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MB-3511 - USA (California) - Medical Claims Clearinghouse Services - Deadline November 1,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3511

Government Authority located in California; USA based organization looking for expert vendor for medical claims clearinghouse services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide medical claims clearinghouse services that has advanced revenue cycle management with features over and above processing medical claims that will enhance existing procedures and processes
- a feature rich, comprehensive service type that will help improve the efficiency of insurance claim processing,
- Services shall include, but not be limited to, the following service types:
- Electronic Remittances Advice: Automatically updates Payments and Adjustments,
- Claim Status Reports: Know the status of our claims at all times,
- Rejection Analysis: Explanation of the error codes,
- Direct Data Entry: Edit and correct claims online,
- Printed Claims: Automatically drop claims to paper when appropriate,
- Secondary Claims Processing: Electronic Submission,
- Real-Time Support: System support and personal training by an experienced consultant,
- Transaction Summary: All the Clearinghouse activities,
- Eligibility verification: beneficiary and subscriber verification, eligibility and benefits, coverage type, deductible data, service specific coverage information
- Patient statement services: cycle billing, clear and concise statements, notes on the patient statements, mailing and address forwarding, holds on statements,
- The proposed solution shall be able to review, and filter claims against established edits to identify any errors, as well as provide a means to correct the claim before the claim is submitted to the insurance company,
- To reduce the number of rejected and denied claims and claims returned for additional information, thereby reducing the days in accounts receivable outstanding and improving cash flow.
(2) A pre-proposal conference will be held on October 16, 2019.
(3) All the questions must be submitted no later than October 23, 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, 1 November, 2019

Pre-proposal Conference Date : Wednesday, 16 October, 2019

Question Answer Deadline : Wednesday, 23 October, 2019

Category : Medical Billing and Coding

Country : USA

State : California

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