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MB-3263 - Canada (Ontario) - Third Party Disability Adjudication and Claims Management Services - Deadline July 17,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3263

Government authority located in Ontario, Canada; based organization looking for expert vendor for third party disability adjudication and claims management services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third party disability adjudication and claims management services.
- Review and adjudication of medical documentation for all eligible staff that would be off due to non-occupational illness/injury, including surgery
- Review and adjudication of medical documentation for staff members that are requesting temporary or permanent modifications to their job for non- occupational reasons
- Support purchaser to ensure medical document templates meet adjudication best practice standards and collective agreement language
- Make a recommendation for support of absence based on a best practice/evidence-based system– which would be the Ontario Disability Guidelines
- case review via telephone every 2 weeks to coincide with pay role weeks to ensure up to date coding and communication
- decision appeal process utilizing internal experts to review all appeals process reviews, looking at new never seen before medical information
- Assist in informing employees of the process for short term disability and providing medical documentation and medical limitations, return to work, participating in modified duties, process for requests for reversing pre-booked vacation to sick time, appeals process, Unemployment Insurance Phase and Long-Term disability  
- Assist with complex claim review, provide expert consultation as requested for specific complex claims, including assessing eligibility for SIEF, workplace accommodation, medical documentation review for compatibility of condition with level of disability, validating the injury is work related or compensable, and suitable modified work offers.
(2) All questions must be submitted in writing no later than July 8, 2019.

[C] Eligibility:

- Onshore (Canada Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Wednesday, 17 July, 2019

Question Answer Deadline : Monday, 8 July, 2019

Category : Medical Billing and Coding

Country : Canada

State : Ontario

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