MB-2802 - USA (Texas) - Third Party Claims Administration and Risk Management Services - Deadline March 8,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-2802

Government Authority located in Texas; USA based organization looking for expert vendor for third party claims administration and risk management services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third party claims administration and risk management services for the self-funded workers' compensation and liability programs, maintain or establish, prior to the start of the contract’s term, a local office, with a local account manager, dedicated liability and workers’ compensation supervisors, and sufficient dedicated claims staff to handle the county’s account, conduct biannual legacy WC claims review for selected claims that exceed thresholds and/or remain open beyond maximum medical improvement to aggressively pursue their eventual closure where warranted, investigate, adjust and subrogate all claims, unless otherwise directed by county, electronic capability to report claims directly into claims system, make all loss reports available to the county’s consultant in an excel format for the purpose of marketing coverage on the county’s behalf, maintain copies of all written correspondence within the claim file, whether physical or electronic, and make same available at any time upon the county’s request at no additional cost to the county, conduct internal audits to ensure contract requirements are being fulfilled every six
months and provide report of findings to county’s risk management staff, perform such functions normally contemplated to be the function of TPAs including but not limited to assuming responsibility for the management of pending, new, and reopened claims and conduct (at least quarterly) compliance reviews and medical bill audits on a randomly selected sample of the claim files with reports to county.
- All network activities should contribute to the county network objectives and focus on treatment of all county injured workers with dignity and respect, quality medical care and medical facilities convenient for use, early diagnosis and definition of the compensable injury, efficiency in the delivery of medical services, teamwork between the county, the consultant, the adjusting service, the case manager and  the NPA, early return to work opportunity for each injured worker and physical therapy services focused on increasing range of motion.
(2) A pre-proposal meeting will be held on February 15, 2019.
(3) All question must be submitted in written no later than February 22, 2019.
(3) Contract period will be three years.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location

Expiry Date : Friday, 8 March, 2019

Pre-proposal Conference Date : Friday, 15 February, 2019

Question Answer Deadline : Friday, 22 February, 2019

Category : Medical Billing and Coding

Country : USA

State : Texas

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