Common use of Service Category 3 Clause in Contracts

Service Category 3. Claims Auditing – Awarded Contractor(s) will audit Customer claims including analyzing payments, procedures, and guidelines of benefits. These services may include interpreting detailed paid and/or unpaid claims, eligibility for benefits, payments, and other various reports or data to determine the eligible types of services. When creating a Customer specific scope of work, Customers are permitted to negotiate terms and conditions which supplement those contained in this Contract. Such additional terms shall be for similar or equivalent services contemplated in this Contract Scope of Work and shall not conflict with the terms and conditions established by this Contract (and any such conflicting terms shall be resolved in favor of terms most favorable to the Customer). Specific terms and conditions within a Customer’s scope of work are only applicable to the Customer’s Contract or Purchase Order.