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MB-3630 - USA (Virginia) - Health, HSA, Pharmacy and Dental Coverage Services - Deadline January 17,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3630

Government Authority located in Virginia; USA based organization looking for expert vendor for health, HSA, pharmacy and dental coverage services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide health, HSA, pharmacy and dental coverage services for the employees, eligible dependents and pre- 65 retirees,
- Maintaining central claims and membership files for each covered member (including the identification number or other identifying number, dates of coverage, type of coverage, etc.) for each covered member,
- Maintaining payment records,
- Provide state-of-the-art data tracking and claims payment services,
- Furnish monthly accounting statements by entity and benefit plan including monthly enrolment, premiums, revenues received, number of claims paid, capitation expenses charged, detailed list of expenses charged, network discounts earned, prescription drug rebates, and claims exceeding the specific stop-loss limit,
- Provide claims, enrolment, and utilization information for hospital, physician, and prescription drug expenses at a level of detail that will allow for the identification of the true cost drivers of the plan,
- Provide responsive and effective customer service for members related to billing, eligibility, and
claims issues,
- Furnish to each employee enrolled in the plan a benefit booklet outlining and defining all covered services, limitations and exclusions for each plan offered, procedures for receiving services, schedule of benefits, and summary of benefits covered,
- Maintain a local or toll-free customer service number for employees,
- Provide a systematic procedure for appeal of claims.
(2) All the questions must be submitted no later than December 16, 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, 17 January, 2020

Question Answer Deadline : Monday, 16 December, 2019

Category : Medical Billing and Coding

Country : USA

State : Virginia

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