Wisconsin In-Network Transportation Provider Checklist

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III.OWNERSHIPThe Software is protected by copyright laws and international copyrighttreaties, as well as other intellectual property laws and treaties. Logisticare and/or itslicensor(s) own the title, copyright and other worldwide intellectual property rights inthe Software and all copies of the Software. The Software is licensed for use and isnot sold. Provider shall not engage in any activity that infringes or misappropriates theintellectual property rights of LogistiCare or of its licensor(s).This Agreement does not grant Provider or Users any rights to trademarks orservice marks of Logisticare.IV.SUBSCRIPTION PRICE, PAYMENTThe right to use the Software is provided at no cost to Provider so long asProvider is under contract as a transportation provider to LogistiCare. If Provider’stransportation agreement with LogistiCare is terminated for any reason Provider’s right toaccess and use the Software and associated web site will also be terminated.V. REGISTRATION DATAUsers must complete a registration process to use the Software and Services andmust (i) provide accurate, current and complete information (the “Registration Data”) asprompted by Logisticare, and (ii) maintain and promptly update the Registration Data tokeep it accurate, current and complete. If Users provide any Registration Data that isinaccurate, not current or incomplete, or if Logisticare has reasonable grounds to suspectthat the date is inaccurate, not current or incomplete, Logisticare may, in its solediscretion, suspend or terminate User’s account and refuse any and all current or futureaccess to and use of the Software or Services (or any portion thereof).VI.PROVIDER ACCESS INFORMATION AND DATA(A) Provider and its Authorized Users are solely responsible for (i) maintainingthe confidentiality and security of Users’ name(s), password(s), and any other security oraccess information used by Users to access the Software and Services (collectively,“Provider Access Information”), and (ii) preventing unauthorized access to or use of theinformation, files or data that users store or use in or with the Software and Services(collectively, “Data”).(B) Provider is responsible for providing access under the terms of thisAgreement to Authorized Users who are Provider’s employees, and for ensuring thatsuch Authorized Users comply with this Agreement.(C) Provider will be responsible for all electronic communications, includingRegistration Data and other data (“Communications”) entered using the Provider AccessInformation. Logisticare assumes that any Communications it receives through use of thePage 68
Provider Access Information were sent or authorized by Users. Provider agrees toimmediately notify Logisticare if it becomes aware of any loss, theft or unauthorized useof any Provider Access Information or Data. Logisticare reserves the right to deny Usersaccess to the Software or Services (or any part thereof) if Logisticare reasonably believesthat any loss, theft or unauthorized use of Provider Access Information has occurred.Users must inform Logisticare of, and hereby grants to Logisticare permission to use,Provider Access Information to enable Logisticare to provide the Services to Users,including updating and maintaining Data, addressing errors or service interruptions, andto enhance the types of data and services Logisticare may provide in the future.VII.SUPPORT SERVICESThe Services provided by Logisticare under this Agreement may include supportservices related to the Software ("Support Services"), such as an online knowledge baseand other documentation, online tutorials, online demonstrations, online slide shows, andan online issue ticketing system. Use of Support Services, if any, is governed byLogistiCare’s policies and programs described in any user’s manual, in onlinedocumentation, and/or in other materials provided by Logisticare. Any supplementalSoftware code provided to Users as a part of Support Services will be considered part ofthe Software and subject to the terms of this Agreement.VIII.SOFTWARE AND SERVICE MODIFICATIONS AND MAINTENANCE(A) Logisticare shall have the right, in its sole discretion, to revise, update, orotherwise modify the Software or Services. Logisticare will attempt to provide priornotice of such a revision, update or other modification of the Software or Services, butdoes not guarantee that such notice will be provided. Logisticare reserves the right tomake such a revision, update or other modification to the Software or Services effectiveimmediately and without prior notice to maintain the security of the TransportationVerification System or to comply with any laws or regulations. Users continued use ofthe Software or Services will constitute Provider’s acceptance of and agreement to suchrevision, update or other modification.(B) Logisticare may, from time to time, perform maintenance upon the Softwareor Services resulting in interrupted service, delays or errors in the Software or Services.Logisticare will attempt to provide prior notice of scheduled maintenance but cannotguarantee that such notice will be provided.IX.THIRD PARTY SERVICESIn connection with Provider’s use of the Software, Users may be made aware ofservices, products, offers and promotions provided by third parties, and not byLogisticare (“Third Party Services”). If Users decide to use Third Party Services, Usersand Provider are responsible for reviewing and understanding the terms and conditionsgoverning any Third Party Services. Provider agrees that the third party, and notLogisticare, is responsible for the performance of the Third Party Services.Page 69
Page 1 and 2:
Please return all documents to:1275
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TRANSPORTATION AGREEMENT(the “Agr
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Provider may be withdrawn by LGTC,
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ii)iii)iv)scheduled B-Leg pick up t
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utilized by Provider.ii) The number
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• ADA regulations;• Client Cont
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vi)type of vehicle in which it is i
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and satisfactorily cleared a nation
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ix)a Participant, or in the presenc
Page 19 and 20: iv)Provider warrants that it has no
Page 21 and 22: a) name, date of birth and social s
Page 23 and 24: from establishing or maintaining se
Page 25 and 26: the dispute shall be referred for b
Page 27 and 28: EXHIBIT ALIQUIDATED DAMAGESThe Part
Page 29 and 30: Requirement:Provider must perform t
Page 32 and 33: To determine the payment amount LGT
Page 34 and 35: Exhibit B - Execution PageLOGISTICA
Page 36 and 37: scope of the employment or other pr
Page 38 and 39: or created or received by BUSINESS
Page 40 and 41: presenting a preponderance of the e
Page 42 and 43: EXHIBIT EMedicare Advantage Program
Page 44 and 45: information and data necessary for:
Page 46 and 47: e reviewed and approved by Health P
Page 48 and 49: Non-Emergency Medical Transportatio
Page 50 and 51: LOGISTICARE INSURANCE CREDENTIALING
Page 52 and 53: Please describe your hours of opera
Page 54 and 55: Network Development503 Oak Place, S
Page 56 and 57: AFTER HOURS CONTACTINFORMATION SHEE
Page 58 and 59: Form W-9 (Rev. 1-2003) Page 2Exampl
Page 60 and 61: Form W-9 (Rev. 1-2003) Page 4Part I
Page 62 and 63: Dear LogistiCare Transportation Pro
Page 64 and 65: Electronic Data Interchange (EDI) A
Page 66 and 67: Date: __________________________Log
Page 68 and 69: Software User AgreementWHEREAS, Log
Page 72 and 73: X. THIRD PARTY WEBSITESThe Software
Page 74 and 75: (B) The Content may not be copied,
Page 76 and 77: this Agreement, or the infringement
Page 78 and 79: LogistiCare Driver ListLegal name D
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Wisconsin In-Network Transportation Provider Checklist

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