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Contract Addendum A <br /> City of Decatur Fees-JWF Specialty Company <br /> Claim Type JWF Specialty Fee-Lifetime of Claim <br /> Lost Time/Indemnity- Non Litigated $ 925.00 <br /> Medical Only $ 185.00 <br /> Info Only $ 20.00 <br /> Litigated Claims $ 1,150.00 <br /> * Per claim rates will be increased annually by 2%for up to 3 years. <br /> **An annual minimum of$25,000 will be applied <br /> Other Services Fees <br /> Systems& Data Processing $ _ <br /> On-Line Access (Unlimited Users) $ _ <br /> MMSEA Reporting-All tasks Annually $ 1,500.00 <br /> Claim Reporting Included <br /> OSHA On-Line System-Free Access-Self Service $ - <br /> Semi-Annual Claim Revies-Up to Quaraterly if necessar Included <br /> Data Transfer Fees TBD-If desired <br /> Optional Loss Control $125/hour <br /> Bill Review/Managed Care Fees <br /> PPO Access 25%of Savings <br /> Fee Schedule Bill Review $6.50/bill <br /> Telephonic Case Management $75/hr <br /> Pre-Authorization/Pre-Certification <br /> Nurse $95 <br /> Physician $300/hr <br /> Field Case Management $95/hr+ Mileage <br /> Subrogation 10%of recovery <br /> Banking(estimated) No Charge <br /> Utilization Review-Nurse $95/hr <br /> Utilization Review-Doctor $300/hr <br /> Medical Cost Projections $95/hr <br /> Durable Medical Equipment No charge for BR/PPO Savings <br />