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MB-2804 - Canada (British Columbia) - Extended Dental, Optical and Hearing Benefits Claims Administration Services - Deadline April 4,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-2804

Government Authority located in British Columbia; Canada based organization looking for expert vendor for extended dental, optical and hearing benefits claims administration services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

Vendor needs to provide extended dental; optical and hearing benefits claims administration services for certain health supplements for clients and for children registered in the healthy kid’s program.
- Services currently being provided include but are not limited to claims adjudication and communication of claims, claims payment, registering service providers, confirming clients’ eligibility with service providers, provision of preapprovals to service providers, managing exceptions for eyeglass replacements, contact lens requests and replacement for dentures, orthodontia eligibility, preauthorization and coverage, crown and bridge eligibility, preauthorization and coverage, payment for alternative hearing supplements, records management and program reporting.
- Reported phone call volumes were approximately 82,000 for the 2017 year from service providers.
- Claims Administrator Services are required processing claims in accordance with the benefits described in the fee schedules including coordination of benefits within the required performance standards, processing requests for preauthorization for the benefits, producing customized claim forms; and claims auditing services including the following documented program for dealing with fraudulent or suspected fraudulent claims and not making any threat or promise as to whether or not an alleged fraudulent claim will or will not be referred for criminal investigation or prosecution.

[C] Eligibility:

- Onshore (Canada Only);

[D] Work Performance:

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

Expiry Date : Thursday, 4 April, 2019

Category : Medical Billing and Coding, Uncategorized

Country : Canada

State : British Columbia

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