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MB-3251 - USA (New Jersey) - Self Insured Medical Plan Administrative Services - Deadline July 18,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3251

Government Authority located in New Jersey; USA based organization looking for expert vendor for self-insured medical plan administrative services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide self-insured medical plan administrative services.
- Direct receipt of claims from employees and providers
- Maintenance and access to provider network for all medical services covered
- Marketing representative that will retain overall responsibility for service to the county
- Capability to receive monthly updates of eligibility from the county and provide check lists, as required
- Monthly reports that explain the utilization of the stop-loss protection, which include, but not limited to large claims that exceed the $350,000 pooling point
- Claim turnaround time - for a clean claim, it is expected that claims will be paid within ten working day
- Availability of provider directories for employees
- Provide upon request full access to all county claims data, utilization records, case management records, and eligibility and benefit records along with any other data requirements necessary to conduct a comprehensive and thorough audit of the county benefit plan.
(2) The term of the contract 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 : Thursday, 18 July, 2019

Category : Medical Billing and Coding

Country : USA

State : New Jersey

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