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MB-2883 - USA (New York) - Third Party Administrative Services for the Hospital and Major Medical Program to the Self-Funded Employee Medical Health Plan - Deadline March 29,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-2883

Government Authority located New York; USA based organization looking for expert vendor for Third Party Administrative Services for the Hospital and Major Medical Program to the Self-Funded Employee Medical Health Plan.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide Third Party Administrative Services for the Hospital and Major Medical Program to the Self-Funded Employee Medical Health Plan include Claims Administration, Network and Utilization Management, Claims Reporting, Legal Compliance to Financial Administration, Internal and External Audit Requirements and Plan Implementation and Communication.
- Administer the hospital and major medical benefits plan on an Administrative Services
- Assign a “dedicated” account executive to responsibilities related to the administration and operation of the required services
- A GeoAccess report and disruption analysis for all network healthcare providers
- case management, second surgical opinions, utilization management, hospital precertification, coordination of benefits and subrogation
- Administer a disease management/chronic condition program and be able to demonstrate short-term reporting in engaging with participants and long term return on investment. Indicate what disease management/chronic condition programs are included in your administrative fee and what programs are optional, for what fee and the return on investment guarantee offered for each optional program
- Allow telehealth services to be independently contracted and will fully integrate and coordinate their services with the independent telehealth vendor
(2) Intent to Bid will be held on March 7, 2019.
(3) All Question must be submitted no later than March 7, 2019.

[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, 29 March, 2019

Question Answer Deadline : Thursday, 28 February, 2019

Category : Medical Billing and Coding

Country : USA

State : New York

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