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MB-3069 - USA (Texas) - Fully-Insured and Self-Funded Medical Third-Party Administrative Services - Deadline May 24,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3069

Government Authority located in Texas; USA based organization looking for expert vendor for fully insured and self-funded medical third-party administrative services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide fully insured and self-funded medical third-party administrative services.
- Maintain a fully automated claims adjudication system in compliance with electronic transmission standards and security requirements and all other regulations as required by HIPAA, provide WEB access to plan participants that allows for claim status and offers various customer service functions.
- Maintain records and managements reports, including claims and accounting information as required by the contract.
- Provide timely response to inquiries from plan participants and providers regarding eligibility and status of claim, correspondence, payment and any other information requested by such parties in a manner that will limit the city’s involvement in day-to-day inquiries.
- Prepare and review with the Human Resources staff the summary plan documents and enrollment materials. In addition, print summary plan documents and enrollment materials, claim forms, and any other communication material as required by the contract.
- If respondent uses ID cards, the City prefers respondent mail identification cards to the employee’s home address.
- Deliver utilization reports. The City and its consultants need to be able to access standard reports online, preferably in excel format.
- Provide online access to additional standard or ad hoc reports as needed by the city. If a specific report cannot be generated online, prepare and provide such to the city electronically.
- Meet with representatives of the city’s human resources department as often as deemed necessary by the city.
- Attend annual open enrollment meetings. The Respondent may be required to give employee’s additional information on plan types and give oral presentations about types of plans offered to city employees.
(2) Contract term 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 : Friday, 24 May, 2019

Category : Medical Billing and Coding

Country : USA

State : Texas

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