Negotiated Fee Arrangements. The above per claim Access Fees and AEA fees will apply unless alternative fees are negotiated with a Host Blue plan.
Negotiated Fee Arrangements. The above per claim Access Fees and AEA fees will apply unless alternative fees are negotiated with a Host Blue plan. PCPM rates are in lieu of standard BlueCard Access and AEA fees for those claims which qualify under such an agreement as indicated above. The PCPM Fee is a financial arrangement negotiated between the Host Blue and BCBSNE and replaces all other fees, including the Access Fee and AEA. The PCPM dollar amount is charged on a per- contract-per-month basis by the Host Blue to BCBSNE for administrative services the Host Blue provides in processing claims for THE GROUP’s Covered Persons. The dollar amount can also be based on the size of THE GROUP’s enrollment. In addition, a Non-Standard AEA fee is another type of alternative fee which is also in lieu of standard per claim BlueCard Access and AEA fees. The Non-Standard AEA Fee is a financial arrangement negotiated between the Host Blue and BCBSNE and replaces all other fees, including the Access Fee and AEA. The Non-Standard AEA is a fixed per- claim dollar amount charged by the Host Blue to BCBSNE for administrative services the Host Blue provides in processing claims for THE GROUP’s Covered Persons. For claims incurred in Host Blue service areas where such an alternative agreement does not exist, the per-claim Access and AEA fees will apply as described above.
