MB-3444 - USA (South Dakota) - Third Party Claims Administrator, Medical Case Management and Bill Review Services - Deadline October 25,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3444

Government authority located in South Dakota, USA; based organization looking for expert vendor for third party claims administrator, medical case management and bill review services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third party claims administrator, medical case management and bill review services for evaluate, pay or deny all Workers’ Compensation claims submitted by injured employees pursuant.
- Workers’ Compensation Program is responsible for investigating, and defending workers’ compensation claims
- review of the Workers’ Compensation Program for determination of compensability for respective claims
- assist the Workers’ Compensation Program with coordination of medical treatment for injured employees, and work with medical providers to develop an appropriate treatment plan and return to work. When directed by the assigned adjuster, the Medical Case Manager will attend medical appointments with the injured employee, correspond with medical providers, and obtain previous medical and vocational history and other tasks as delegated by the assigned adjuster
- provide savings, discounts, and other reductions to a workers’ compensation medical claim or billing.
- conjunction with internal investigations of the workers’ compensation cases for determination of compensability or denial of the respective claims
- employee reimbursement requests, medical bills, and medical records submitted by a provider.
- assure the State pays all appropriate medical bills in a timely manner while eliminating wasteful, excessive, inappropriate, and duplicate medical payments.
- review and flag duplicate bills
- statistical reports on at least a monthly basis describing such activities as number of bills processed, types of providers per bill, amounts billed, amounts reduced, and savings realized.
(2) A letter of intent to due on September 19, 2019.
(3) All questions must be submitted in writing no later than September 26, 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, 25 October, 2019

Question Answer Deadline : Thursday, 26 September, 2019

Category : Medical Billing and Coding

Country : USA

State : South Dakota

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