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. . standards can be pre-set based on the following options: 1) physician's or case manager's treatment plan; 2) elapsed time from the date of injury; 3) number of treatments; 4) a dollar amount per injury. The claims professional will then be notified on the EaR when treatment is approaching its parameter limit. This cost-free. proactive case management will allow you to open discussions with the treating physician before overutilization has occurred. This results in fewer referrals to formal case management and preemption of an adversarial role among physician. patient and claims professional. . Inclusion of the City as an additional named insured. . Multiple-tiered PPO access. . Two-hour turnaround on faxed rush reviews. . We will guarantee a two-business-day turnaround on all batches. If this commitment is not met we will not charge the City for bill review fees. . On inpatient hospital bills that are not subject to either fee schedule or PPO reductions. we will provide free screening to ensure a reduction for audit by a nurse case manager (desk audit). All other inpatient hospital bills not otherwise reducible. will be forwarded to a hearing representative in the Lien Division for a direct negotiated discount with the provider. . Should the City choose LaM and later decide it would prefer an alternate pricing option than the one originally chosen. LaM would change the option and the beginning of any billing cycle (the first of each month). 11. Describe your pricing in detail on a volume of 350 estimated bills per month. . What optional pricing is available (flat. percentage. per line)? Flat Fee Option: reductions. NB: DRG reductions for inpatient billed at a percentage of savings for $10.00 per bill and 20% of the savings for PPO hospital fee schedule this option. are not Percentage Option: 12% of the fee schedule savings and 20% of the savings for PPO reductions 5