MB-3689 - USA (Texas) - Medical Claims Clearinghouse Services - Deadline January 20,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3689

Government Authority located Texas; USA based organization looking for expert vendor for Medical Claims Clearinghouse Services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide Medical Claims Clearinghouse Services to securely and electronically transmit medical claims for state hospitals to insurance payers and to electronically verify patient insurance coverage and eligibility. Electronic transmission of claims to insurance payers will improve the revenue cycle by providing a centralized method for claims submission and eliminating the need to generate claims manually. Claims data will be sent to the clearinghouse using data from the Avatar (NetSmart) system.
- Electronic eligibility/verification of patient insurance coverage (i.e., verifying the patient is eligible with his/her insurance company on the date of service); and creating electronic claim(s) that could then be reviewed and filtered against any/all established claim edits to identify any claim errors and provide a means to correct the electronic claim prior to submission to insurance payer.
1. Project Management
2. Payer Client List
3. Coding Systems
4. Eligibility Verification
5. Claims Submission
6. Claims Editing
7. Claims Rejected in Claim Editing
8. Claim Submission to Payer
9. Claim Correction and Resubmission
10. Appeals
11. Customer Service Support
12. Web Based Resources
13. Reporting Functions
14. Website Access
(2) All Questions must be submitted no later than December 28, 2019.
(3) A contract period will be for one year.

[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 : Monday, 20 January, 2020

Question Answer Deadline : Saturday, 28 December, 2019

Category : Medical Billing and Coding

Country : USA

State : Texas

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