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MB-2885 - USA (California) - Worker Compensation Medical Bill Review, Cost Containment and Check Writing Services - Deadline March 25,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-2885

Government Authority located in California; USA based organization looking for expert vendor for worker compensation medical bill review, cost containment and check writing services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide worker compensation medical bill review, cost containment and check writing services.
- Provide expert analysis of WC invoices for medical treatment including hospital, medical and legal, pharmacy, medical supplies, out-of-state bills and appropriately reducing the bills according to the prescribed rates.
- Maintain an up to date bill review system, fee schedule, PPO Network contract rates, and changes in PPO Network providers.
- Bills should be reviewed and processed within five to ten business days from the contractor’s receipt date, with the exception of provider bills sent via ebilling.
- Review and provide payment recommendation on bills and liens to guide the claims analyst in negotiating or settling any billing issues.
- Establish and maintain a bank account may wire transfer funds for the issuance of the recommended payment of reviewable medical bills, and full payment of non-reviewable WC bills for services provided to injured workers.
- Review wire transfer information from the bank to ensure that funding is available and received before issuance of payments.
- Provide an electronic method for tracking the wire transfer process, check printing, and check mailing.
- Provide with the ability to accept ebilling, in accordance with state regulatory and technical requirements, from service providers who choose to utilize ebilling.
- Provide a formulary program for PBM services that includes the ability to customize the formulary by claimant, employee classification, and drug type.
(2) All questions must be submitted no later than March 12, 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 : Monday, 25 March, 2019

Question Answer Deadline : Tuesday, 12 March, 2019

Category : Medical Billing and Coding

Country : USA

State : California

Cost to Download This RFP Document : $ 5

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