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9.3 .1 jNDING EXTERNAL !i~ -For disputes that have eJChausted the Pro111der
<br />BiUl,:,9 Dlspule and Medfcal Necesslty/lnvesllgational Procedure Appeal Process,
<br />Medical Group may elect blrtd lng c,cternal review to resollle lhe dlspu~d isouo(s),
<br />It certain conditions are met. In all cases if a dispute I., -subm itted to external
<br />rev.lew, .the deeislo11 of t!,e extemal reviewe r Is blhdlng and the flnel dec ision 011
<br />the d[9puted Issue. Disputes submitted to external review shall not be subrnilled
<br />to med iation . arbitration or jud icial remedy as Pf0VJded herelfl . A desortptlon Qf
<br />the eKternal review pror.ess and any p_re1equisiies 10 lnltlatfng the external relliew
<br />process Ci3.n be found In Exh ibit 0 . Disputes that do not meet the criteria to be
<br />submitted to binding external review may be s1.1bmitled to binding externa l re\l lew
<br />only upon mutual wnL!e n agreem~nt of the parties .
<br />9.3.2 MANOATOR)'. NON•WOOJING MEDIATION -For disputes that have not been or
<br />cannot be submi tted to external rev iew, lhe dlsputc.d issue(s) must be subm itted
<br />to mandatory non-bi nding medh;illon prior to seek ing bind ing arbitration .or
<br />Jud lclat reme.dy, except as otherwise provided he,ein. Mandatory non•bi nding
<br />mediation must be roquested with in shc:ty (60) days foUowlng the date of ll't e
<br />Co111f1any 's de ci sion on Med ica l Gro up•s lc1st internal proviaer appeal. Where
<br />t:,:led ical Group Is allowed to bypass the Internal provider appeal process as
<br />provided he rei n, mandatory non-binding mediation mus t be requested wllh1n sixty
<br />(60) days from the last day the Company has to Umely respor,d to a dispute or a
<br />request for a disp ute . Med ical Group and the Compa ny shaD each bear the ir
<br />own costs of med labon and shall split equally the costs of the third-party
<br />m.ed lotor.
<br />9.3.3 4,_UDICIAL ..B.s.M._~Q U B.eJ: RA~ -If. after exhausti ng the Company's
<br />Internal pro.vlder appeals process and compleling manl1alory no n-binding
<br />mediation , either party Is s.1111 dis9atislied with tt,e outcome arrd wan!S to furthe r
<br />dispute the lsS\le(s), the disputing party shall elect to resolve the disputed
<br />lssue(s) through Judicial remedy or binding a1bitration .
<br />9.3.3 .1 ..!!,!Q!g,AL REMEDY -If, after completing any pre requis \8!1 to Judl ol al
<br />re me.dy _as provided here in, the di.spu Ung. party elects to resolve the
<br />dispute through Jud lcal remedy , -the parties · agree lo comply with the
<br />terms set forti, In Sectio n 10, 7.
<br />9.3.3 .2 ~ ARBI TRATION -If, after complell.ng any prerequisites 10
<br />binding ·arbitration as provided herein, the Medical Group elects to
<br />resorve 11:i e disput e through final and bind ing artJ ltrallon 1 arb ilrat i on must
<br />be Initiated by making a written dema nd for arbltraUo.n on ,the Company .
<br />The demand for arbitration mu st identify all ,l iSues on whlc;h the Medlc:al
<br />Group seeks arbllratJon , the contractual provisions on wh ich the Medical
<br />Group relies , Ille amount In dis pute , and the rel ier requested .
<br />Asurls MGA Agreement (Rev. 0512017)
<br />The arbftradq n shall be conducted w!lhlh O11 e hundred and fifty (150 )
<br />miles or Med ical Group's principal office address where notices under
<br />lhe Agreement are sent un le&9 the pa.rt fes mutually -agree to conduct the
<br />arbitration fn a different location. The parties agree tha t the dispute .shall·
<br />be submitted to one (1) arb itrator selecetad by mutual agreement of \he
<br />parti es . If lhe part ies cannot agree on an arbitrator, tttey shall obta in a /!st
<br />of ten (1 O) possible arbitrators fr.orn a neut ral source , such as the
<br />American Arb ilratton Aa_S(lcfallon , and shall strike arbitrators from the fist
<br />In tun,, beginn ng wi lh the pa.rty who won a coi n toH, until orily ono
<br />arbitrato r, remains , Tt,e rema ining arb itrator shall hear the dJspute ,
<br />1.1nless either, party shows suoh bias as would d\s"quatlfy a judge fro l'll
<br />hearing the proceed ing, in wh ich case lhe arb itrator shall be the next to
<br />lirst name sllicke n. The part l~s shall share eq ually the fee of the
<br />artl trato(, exclud ing the filing fee , if any, Incurred In oommern:errw1nt ol
<br />1he proceed ing . The parties-shall have Iha right lo ma ke substan ti ve
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