MB-3243 - USA (Florida) - Third Party Administrator for Insurance Claims Services - Deadline July 22,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3243

Government Authority located in Florida; USA based organization looking for expert vendor for third party administrator for insurance claims services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third party administrator for insurance claims services of claims adjusting and related third party administrator services to the city’s risk management division for its self-insured property casualty and worker’s compensation program.
- Assume the complete handling of all prior claims as well as new claims originating from the effective date of this contract, it is required that claims data and all other documentation (open and closed) associated with all claims occurring prior to October 01, 2019 be transferred into the new claims administrator’s computer information system to ensure future city loss runs will contain a complete history of all claim years, the transfer of all claims data shall be completed no later than december 31, 2019,
- Review all claims and loss reports filed by the City,
- Thoroughly investigate all claims made against the city through appropriate claim procedures as necessitated by the severity of the injury and ensures correct payment of medical and time loss claims,
- Provide cost containment services, including medical fee reductions and a preferred provider network, provide quarterly report of cost containment services,
- Attend trials, mediations and settlement conferences as necessary,
- Develop and maintain an investigative file on each claim. files are to be readily available for the city’s review and shall be well documented and up-to-date,
- Notify excess insurance carriers of claims and or occurrences at predetermined levels required by excess insurers, provide information and status of claims as requested by the excess insurance carrier,
- Develop and maintain a claims database to be used in the administration of the claims and to generate reports to the city,
- Provide detailed daily check registry in Excel format for claims paid to the required recipients,
- Have the capability of providing data necessary to prepare financial and statistical reports on losses or claims,
- Provide assistance as necessary to designated City staff for proper procedural handling of claims,
- Identify and investigate all subrogation possibilities for potential recovery, including; investigation, evaluation, and negotiations of subrogation cases,
- Conduct the required investigations deemed necessary, including scene investigations and claimant contact on all reported claims,
- Employ the services of outside professionals to assist in investigations, claims adjustments, etc. as necessary. Such services may include, but shall not be limited to surveillance, rehabilitation, claim specific medical care managers and subject matter experts,
- Prepare and assist City staff with all appropriate responses to audits and inquires of all regulatory agencies,
- Provide on-line electronic access to the City’s claims, including payments, claims notes, status and messaging capabilities.
(2) All the questions must be submitted no later than July 15, 2019.

[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 : Monday, 22 July, 2019

Question Answer Deadline : Monday, 15 July, 2019

Category : Medical Billing and Coding

Country : USA

State : Florida

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