Medical Claims Data Sample Clauses

Medical Claims Data. To assist in the identification and treatment of Participants with chronic conditions such as diabetes, asthma, heart disease, pulmonary disease and hypertension, Client agrees to make reasonable efforts to provide Marathon, through its carrier, third party administrator, or third party vendor for claims data mining, with access to medical claims data for the Participants enrolled in Client’s health plan(s), for the 12 months prior to the initiation of onsite services, and minimally at twelve month intervals thereafter through the term of the contract. Marathon specifically acknowledges that Client's efforts to provide Marathon with any medical claims data is subject to the Client’s discretion and control, including, but not limited to, the file format defining the specifications for the data, the specific chronic conditions for which data is sought, the procedures that Marathon will utilize in contacting Participants, the minimum necessary data to meet the purpose for which Marathon is requesting such data and any requirement that Marathon execute Business Associate Agreements. Any such medical claims data will only be provided to the extent permitted by applicable law, including, but not limited to, the Health Insurance Portability and Accountability Act of 1996 (“HIPAA"). Moreover, Marathon agrees not to use or disclose medical claims data (or other Participant protected health information), for any purposes other than the Marathon Services specifically identified in this Agreement, or as required by law.

Medical Claims Data. Medical Claims file submissions shall include paid claims and adjudicated encounters for covered services under capitated, global, bundled, episode or other payment arrangement.

Medical Claims Data. To assist in the identification and treatment of Members with chronic conditions such as diabetes, asthma, heart disease, pulmonary disease and hypertension, and subject to applicable law and any confidentiality and business associate agreements, Client will direct its carrier, third party administrator, or third party vendor for claims data mining (each, a “Claim Processor”) to provide to Marathon medical claims data and pharmaceutical claims data via SFTP for the Members enrolled in Client’s health plan(s) for the 24 months prior to the initiation of the Health Services, and minimally at monthly intervals thereafter through the Term. In the event such claims data is not provided to Marathon, the Parties shall agree to adjust the performance guarantees as appropriate. In the event Client desires to use an alternative format to transmit the claims data, Marathon will evaluate using such alternative format, including whether additional costs shall apply.