RFP ID: MB-0025
We are British Columbia; Canada based organization looking for expert vendor (From CANADA Only) for Collection and Reporting Services. Vendor needs to provide physician billing and statistical reporting services for over 180 physicians contracted with us. Contract will be of two (2) years and can be extended further for three (3) years.
[A] Notice Type: Request for Proposal (RFP)
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Pick up physician billing and statistical data from the physician groups which are located throughout Vancouver Island. Service Provider will pick up documents from central locations in Victoria and Nanaimo or other locations as mutually agreed on a regular basis for processing.
(2) Follow up on missing billing and statistical data from physician contract groups.
(3) Entering data from service billing and encounter forms into database system. These forms will have an approximate of 13 data elements which are Physician Name, MSC-Billing Number, Date of Service, Patient Surname, Patient First Name, Date of Birth (DOB), Provincial Health Number (PHN), Fee Code, Diagnostic Code, Number of times seen/day, Referred to/by, Location Code (required for rural communities only) and Facility Code (required for specific fee codes only).
(4) Transmit Medical Services Plan (MSP) billings through Teleplan Electronic Medical Claims System
(5) Bill third party (WCB, ICBC, etc.) and follow up and collection of accounts receivables;
(6) Providing regular reporting on specified data including encounter record data, MSP billing data and third party billings, rejections and resubmission rates.
(7) Inform us of any long term third party bad debts which we then collect internally.
(8) Work with physician groups to improve billings as decided with Corporate Director, Medical Affairs or delegate, who is provided with adequate information to support appropriate revenue accruals and bad debt transactions at the end of each accounting period
(9) Service Provider will have to ensure:
a) Accurate and complete entry of data forms into the database system
b) All reasonable and appropriate efforts are taken to maximize revenues
c) All data is submitted in a timely manner to the Medical Services Plan (MSP) of British Columbia and meets Teleplan Specification for Transmission which can be found at http://www.health.gov.bc.ca/msp/infoprac/teleplanspecs/
d) Secure storage and confidential disposal of records per our appropriate policy.
e) a disaster recovery plan is in place
(10) Service Provider will maintain appropriate software and related updates to support the efficiency and effectiveness of systems and processes.
(11) Privacy and Security Requirements: Service Provider will maintain the confidentiality of the data.
(12) Quantity: Service Provider will be required to enter an estimated 269,000+ forms annually. Service Provider will commit to a reasonable volume of transaction entry daily, weekly and monthly recognizing that there will be fluctuations in workload.
[D] Eligibility:
Onshore (Canada Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within Canada.
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