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MB-3477 - USA (Florida) - Property and Casualty Claims Administration Services - Deadline October 22,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3477

Government Authority located in Florida; USA based organization looking for expert vendor for property and casualty claims administration services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide property and casualty claims administration services to covered by the Consortium Loss Fund: • Workers’ Compensation • Third Party Liability • Property • Crime • Educator’s Legal Liability • Network Security and Privacy Liability.
- Management of self-insurance, specific insurance and excess insurance for 27 state colleges Property and Casualty Programs. • The Consortium coordinates the marketing and purchasing and administration of all excess insurance, specific insurance, self-insurance and Third-Party Administrator requirements for both Property and Casualty insurance programs. • Recommend actions for new and renewal coverages to colleges as needed using the Consortium Operations Committee and the Risk Management Council for the approval process. • Providing coverage and claims information for participating colleges as needed. • Coordinating with the fiscal agent all Consortium accounting and human resource needs.
¬ Workers’ Compensation Required Services include administrative services, claims services, telephonic case management services, first notice of injury services, loss statistic services, network access, managed care and development services, medical bill review and audit services, pharmaceutical benefit management services
- Medical Bill Review: (a) Promptly review medical/surgical bills (in and out of network) for accuracy including, but not limited to, as they relate to the following: (i) Duplicate billings (ii) Unbundling of charges (iii) Upcoding of charges (iv) Approval and appropriate precertification (b) Review all medical bills that: (i) Are not subject to fee schedule coding (ii) Are for services not specifically addressed in the fee schedule (iii) Need an in-depth medical interpretation of the rules and regulations (iv) In the exercise of professional judgment, specifically warrant review.
(2) All questions must be submitted no later than October 1, 2019.
(3) Contract period will be for five 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 : Tuesday, 22 October, 2019

Question Answer Deadline : Tuesday, 1 October, 2019

Category : Medical Billing and Coding

Country : USA

State : Florida

Cost to Download This RFP Document : $ 5

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