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MB-2944 - USA (Massachusetts) - Workers Compensation Utilization Review and Related Services - Deadline April 4,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-2944

Government Authority located in Massachusetts; USA based organization looking for expert vendor for workers compensation utilization review and related services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide workers compensation utilization review and related services shall confirm with the city the compensability of a new utilization review case on the date of receipt, send out an introductory letter to the employee outlining its services and utilization review guidelines, review the written request from the city or a medical provider within one (1) business day of receipt of said request by performing initial utilization review, approving or denying said request, or requesting a peer review, maintain ongoing contact with the city concerning all utilization review requests, respond to all inquiries from city, medical providers, and employees and their counsel related to utilization review and submit to the city a utilization review approval determination letter for each request for utilization review.
- Medical Bill Review and Re-Pricing shall review, evaluate and analyse submitted worker’s compensation medical bills to ensure that the lowest rate is charged for reimbursement, review each bill to ensure that all charges are valid and related to the work injury, review each bill for diagnosis and procedure code accuracy and to insure non-duplication of payment, calculate pharmacy bills three (3) ways to find the lowest payable amount as is required by law, responsible for handling all inquiries related to the billing, including but not limited to telephone calls from medical providers, employees and their counsel, maintain on-going contact with the city regarding all bills submitted for bill review and re-pricing.
(2) All question must be submitted no later than March 26, 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 : Thursday, 4 April, 2019

Question Answer Deadline : Tuesday, 26 March, 2019

Category : Medical Billing and Coding

Country : USA

State : Massachusetts

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