MB-3313 - USA (Minnesota) - Worker Compensation Program Services - Deadline August 14,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3313

Government Authority located in Minnesota; USA based organization looking for expert vendor for worker compensation program services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide administering the self-insured workers’ compensation program and working collaboratively in delivering TPA services.
• Reducing the program’s benefit expenses and other claim related costs so they are more commensurate with expected norms.
• Securing claim handling services that consistently adhere to industry best practices and the program standards established by the agency.
• Engagement with a service team accustomed to working on a collaborative basis with the client’s program management team.
• Accessing a risk management information system (RMIS) capable of producing desired loss analytic reports and benchmarking data.
• Engagement with a service team that has immediate access to another medical and claim expertise to explore alternative solutions or research options for guidance in making decisions to advance claim resolution.
- Claim administration
a. Claim investigation
b. Communication with claimant, medical provider and agency
c. Medical and disability management services
d. File documentation protocols
e. Development and implementation of claim action plans
f. Denial of liability or payment of claims
g. Settlement negotiation with proper authority granted
h. Medical cost containment measures
i. Indemnity cost containment measures
j. Litigation cost containment measures
k. Procedures for determining appropriate use and selection of outside service vendors
l. Subrogation and recovery protocols
m. Internal quality control protocols
n. Integration or customization of client service directives within service procedures
o. Medical billing review services
p. Quarterly claim reviews
- Regulatory Reporting Services
a. Minnesota department of commerce reports
b. Minnesota department of labor and industry reports
c. Workers compensation reinsurance association (WCRA)
d. Minnesota workers compensation reinsurance association (MWCIA)
e. Centres for Medicaid and Medicare services (CMS)
f. Any other regulatory reporting as required
- Financial Accounting for Claim Funds
a. Types of claim account required
b. Funding requirements and notifications based on thresholds
c. Reconciliation reports
- RMIS System with data reporting and benchmarking tools
a. Online access for human resources to follow claims administration
b. Report writing capabilities
c. Loss reports
- Data Conversion and Data Practices
a. Conversion process to handle legacy claims
b. Maintain data to comply with Minnesota government data practices act
c. Provide data in electronic format to agency upon termination of vendor relationship
(2) All questions must be submitted no later than July 31, 2019.
(3) Contract term 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 : Wednesday, 14 August, 2019

Question Answer Deadline : Wednesday, 31 July, 2019

Category : Medical Billing and Coding

Country : USA

State : Minnesota

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