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MB-3617 - USA (Texas) - Pharmacy Benefit Manager Services - Deadline January 16,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3617

Government authority located in Texas, USA; based organization looking for expert vendor for pharmacy benefit manager services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide pharmacy benefit manager services for eligibility set-up and ongoing eligibility maintenance.
- Claims Adjudication including, appeals services, utilization management of clinical rules (prior authorization, quantity and day supply limits, step therapy, dispense as written, etc.), systematic prospective, concurrent, and retrospective drug utilization review and external review services
- Member Services Call Center Support. Supplier will provide 24-hours a day, 7-days a week toll-free telephone (preferred), IVR and internet support to assist HISD, HISD's agents and members with member eligibility and benefits verification, location of participating pharmacies or other related member concerns. Multilingual call center support is preferred
- Ability to provide claims Data to HISD vendor partners
- Deliver Flexible Savings Account (FSA) eligibility feeds to the applicable vendor
- Offer website services including employer admin website; member portal, mobile app for members; chat and/or texts
- ongoing member communications including implementation packages
- Data Reporting (standard and ad-hoc reporting
- Load all current prior authorizations, open mail order refills, specialty transfer files, claim history files, and accumulator files that exist for current members from the existing PBM.
- Allow the right to review, edit, or customize any communication from the PBM to our membership
- Integration of pharmacy third party claims data to support benefit accumulators as well as predictive modeling
- Allow reporting to designated data warehouse
- Prepare and execute a communications campaign to promote.
(2) A pre-proposal conference will be held on December 10, 2019.
(3) All questions must be submitted no later than January 9, 2020.

[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 : Thursday, 16 January, 2020

Pre-proposal Conference Date : Tuesday, 10 December, 2019

Question Answer Deadline : Thursday, 9 January, 2020

Category : Medical Billing and Coding, Call Center and Answering, Pharmaceutical, Pharmacy & Related Services, Web Design and Development

Country : USA

State : Texas

Cost to Download This RFP Document : $ 5

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