MB-3094 - USA (Kansas) - Dental Plan Administration Services - Deadline May 28,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3094

Government Authority located in Kansas; USA based organization looking for expert vendors for Dental Plan Administration Services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide Dental Plan Administration Services for Employer offers comprehensive dental benefits under a self-funded program to its Eligible Employees and their Eligible Dependents as those terms are defined. Employer desires to utilize the services of DDKS to investigate, administer, process, and adjust the claims of its Enrollees for dental benefits.
- Coverage for any patient who has been, but no longer is, an Enrolee.
- benefits or services of injuries or condition compensable under workers compensation employers Liability laws; or benefits or services which are available from any Federal or State government agency, or similar entity.
- Benefits, services or appliances, including but not limited to prosthodontics, including crowns and bridges, started prior to the date the person became an Enrolee.
- facility or medical emergency room charges; laboratory charges; anaesthesia for restorative dentistry;
preventive control programs.
- Charges for failure to keep a scheduled visit.
- Appliances or restorations for altering vertical dimension; restoring occlusion; replacing tooth structure lost by attrition, abrasion, bruxism, erosion, a fraction or corrosion; splinting or equilibration.
- Dental care injuries or disease caused by riots or any form of civil disobedience if the Enrolee was a
participant therein; war or act of war (whether declared or undeclared) while serving in the military or an auxiliary unit attached to the military or working in an area of war whether voluntarily or as required by an employer; injuries sustained while in the act of committing a criminal act; and injuries intentionally self-inflicted.
- Temporary services and procedures, including, but not limited to, temporary prosthetic devices.
- Any dental services, procedures, or products for which no benefit is provided, in whole or in part, under the terms of this Agreement.
- Crowns and endodontic treatment in conjunction with an over denture.
- Bridges and dentures, including repairs and adjustments, unless specifically included as a Covered
- Replacement of lost or stolen dentures or charges for duplicate dentures.
- Orthodontic Services and procedures related to Orthodontic Services, such as, but not limited to, x-rays, extractions, orthodontic appliance repairs and adjustments, unless Orthodontic Services are
specifically included as a Covered Service.
- No benefits are payable for accidental bodily injuries arising out of a motor vehicle accident to the
extent such benefits are payable under any medical expense payment provision (by whatever
terminology used-including such benefits mandated by law) of any automobile policy.
- Any benefit, procedure or service, to treat, modify, correct or change an existing condition or status
caused or contributed to by prior medical or dental treatment, when prior treatment was performed in accordance with then generally accepted standards of medicine or dentistry in the local community where performed.
- Dental benefits and services which are not completed
- Benefits or services for control of harmful habits
- Diagnosis or treatment of temporomandibular joint dysfunction, unless these are specified as Covered Services
(2) All question must be submitted no later than May 16, 2019.
(3) The contract term will be for three 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 : Tuesday, 28 May, 2019

Question Answer Deadline : Thursday, 16 May, 2019

Category : Medical Billing and Coding

Country : USA

State : Kansas

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