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MB-3336 - USA (Connecticut) - RFI for Medical Bill Review, Medical Bill Payment, Auditing and Pharmacy services - Deadline August 30,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3336

Government authority located in Connecticut, USA; based organization looking for expert vendor for medical bill review, medical bill payment, auditing and pharmacy services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide medical bill review, medical bill payment, auditing and pharmacy services for medical bill review, medical bill payment, auditing services of injured worker medical bills that require discounting, providing pharmacy services, issuing payments to medical providers and hospitals on behalf of the SIF, pharmacy invoice reimbursements and injured worker reimbursements.
- auditing of bills and invoices from medical providers, hospitals and pharmacies to ensure the prevention, detection and correction of duplicate payments, non-compensable provider invoices, mathematical errors, excessive or unauthorized medical or pharmacy rates and discounting invoices
- issue checks to medical providers on behalf of the SIF utilizing an electronic check issuing
process and transmit a secure electronic positive payee file to the Fund’s bank; collect duplicate
payments made in error to medical providers or hospitals and refund the Fund; pharmacy
invoice reimbursement and injured worker reimbursements
- An efficient and effective invoice process, payment and check issuing system including a positive payee file transmission to the Fund’s bank or other such transmissions as required by the bank, capable of utilizing the Fund’s current claimant payment history, and institute improvements as required by the Fund
- Analyze, research and document, when requested by the Fund, decisions regarding payment adjustment recommendations
- Re-price bills and respond to provider and hospital inquiries
- Analyze trends in billing patterns, and demonstrate the ability to provide such analysis to Fund personnel upon request
- Ability to receive, review and pay on behalf of the Fund complete and accurate bills for covered drugs
- Identify if an injured worker is refilling prescriptions before the refill time period
- A bill review system that has processes priority bills as designated by the Fund.
(2) All questions must be submitted no later than August 6, 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 : Friday, 30 August, 2019

Question Answer Deadline : Tuesday, 6 August, 2019

Category : Medical Billing and Coding, Auditing, Finance and Accounting, Pharmaceutical, Pharmacy & Related Services

Country : USA

State : Connecticut

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