Common use of Billing and Collections Clause in Contracts

Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. Collection services shall include:  Creating and maintaining HIPAA compliant POWER Account contribution billing services;  Generating and mailing invoices, although members may opt-in to receiving electronic invoices;  Receiving and posting payments;  Monitoring and tracking missed payments;  Processing returned checks;  Stopping or placing collections on hold as directed by the State;  Generating past due notices and other notifications;  Generating other informational materials as requested by the State;  Providing documentation of account activities and other financial reports;  Processing and mailing fast track prepayment and/or POWER Account contribution refunds;  Transferring collected funds as requested by the State;  Documentation and reconciliation of funds received and transferred;  Establishing and handling a lockbox for HIP payments;  Providing services online that support and interface with the State’s current website;  Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State;  Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures;  Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto;  Date stamping mail received; and  Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will assist the Contractor by identifying vendor(s) that can accept cash contributions. The Contractor agrees to use commercially reasonable efforts to work with such vendor(s) to accept cash contributions at no cost to the member. The Contractor shall ensure that any cash contributions collected by third party vendors in accordance with this Section 4 are credited toward the member’s POWER Account within two (2) business days. More information about preferred vendor(s) and cash collection methods may be found in the HIP MCE Policies and Procedures Manual. The State will determine the member’s required POWER Account contribution amounts during the application process and will notify the Contractor of these amounts. The required POWER Account contribution will be provided to the Contractor in both an annual benefit period amount and a monthly billing amount. POWER Account contributions will be recalculated by the State during eligibility redetermination, and as otherwise required throughout the benefit period based on member reported changes, in accordance with Section 4.4 below.

Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK Collection services shall include:  Creating and maintaining HIPAA compliant POWER Account contribution billing services;  Generating and mailing invoices, although members may opt-in to receiving electronic invoices;  Receiving and posting payments;  Monitoring and tracking missed payments;  Processing returned checks;  Stopping or placing collections on hold as directed by the State;  Generating past due notices and other notifications;  Generating other informational materials as requested by the State;  Providing documentation of account activities and other financial reports;  Processing and mailing fast track prepayment and/or POWER Account contribution refunds;  Transferring collected funds as requested by the State;  Documentation and reconciliation of funds received and transferred;  Establishing and handling a lockbox for HIP payments;  Providing services online that support and interface with the State’s current website;  Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State;  Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures;  Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto;  Date stamping mail received; and  Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will assist the Contractor by identifying vendor(s) that can accept cash contributions. The Contractor agrees to use commercially EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK reasonable efforts to work with such vendor(s) to accept cash contributions at no cost to the member. The Contractor shall ensure that any cash contributions collected by third party vendors in accordance with this Section 4 are credited toward the member’s POWER Account within two (2) business days. More information about preferred vendor(s) and cash collection methods may be found in the HIP MCE Policies and Procedures Manual. The State will determine the member’s required POWER Account contribution amounts during the application process and will notify the Contractor of these amounts. The required POWER Account contribution will be provided to the Contractor in both an annual benefit period amount and a monthly billing amount. POWER Account contributions will be recalculated by the State during eligibility redetermination, and as otherwise required throughout the benefit period based on member reported changes, in accordance with Section 4.4 below.

Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. Collection services shall include:  ▪ Creating and maintaining HIPAA compliant POWER Account contribution billing services;  ▪ Generating and mailing invoices, although members may opt-in to receiving electronic invoices;  ▪ Receiving and posting payments;  ▪ Monitoring and tracking missed payments;  ▪ Processing returned checks;  ▪ Stopping or placing collections on hold as directed by the State;  ▪ Generating past due notices and other notifications;  ▪ Generating other informational materials as requested by the State;  ▪ Providing documentation of account activities and other financial reports;  ▪ Processing and mailing fast track prepayment and/or POWER Account contribution refunds;  ▪ Transferring collected funds as requested by the State;  ▪ Documentation and reconciliation of funds received and transferred;  ▪ Establishing and handling a lockbox for HIP payments;  ▪ Providing services online that support and interface with the State’s current website;  ▪ Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State;  ▪ Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures;  ▪ Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto;  ▪ Date stamping mail received; and  ▪ Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will assist the Contractor by identifying vendor(s) that can accept cash contributions. The Contractor agrees to use commercially reasonable efforts to work with such vendor(s) to accept cash contributions at no cost to the member. The Contractor shall ensure that any cash contributions collected by third party vendors in accordance with this Section 4 are credited toward the member’s POWER Account within two (2) business days. More information about preferred vendor(s) and cash collection methods may be found in the HIP MCE Policies and Procedures Manual. The State will determine the member’s required POWER Account contribution amounts during the application process and will notify the Contractor of these amounts. The required POWER Account contribution will be provided to the Contractor in both an annual benefit period amount and a monthly billing amount. POWER Account contributions will be recalculated by the State during eligibility redetermination, and as otherwise required throughout the benefit period based on member reported changes, in accordance with Section 4.4 below.

Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. Collection services shall include:   Creating and maintaining HIPAA compliant POWER Account contribution billing services;   Generating and mailing invoices, although members may opt-in to receiving electronic invoices;   Receiving and posting payments;   Monitoring and tracking missed payments;   Processing returned checks;   Stopping or placing collections on hold as directed by the State;   Generating past due notices and other notifications;   Generating other informational materials as requested by the State;   Providing documentation of account activities and other financial reports;   Processing and mailing fast track prepayment and/or POWER Account contribution refunds;   Transferring collected funds as requested by the State;   Documentation and reconciliation of funds received and transferred;   Establishing and handling a lockbox for HIP payments;   Providing services online that support and interface with the State’s current website;   Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State;   Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures;   Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto;   Date stamping mail received; and   Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will assist the Contractor by identifying vendor(s) that can accept cash contributions. The Contractor agrees to use commercially reasonable efforts to work with such vendor(s) to accept cash contributions at no cost to the member. The Contractor shall ensure that any cash contributions collected by third party vendors in accordance with this Section 4 are credited toward the member’s POWER Account within two (2) business days. More information about preferred vendor(s) and cash collection methods may be found in the HIP MCE Policies and Procedures Manual. The State will determine the member’s required POWER Account contribution amounts during the application process and will notify the Contractor of these amounts. The required POWER Account contribution will be provided to the Contractor in both an annual benefit period amount and a monthly billing amount. POWER Account contributions will be recalculated by the State during eligibility redetermination, and as otherwise required throughout the benefit period based on member reported changes, in accordance with Section 4.4 below.

Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. Collection services shall include:  ▪ Creating and maintaining HIPAA compliant POWER Account contribution billing services;  ▪ Generating and mailing invoices, although members may opt-in to receiving electronic invoices;  ▪ Receiving and posting payments;  ▪ Monitoring and tracking missed payments;  ▪ Processing returned checks;  ▪ Stopping or placing collections on hold as directed by the State;  ▪ Generating past due notices and other notifications;  ▪ Generating other informational materials as requested by the State;  EXHIBIT 2.I SCOPE OF WORK – HEALHTY INDIANA PLAN ▪ Providing documentation of account activities and other financial reports;  ▪ Processing and mailing fast track prepayment and/or POWER Account contribution refunds;  ▪ Transferring collected funds as requested by the State;  ▪ Documentation and reconciliation of funds received and transferred;  ▪ Establishing and handling a lockbox for HIP payments;  ▪ Providing services online that support and interface with the State’s current website;  ▪ Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State;  ▪ Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures;  ▪ Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto;  ▪ Date stamping mail received; and  ▪ Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will assist the Contractor by identifying vendor(s) that can accept cash cas h contributions. The Contractor agrees to use commercially reasonable efforts to work with such vendor(s) to accept cash contributions at no cost to the member. The Contractor shall ensure that any cash contributions collected by third party vendors in accordance with this Section 4 are credited toward the member’s POWER Account within two (2) business days. More information about preferred vendor(s) and cash collection methods may be found in the HIP MCE Policies and Procedures Manual. The State will determine the member’s required POWER Account contribution amounts during the application process and will notify the Contractor of these amounts. The required POWER Account contribution will be provided to the Contractor in both an annual benefit period amount and a monthly billing amount. POWER Account contributions will be recalculated by the State during eligibility redetermination, and as otherwise required throughout the benefit period based on member reported changes, in accordance with Section 4.4 below.

Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK Collection services shall include:  ▪ Creating and maintaining HIPAA compliant POWER Account contribution billing services;  ▪ Generating and mailing invoices, although members may opt-in to receiving electronic invoices;  ▪ Receiving and posting payments;  ▪ Monitoring and tracking missed payments;  ▪ Processing returned checks;  ▪ Stopping or placing collections on hold as directed by the State;  ▪ Generating past due notices and other notifications;  ▪ Generating other informational materials as requested by the State;  ▪ Providing documentation of account activities and other financial reports;  ▪ Processing and mailing fast track prepayment and/or POWER Account contribution refunds;  ▪ Transferring collected funds as requested by the State;  ▪ Documentation and reconciliation of funds received and transferred;  ▪ Establishing and handling a lockbox for HIP payments;  ▪ Providing services online that support and interface with the State’s current website;  ▪ Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State;  ▪ Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures;  ▪ Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto;  ▪ Date stamping mail received; and  ▪ Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will assist the Contractor by identifying vendor(s) that can accept cash contributions. The Contractor agrees to use commercially EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK reasonable efforts to work with such vendor(s) to accept cash contributions at no cost to the member. The Contractor shall ensure that any cash contributions collected by third party vendors in accordance with this Section 4 are credited toward the member’s POWER Account within two (2) business days. More information about preferred vendor(s) and cash collection methods may be found in the HIP MCE Policies and Procedures Manual. The State will determine the member’s required POWER Account contribution amounts during the application process and will notify the Contractor of these amounts. The required POWER Account contribution will be provided to the Contractor in both an annual benefit period amount and a monthly billing amount. POWER Account contributions will be recalculated by the State during eligibility redetermination, and as otherwise required throughout the benefit period based on member reported changes, in accordance with Section 4.4 below.

Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. Collection services shall include:  ▪ Creating and maintaining HIPAA compliant POWER Account contribution billing services;  ▪ Generating and mailing invoices, although members may opt-in to receiving electronic invoices;  ▪ Receiving and posting payments;  ▪ Monitoring and tracking missed payments;  ▪ Processing returned checks;  ▪ Stopping or placing collections on hold as directed by the State;  ▪ Generating past due notices and other notifications;  ▪ Generating other informational materials as requested by the State;  EXHIBIT 2.I SCOPE OF WORK – HEALTHY INDIANA PLAN ▪ Providing documentation of account activities and other financial reports;  ▪ Processing and mailing fast track prepayment and/or POWER Account contribution refunds;  ▪ Transferring collected funds as requested by the State;  ▪ Documentation and reconciliation of funds received and transferred;  ▪ Establishing and handling a lockbox for HIP payments;  ▪ Providing services online that support and interface with the State’s current website;  ▪ Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State;  ▪ Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures;  ▪ Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto;  ▪ Date stamping mail received; and  ▪ Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will assist the Contractor by identifying vendor(s) that can accept cash contributions. The Contractor agrees to use commercially reasonable efforts to work with such vendor(s) to accept cash contributions at no cost to the member. The Contractor shall ensure that any cash contributions collected by third party vendors in accordance with this Section 4 are credited toward the member’s POWER Account within two (2) business days. More information about preferred vendor(s) and cash collection methods may be found in the HIP MCE Policies and Procedures Manual. The State will determine the member’s required POWER Account contribution amounts during the application process and will notify the Contractor of these amounts. The required POWER Account contribution will be provided to the Contractor in both an annual benefit period amount and a monthly billing amount. POWER Account contributions will be recalculated by the State during eligibility redetermination, and as otherwise required throughout the benefit period based on member reported changes, in accordance with Section 4.4 below.

Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. Collection services shall include:  ▪ Creating and maintaining HIPAA compliant POWER Account contribution billing services;  ▪ Generating and mailing invoices, although members may opt-in to receiving electronic invoices;  ▪ Receiving and posting payments;  ▪ Monitoring and tracking missed payments;  ▪ Processing returned checks;  ▪ Stopping or placing collections on hold as directed by the State;  ▪ Generating past due notices and other notifications;  ▪ Generating other informational materials as requested by the State;  EXHIBIT 2.I SCOPE OF WORK – HEALTHY INDIANA PLAN ▪ Providing documentation of account activities and other financial reports;  ▪ Processing and mailing fast track prepayment and/or POWER Account contribution refunds;  ▪ Transferring collected funds as requested by the State;  ▪ Documentation and reconciliation of funds received and transferred;  ▪ Establishing and handling a lockbox for HIP payments;  ▪ Providing services online that support and interface with the State’s current website;  ▪ Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State;  ▪ Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures;  ▪ Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto;  ▪ Date stamping mail received; and  ▪ Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will assist the Contractor by identifying vendor(s) that can accept cash cas h contributions. The Contractor agrees to use commercially reasonable efforts to work with such vendor(s) to accept cash contributions at no cost to the member. The Contractor shall ensure that any cash contributions collected by third party vendors in accordance with this Section 4 are credited toward the member’s POWER Account within two (2) business days. More information about preferred vendor(s) and cash collection methods may be found in the HIP MCE Policies and Procedures Manual. The State will determine the member’s required POWER Account contribution amounts during the application process and will notify the Contractor of these amounts. The required POWER Account contribution will be provided to the Contractor in both an annual benefit period amount and a monthly billing amount. POWER Account contributions will be recalculated by the State during eligibility redetermination, and as otherwise required throughout the benefit period based on member reported changes, in accordance with Section 4.4 below.