The URL can be used to link to this page

Home My WebLink AboutP-25-504 Inovalon Vendor Agreement.pdf Docusign Envelope ID:2BA061CD-03F5-4DBE-A45D-AOFD456000E1 Inovalon® healthcare empowered Order Information Order Number Q-140280 Offer valid through 11/30/2025 Prepared by Sean Connolly Manager Chris Riddle Customer Information Account Name County of Fresno Account Number 442292 Physical Address 1925 E Dakota Ave Billing Address 1925 E Dakota Ave Fresno, CA 93726 Fresno, CA 93726 us us Business Contact Technical Contact Billing Contact Riley Blackburn Michael Miller Sean Patterson 5596009180 5596004608 5596004601 rlackburn@fresnocountyca.gov mimiller@fresnocountyca.gov spatterson@fresnocountyca.gov Order Details Billing Frequency Monthly Fee Type Quantity Servic Service Name Sales Price Total Price Recurring 1 7B ,7, CMP7 Claims Management Pro $641.66 $641.66 Recurring 1 FIR cm Insurance Discovery $225.00 $225.00 One Time 1 CMP-IMP Claims Management Pro $468.75 $468.75 Implementation One Time 1 BRCM-ALL-HistCl-IMP Historic Claim Import $162.50 $162.50 Implementation One Time 1 FRCM-ID-IMP Insurance Discovery $95.25 $95.25 Implementation Recurring 1 FRCM-EVStd Eligibility Verification Standard $250.00 $250.00 One Time 1 FRCM-EVStd-IMP Eligibility Verification Standard $105.00 $105.00 Implementation One Time Fee Amount: $831.50 Recurring Amount: $1,116.66 If taxable, invoice will include applicable Sales Tax Order Notes. This order form ("Order Form") is entered into by Inovalon Provider, Inc. ("Inovalon") and County of Fresno ("Customer") as of the date of Customer's signature below("Effective Date"). Service Period Start Date: 11/01/2025 Inovalon Confidential and Proprietary Q-140280(10/31/2025) Page 1 of 3 Docusign Envelope ID:2BA061CD-03F5-4DBE-A45D-AOFD4560OOE1 Services. Customer will utilize the services defined below(each a"Service"and collectively the"Services"): Service Service Unit Delivery Volume Overage Name Description of Measure Method Limit* Rate Claims Management Pro accelerates Claims reimbursements and strengthens revenue Annual Claim Web UI 10,000 $2 48 Management Pro through submitting, editing, and receiving Transactions claims and remittances for Medicare, Medicaid and commercial insurances. Insurance Discovery leverages robust Annual Insurance Insurance Web Uland 1,500 Discovery algorithms to identify previously unknown, Discovery API $7.18 active patient coverage with limited patient Transactions information. Eligibility Eligibility Verification Standard unifies Annual Web UI and 10,000 Verification workflow into user-friendly dashboards to Eligibility API $0.76 Standard manage alerts and ensure timely resolution. Transactions *The Volume Limit is either, as applicable, (1)the number of Transactions Customer may submit within each term of this Order Form as included with payment of the applicable Fee; or (2) the total allowance, based on the Unit of Measure, that Customer can utilize the Service for. Any Transactions submitted or utilization of the Services in excess of the Volume Limit for a particular Service within a term will incur an additional Fee in accordance with the applicable Overage Rate, which shall be invoiced monthly in arrears. The Overage Rate for Transaction Services shall be assessed per Transaction for each Transaction submitted in excess of the Volume Limit and for Services whereby the Fee is based upon a fixed Unit of Measure, the Overage Rate shall be assessed monthly and applicable per Unit of Measure in excess.Any unused Transactions shall expire at the end of each term. Inovalon Confidential and Proprietary Q-140280(10/31/2025) Page 2 of 3 Docusign Envelope ID:2BA061CD-03F5-4DBE-A45D-AOFD4560OOE1 NOTE:ALL PAGES OF THIS DOCUMENT MUST BE SUBMITTED TOGETHER TO CONSTITUTE A COMPLETE ORDER. THIS IS A BINDING AGREEMENT SUBJECT TO THE TERMS AND CONDITIONS OF THE SERVICE AGREEMENT AND BUSINESS ASSOCIATE AGREEMENT AVAILABLE ON THE INOVALON PUBLIC WEBSITE AT HTTPS://WWW.INOVALON.COM/PROVIDER- AGREEMENTS/OR UPON REQUEST("AGREEMENTS").THE AGREEMENTS ARE INCORPORATED HEREIN AND MADE A PART OF THIS ORDER FORM. IN THE EVENT OF A CONFLICT IN TERMS BETWEEN THIS ORDER FORM AND THE AGREEMENTS, THE TERMS OF THIS ORDER FORM SHALL CONTROL; OTHERWISE, THE TERMS OF THIS ORDER FORM ARE IN ADDITION TO AND SUPPLEMENT THE TERMS OF THE AGREEMENTS. Payment is due within Net 30 days of the invoice date regardless of whether usage has begun for any or all Services listed on this Order Form. Tax Status:Taxable If exempt(Non-Taxable), a state tax exemption certificate is required with this signed Order Form. Customer hereby authorizes Inovalon to provide the Services as described above and warrants and represents that the authorized representative signing below has the requisite authority to legally bind and approve payment of forthcoming invoices. AGREED AND ACCEPTED County of Fresno Inovalon Provider, Inc. Signed by: Signed by: 6j&um E S KPI't, 73974786F8804N2 697A012506E34E9... Authorized Signature Authorized Signature Riley Blackburn Chris Riddle Printed Name Printed Name Rileyblackburn Senior Director Title Title 10/31/2025 10/31/2025 Date Date Inovalon Confidential and Proprietary Q-140280(10/31/2025) Page 3 of 3