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MB-3438 - USA (California) - Independent Bill Review Services - Deadline October 4,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3438

Government Authority located in California; USA based organization looking for expert vendor for independent bill review services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide independent bill review services to resolve medical billing disputes,
- Recruiting and verifying credentials of bill reviewers,
- Performing conflicts of interest checks,
- Disclosing financial interests of its employees,
- Accepting IBR applications via mail, fax or online submission,
- Conducting the initial review of the IBR applications,
- Conducting a secondary review of the IBR applications for eligibility under guidelines determined following the submission of documents by the payer/claims administrator,
- Notifying the parties of IBR assignments and requesting mandatory information in a timely manner,
- Ensuring that at all times it will have sufficient number of reviewers available to satisfy the review time frames set forth,
- Managing the processing of reviews, drafting of reviews, and revising written determinations,
- Ensuring the confidentiality of medical records and other data,
- All decisions transmitted must be in an accessible format for compliant web posting,
- The case workflow tracking system will work on the following browsers and versions:
- Latest versions of Chrome, Firefox, and Safari,
- Android Browser 4.0 and above,
- Mobile Safari 5.0 and above,
- The case workflow tracking system will allow staff to update cases with eligibility determinations and other information as needed,
- The case workflow tracking system will manage workflow, routing and assignment of cases throughout the lifecycle of a case,
- The case workflow tracking system must contain dates and documents that include, but are not limited to, the following: receipt of applications; assignment of cases; requests for and receipt of supporting documentation; notices to parties; changes in case status; selection of reviewers; qualifications of reviewers; final determinations.
(2) All the questions must be submitted no later than September 23, 2019.
(3) A contract term will be for 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 : Friday, 4 October, 2019

Question Answer Deadline : Monday, 23 September, 2019

Category : Medical Billing and Coding

Country : USA

State : California

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