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MB-3632 - USA (Florida) - Third Party Administration Services for the Self-Funded Workers Compensation and Liability Program - Deadline December 17,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3632

Government Authority located in Florida; USA based organization looking for expert vendor for third party administration services for the self-funded workers compensation and liability program.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third party administration services for the self-funded workers compensation and liability program.
- Third Party Administration Services includes administrative services, claims services, first notice of injury services, claims information system services, network access and development services, medical bill review and audit services, pharmaceutical benefit management services, wellness initiative services, and contagious disease management program services.
- Claims Information System services shall provide the district with the ability to access comprehensive on-line real-time electronic claim information data, including reporting capabilities, at no additional cost to the district.
- Network access and development services to assure that high quality providers, particularly in key specialties, are encouraged to participate in the network and who contractually agree to preferred appointment setting criteria, reporting and standards to best address the medical and rehabilitative needs of the district injured employees. key specialties include but are not limited to, orthopaedics, neurology, neurosurgery, occupational medicine specialties, pulmonology, infectious disease specialists, ear/nose/throat specialists, allergists, psychiatry and psychology.
- Medical Bill Review to promptly review medical/surgical bills (in and out of network) for accuracy
including, but not limited to, as they relate to the following duplicate billings, unbundling of charges, upcoding of charges, approval and appropriate precertification.
- TPA who through its medical management program has the ability to manage physician dispensed prescriptions through its proprietary provider contracts, has the ability to develop client specific formularies, implement hard stops for specific compound and other prescriptions, and a PBM who can actively manage the cost of pharmaceuticals.
(2) A pre-proposal conference will be held on December 03, 2019.
(3) All question must be submitted no later than December 03, 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 : Tuesday, 17 December, 2019

Pre-proposal Conference Date : Tuesday, 3 December, 2019

Question Answer Deadline : Tuesday, 3 December, 2019

Category : Medical Billing and Coding

Country : USA

State : Florida

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