONLY
YEAR TWO (2)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00028 COMM CODE:  946-11-073693
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES-TORT
RECOVERIES ONLY
YEAR TWO (2)
9.65 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR

1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00029 COMM CODE:  946-11-073694
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- TORT
IDENTIFICATION AND RECOVERY
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION AND RECOVERY
DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00030 COMM CODE:  946-11-073695
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
IDENTIFICATIONS ONLY
YEAR TWO (2)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00031 COMM CODE:  946-11-073696
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
RECOVERIES ONLY
YEAR TWO (2)
9.65 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00032 COMM CODE:  946-11-073697
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
IDENTIFICATION AND RECOVERY
YEAR TWO (2)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION AND RECOVERY DOLLAR
TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00033 COMM CODE:  946-11-073698
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
COMPREHENSIVE MEDICAL COVERAGE
YEAR THREE (3)


1.000 EACH N/A $39.84000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00034 COMM CODE:  946-11-073699
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
PRESCRIPTION COVERAGE
YEAR THREE (3)
1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00035 COMM CODE:  946-11-073700
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS: MINOR MEDICAL COVERAGE;
SUCH AS VISION ONLY; DENTAL ONLY;
MENTAL HEALTH ONLY; ETC.
YEAR THREE (3)

1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00036 COMM CODE:  946-11-073701
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
MEDICARE SUPPLEMENTAL
YEAR THREE (3)


1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00037 COMM CODE:  946-11-073702
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
COMPREHENSIVE MEDICAL COVERAGE
YEAR THREE (3)



1.000 EACH N/A $37.85000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00038 COMM CODE:  946-11-073703
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATION
PRESCRIPTION COVERAGE
YEAR THREE (3)
1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00039 COMM CODE:  946-11-073704
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
MINOR MEDICAL COVERAGE, SUCH AS
VISION ONLY; DENTAL ONLY; MENTAL HEALTH
ONLY, ETC.
YEAR THREE (3)



1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00040 COMM CODE:  946-11-073705
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
MEDICARE SUPPLEMENTAL
YEAR THREE (3)
1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00041 COMM CODE:  946-11-073706
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
COST AVOIDANCE:
NON-RESIDENT TERMINATIONS
FROM MEDICAID
YEAR THREE (3)
4.9 % CONTINGENCY PAID FOR EACH
COST AVOIDANCE DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00042 COMM CODE:  946-11-073707
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
RECOVERIES: ONSITE AUDITS; MEDICARE
PARTS A & B RECOVERIES; ALL TYPES OF
THIRD-PARTY-CARRIER RECOVERIES AND/OR
ADJUSTMENTS
YEAR THREE (3)
9.26 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00043 COMM CODE:  946-11-073708
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES-TORT
IDENTIFICATIONS ONLY
YEAR THREE (3)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00044 COMM CODE:  946-11-073709
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES-TORT
RECOVERIES ONLY
YEAR THREE (3)
9.65 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00045 COMM CODE:  946-11-073710
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- TORT
IDENTIFICATION AND RECOVERY
YEAR THREE (3)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION AND RECOVERY
TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00046 COMM CODE:  946-11-073711
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
IDENTIFICATIONS ONLY
YEAR THREE (3)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00047 COMM CODE:  946-11-073712
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
RECOVERIES ONLY
YEAR THREE (3)
9.65 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00048 COMM CODE:  946-11-073713
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
IDENTIFICATION AND RECOVERY
YEAR THREE (3)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION AND RECOVERY
DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00049 COMM CODE:  946-11-073714
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
COMPREHENSIVE MEDICAL COVERAGE
YEAR FOUR (4)



1.000 EACH N/A $39.84000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00050 COMM CODE:  946-11-073715
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
PRESCRIPTION COVERAGE
YEAR FOUR (4)



1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00051 COMM CODE:  946-11-073716
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS: MINOR MEDICAL COVERAGE;
SUCH AS VISION ONLY; DENTAL ONLY;
MENTAL HEALTH ONLY; ETC.
YEAR FOUR (4)


1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00052 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
IDENTIFICATIONS
MEDICARE SUPPLEMENTAL
YEAR FOUR (4)


1.000 EACH N/A $37.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00053 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
COMPREHENSIVE MEDICAL COVERAGE
YEAR FOUR (4)


1.000 EACH N/A $37.85000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00054 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATION
PRESCRIPTION COVERAGE
YEAR FOUR (4)


1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00055 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
MINOR MEDICAL COVERAGE, SUCH AS
VISION ONLY; DENTAL ONLY; MENTAL HEALTH
ONLY, ETC.
YEAR FOUR (4)
1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00056 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
REVERIFICATIONS
MEDICARE SUPPLEMENTAL
YEAR FOUR (4)


1.000 EACH N/A $36.50000
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00057 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
COST AVOIDANCE:
NON-RESIDENT TERMINATIONS
FROM MEDICAID
YEAR FOUR (4)
4.9 % CONTINGENCY PAID FOR EACH
COST AVOIDANCE DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00058 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
RECOVERIES: ONSITE AUDITS; MEDICARE
PARTS A & B RECOVERIES; ALL TYPES OF
THIRD-PARTY-CARRIER RECOVERIES AND/OR
ADJUSTMENTS
YEAR FOUR (4)
9.26 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00059 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES-TORT
IDENTIFICATIONS ONLY
YEAR FOUR (4)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00060 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES-TORT
RECOVERIES ONLY
YEAR FOUR (4)
9.65 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00061 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- TORT
IDENTIFICATION AND RECOVERY
YEAR FOUR (4)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION AND RECOVERY DOLLAR
TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00062 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
IDENTIFICATIONS ONLY
YEAR FOUR (4)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00063 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
RECOVERIES ONLY
YEAR FOUR (4)
9.65 % CONTINGENCY PAID FOR EACH
RECOVERY DOLLAR TO THE VENDOR
1.000 PCNT NET N/A
LINE#  DESCRIPTION/MFGR/BRAND EST QUANTITY UNIT % DISCOUNT UNIT PRICE
00064 COMM CODE:  946-11-073667
[FINANCIAL SERVICES]
 
ITEM DESCRIPTION:
SPECIFIC TPL SERVICES- CASUALTY
INSURANCE
IDENTIFICATION AND RECOVERY
YEAR FOUR (4)
9.65 % CONTINGENCY PAID FOR EACH
IDENTIFICATION AND RECOVERY
DOLLAR TO THE VENDOR
1.000 PCNT NET N/A


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