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MB-3250 - USA (Florida) - Electronic Claims Clearing House Services - Deadline July 30,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3250

Government Authority located in Florida; USA based organization looking for expert vendor for electronic claims clearing house services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide electronic claims clearing house services seeking a vendor to serve as a comprehensive tool for insurance verification, electronic claim submission, electronic remittance and claim denial, electronic resubmission and electronic billing to secondary payers, currently processes denials and claim resubmissions on an individual-claim basis, in a non-automated environment,
- Achieve a more efficient and automated billing process,
- Increase revenue through advanced demographics and insurance verification and detection capabilities,
- Facilitate more timely reimbursement through electronic and paper cross-over to secondary payers and electronic claim rejection capabilities,
- Facilitate the management of protected health information efficiently and securely,
- Manage Protected Health Information efficiently and securely,
- Provide the capability to import into the medical billing software for total claims processing management using standard and electronic files,
- Provide claim confirmations, rejections, and claim status updates in compliance with standards in
human readable formats,
- Provide real-time editing of claims on their website for any rejected claim without the requirement of a new batch process from medical billing software,
- Transmit an electronic claim to the supplemental insurance company along with the payment information from the primary payer,
- Print an electronic claim file to a paper CMS1500 Claim Form and mail the paper claim to insurance companies that are unable to accept an electronic file,
- Utilize compliant technologies and the selected vendor may be asked to provide a general
explanation (graphical or text) of the security architecture of the system with specific points relating to compliant technologies and data transmissions,
- The vendor system's mechanisms to transmit and receive medical data must be in compliance,
- The system shall have the capability of creating industry standard reports without the need for additional vendor support,
- Report generation should be straightforward and easy to use; the reporting module should provide the user with the ability to query different data relating to the key functionality, there must be a large selection of pre-designed management reports available for routine performance analysis,
- The system should be able to interface with Microsoft office suite applications and functionalities such as exporting data or reports directly into office applications,
- The system shall also include capabilities in the following areas: insurance verification, insurance coverage detection, claims management, submission of claims with attachments, electronic or paper cross-over to supplemental payer, conversion from electronic claims to paper claims, electronic remittance, electronic claim rejection, claims status review, billing record maintenance and analytical reporting.
(2) All the questions must be submitted no later than July 17, 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 : Tuesday, 30 July, 2019

Question Answer Deadline : Wednesday, 17 July, 2019

Category : Medical Billing and Coding

Country : USA

State : Florida

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