Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3321

Government Authority located in Texas; USA based organization looking for expert vendor for workers compensation third party administrative services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide workers compensation third party administrative services.
¬ Proposer must be a qualified Third-Party Claims Administrator (TPA) and agrees to administer the workers' compensation program in full compliance with all laws, rules, and regulations governing the administration of self-insurance pursuant to the laws of the state.
- TPA shall provide dedicated claims handling staff to include at a minimum 2 adjusters and support staff. The support staff need not be dedicated but must be sufficient to address the Health System’s claims’ volume and customer service standards.
- TPA shall coordinate with the Health System and other related services providers on all medical cost containment issues.
- TPA agrees to collaborate with the Health System regarding language used in standard letters, filings and documents.
- TPA agrees that the Health System shall have right, title, interest and ownership of all claim data, statistics, electronic media, and claim files including attendant managed care information assembled in the handling of the account. At the sole option of the Health System and upon 15 working days’ notice the TPA shall return such material to the Health System in a form agreeable to the Health System.
- TPA shall pursue Peer Reviews judiciously, but routinely and provide a mechanism within the claim handling realm to furnish the reviewer sufficient information upon which to base their medical opinion. Any use of Peer Review Coordination Companies shall be preapproved by the Health System.
- TPA must be able to support each electronic medical billing transaction type; including the receipt of health claims and the transmission of acknowledgements and payment remittance/advice.
(2) All question must be submitted no later than August 08, 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 : Thursday, 22 August, 2019

Question Answer Deadline : Thursday, 8 August, 2019

Category : Medical Billing and Coding

Country : USA

State : Texas

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