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MB-3567 - USA (Colorado) - Workers Compensation Claims Administration Services - Deadline November 22,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3567

Government Authority located in Colorado; USA based organization looking for expert vendor for workers compensation claims administration services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide worker's compensation claims administration services.
provide all customary third-party administrator services that a self-insured worker’s compensation program would provide including, but not limited to the following:
Task 1 Claim Payment
(a) Maintain a weekly check register
(b) Provide the check register for approval prior to processing of any payment
(c) Process all approved payments
Task 2 Excess Policy Management
(a) Obtain copies of all excess insurance policies
(b) Maintain a familiarity with the excess insurance policy
(c) Establish a point of contact with excess insurer
(d) Report all claims information to the excess insurer per excess policy requirements
(e) Copy the Commission on all correspondence or notification to the excess
insurance carrier
Task 3 Department of Industrial Accidents and other Hearings
(a) Assist the Commission’s counsel in preparation for hearings and appeals at the
Department of Industrial Accidents
(b) Assist as the Commission directs regarding other forms of
litigation/representation
Task 4 Claim’s Administration
(a) Provide on-line claims access populated with information
(b) Provide written claims analysis
(c) Attend the quarterly claims management meetings
(d) Update the Commission on any and all claims
(e) Provide the Commission with hard copy and an electronic copy of each
file formatted to the Commission’s specifications
(f) Provide all Loss Run Reports & Information to the Commission as necessary
(g) Provide the Commission with access to surveillance and investigatory services
(h) Provide the Commission with Medical Case or Nurse Case Management services
(i) Establishment of Reserves (with Commission’s approval)
Task 5 Cost
(a) Provide a breakdown of all services and costs for a three-year term. State whether
costs will be guaranteed for two 1-year contract extensions
(b) State fee basis, using separate flat fees per lost time and medical claim
(c) State definition of “Allocated Loss Expenses” (“ALE”) and identify all services which fall under this category. Provide list of all expenses included in your
fee quotation and identify costs which are considered ALE
(d) Describe transition phase upon termination of the service agreement and provide the cost to service all open claims during the transition to a new provider
Task 6 Service Team and References
(a) Identify claim service team: job titles; role of each team member; resumes with professional experience; number of staffs assigned to handle the Commission’s account; office location and daily case load
(b) Provide three current references, including company or agency name, contact person and telephone number.

[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, 22 November, 2019

Category : Medical Billing and Coding

Country : USA

State : Colorado

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