MB-3386 - USA (Colorado) - Medical Benefits Program Services - Deadline September 16,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3386

Government Authority located in Colorado; USA based organization looking for expert vendor for medical benefits program services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide medical benefits program services.
- Accepts claims fiduciary responsibility
- Provides full-service claims adjudication, appeals processing, subrogation services, reporting, and vendor coordination, including to the following:
- Adjudicates claims with timeliness and accuracy as measured by ongoing performance report district
- Adjudicates coordination of benefits
- Provides medical necessity and coverage denial determinations, working in concert with navigator services
- Provides utilization review services, including internal appeals and coordination of external review
- Provides third-party liability recovery services in accordance with best practice
- Coordinates services and data feeds with cobra, other plan program providers, such as prescription drug, data management, stop loss, episodes of care, direct primary care, medical care management, navigation, transparency, expert 2nd opinion, telemedicine or another vendor the district may identify
- Sends data to state all claims-payer database
- Provide telephonic, web-based, chat and mobile application-based access to broad primary-care physician services.
(2) A pre-proposal conference will be held on August 22, 2019.
(3) All questions must be submitted no later than August 26, 2019.
(4) The term of the contract will be one year.

[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 : Monday, 16 September, 2019

Pre-proposal Conference Date : Thursday, 22 August, 2019

Question Answer Deadline : Monday, 26 August, 2019

Category : Medical Billing and Coding

Country : USA

State : Colorado

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