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MB-3167 - USA (California) - Independent Bill Review Services - Deadline July 9,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3167

Government authority located in California; USA based organization looking for expert vendor for independent bill review services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide independent bill review services to resolve medical billing disputes referred, conduct independent bill review for cases, recruiting and verifying credentials of bill reviewers, performing conflicts of interest checks, conducting a secondary review of the applications for eligibility under guidelines, allow timely and effective referral of cases to qualified reviewers, managing the processing of reviews, drafting of reviews, and revising written determinations, ensuring the confidentiality of medical records and other data, improving access to medical care for injured workers, avoiding delays and disputes, and reducing costs to employers.
- The Contractor shall enter all case-related events and milestones into a secure case workflow tracking system.
- The case workflow tracking system will manage workflow, routing and assignment of cases throughout the lifecycle of a case.
- The case workflow tracking system will allow bulk transmission of all data and documents.
- The Contractor will have the ability to translate the e-billing data into human-readable format for easy transmission and will provide the raw data upon request.
- ensure that reviewers promptly review all pertinent medical records and other appropriate information relevant to a case.
(2) All questions must be submitted in writing no later than June 17, 2019.
(3) Contract period will be 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, 9 July, 2019

Question Answer Deadline : Monday, 17 June, 2019

Category : Medical Billing and Coding, Software, System and Application

Country : USA

State : California

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