MB-3041 - USA (Michigan) - Medical Claims Audit Services - Deadline May 20,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3041

Government authority located in Michigan, USA; based organization looking for expert vendor for medical claims audit services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide medical claims audit services for benefits claims auditors to perform a comprehensive and objective review of the claims processed by the third party administrators and the pharmacy benefit administrator to determine if the claims were adjudicated according to contractual standards, appropriate plan benefits, and industry standards for medical claims paid on behalf of those covered for all prior benefit plan years that are legally allowable to be audited and recoveries sought, comparison of amount paid to amount invoiced on claims, accuracy of in and out of network claims payment, determining primary payer and coordination of benefits, including subrogation and worker compensation, accuracy of deductible amounts and urgent care visit payments, ability to identify duplicate claims, analyze use of override codes.
(2) All questions must be submitted no later than May 13, 2019.
(3) Contract period will be one year.

[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, 20 May, 2019

Question Answer Deadline : Monday, 13 May, 2019

Category : Medical Billing and Coding

Country : USA

State : Michigan

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