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MB-3232 - USA (Texas) - National Network and Local Network and Secondary Network or other Network Services - Deadline July 9,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3232

Government Authority located Texas; USA based organization looking for expert vendor for National Network and Local Network and Secondary Network or other Network Services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide National Network and Local Network and Secondary Network or other Network Services tore-insured, self-funded Health Plan of medical & pharmacy benefits that can fully integrate their services with the selected Third Party Administrator
- Health plan will be made available to all active employees
a) Reporting Capabilities - ability to report monthly on services provided by volume,
turnaround time, and accurate utilization reports by service and diagnosis.
b) Technology Deployment - the deployment of technologies which assure claims repricing
accuracy and timely turnaround; straight forward and efficient electronic
eligibility interface with the current TPA, and Nueces County is requested by the
County.
c) Resource Allocation - demonstrable investment in continuous improvement of products
and services, supported by appropriate and regular training and technical support or
infrastructure support for technologies deployed.
d) Customer Service – A dedicated point of contact who is proactive, demonstrable
reputation as provider of high quality customer service to the employees and benefits
staff regarding Network Services.
- Account Service
-  The plan implementation includes completion of all enrollment packets, enrollment
meetings, system updates
- Medical claim submission may be direct to the Network for re-pricing purposes, unless the
TPA is authorized by the selected network, or networks to provide re-pricing services; the
administrator will certify eligibility.
- Fee Administration
- Open Enrollment
(2) A contract period will be for 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 : Tuesday, 9 July, 2019

Category : Medical Billing and Coding

Country : USA

State : Texas

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