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MB-3360 - USA (Texas) - Medical Coding Services - Deadline September 4,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3360

Government Authority located in Texas; USA based organization looking for expert vendor for medical coding services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide medical coding services.
• Respondent will describe their project management and implementation methodology and how they would apply it to agency.
• Respondent will cooperate with agency in establishing necessary system access according to agency policies and procedures.
• Respondent will review medical record to appropriately assign ICD-10-CM, ICD-10-PCS and CPT® codes, using the Computer Assisted Coding (CAC) and EPIC abstracting software.
• Respondent will monitor work queues (WQs) that hold pending and combined accounts and prioritize and complete these accounts in a timely and accurate manner in accordance with agency’s instructions.
• Respondent will provide coding services that includes adding appropriate modifiers and resolving front end edits and abstracting based on agency procedure.
• Respondent will be responsible for providing all necessary office supplies, equipment, etc.
• Respondent will provide monthly executive summaries. A sample of the executive summary and any other reports offered must be included.
• Respondent will maintain an overall and DRG accuracy rate of at least 95% for IP coding and 95% overall for OP coding.  The quality of codes shall be measured according to the quality assurance standards and procedures established by agency and communicated to vendor.
• Respondent will provide a detailed second level and two tier audit review process to confirm accuracy rates. A detailed breakdown of the audit review process must be included.
• Respondent will provide process improvement plans and follow up results if there are areas of concern found related to accuracy rates, process efficiency, performance, etc. A sample report must be included.
• Respondent will provide a detailed description of their quality assurance program, including percentage of charts audited, percentage of individual coder charts audited, frequency of audits and possible corrective actions taken.
• Respondent will provide a description of concurrent and retroactive Quality Assurance procedures and performance targets.
• Respondent will describe their internal escalation process to resolve issues and concerns.
• Respondent will provide information on productivity and quality standards enforced for their staff.
• Regular work days are Monday through Friday. Work hours will be determined and agreed upon mutually.
• Given advance notification, coders must be available for occasional weekends and holidays with no overtime charge.
• Respondent will provide information on unit and department goals.
• Respondent will provide their approach to continuing education and training.
• Respondent will provide monthly itemized invoices to agency.
• In the case of financial harm to agency caused by vendor’s coding errors that result in disallowance of payment, recoupment of prior payment, denial of claim, reduced future reimbursement or other adverse financial consequence, respondent will refund agency the fees paid to code such accounts.
(2) All questions must be submitted no later than August 19, 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, 4 September, 2019

Question Answer Deadline : Monday, 19 August, 2019

Category : Medical Billing and Coding

Country : USA

State : Texas

Cost to Download This RFP Document : $ 5

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