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MB-3331 - USA (New York) - Dental Plan Administrative Services - Deadline August 15,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3331

Government Authority located in New York; USA based organization looking for expert vendor for dental plan administrative services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide dental plan administrative services.
- Provide an account representative and a customer service team that is knowledgeable about all aspects of the dental program and is accessible by phone during regular working hours to address employee and inquiries regarding the dental plan,
- Administer the dental program per the plan document to be provided,
- Provide a dental network of participating providers to limit the participants out of pocket expenses,
- Accept provider bills filed within one year from the date of provision of dental services,
- Smoothly transfer dental claims processing from current third-party administrator to selected vendor,
- Perform all claims processing functions including verification of enrolment, determination of benefit coverage, and application of appropriate provider reimbursement, creation and mailing of explanation of benefits, timely payment, and storage of claims information for easy viewing access by customer representatives,
- Pay dental claims weekly,
- Provide timely management and claim detail monthly reports which minimally include the following information: enrolment and tier statistics; claim dollars and number of claims billed and paid grouped by type of provider service,
- Provide a toll-free number that is available at least ten hours per day to enrolees who want to speak with a thoroughly knowledgeable customer service representative (not a recording) regarding specific details of the dental program, claims, or identification of network providers,
- Provide a toll-free number, web site, or other sources of information regarding the selected vendor’s services that will be available 24 hours a day/seven days a week,
- Provide excellent support services that help enrolees understand and use their dental benefits and resolve issues promptly,
- Offer well-defined complaint and appeal procedures to enrolees who are dissatisfied with a claim denial or have a complaint of any kind concerning the dental program.
(2) All the questions must be submitted no later than August 8, 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, 15 August, 2019

Question Answer Deadline : Thursday, 8 August, 2019

Category : Medical Billing and Coding

Country : USA

State : New York

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