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MB-3088 - USA (Texas) - Third Party Administrative Services for Self-Funded Workers - Deadline May 24,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3088

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

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide third party administrative services for self-funded workers compensation and liability program claims.
- Claims management must focus on early recovery from injury and early return to productive employment.
- Identification of and aggressive defense against fraudulent claims.
- Claims management must coordinate with the District’s workers’ compensation staff
- Quality claims adjusting services
- Must be willing to encourage and enforce compliance with the District’s claims management standards as provided in CLAIMS HANDLING
- The option to arrange audits of claims administration services on an annual basis. The third-party administrator shall, subject to advance notice from the district, provide the auditor with full access to the District’s claim files and cooperate with the audit process.
- Medical bills must be audited for causal relationship and reasonableness of charges by the administrator or by an outside agency approved by the district.
- Within 48 hours from receipt of initial report of injuries, contact will be made with the District to confirm whether compensability is acknowledged or should be questioned.
- Claim Management System
(2) All questions must be submitted no later than May 8, 2019.
(3) Contract period will be for two years.

[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

Question Answer Deadline : Wednesday, 8 May, 2019

Category : Medical Billing and Coding

Country : USA

State : Texas

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