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MB-3736 - USA (Texas) - Medical Cost Containment Services - Deadline January 31,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3736

Government Authority located in Texas; USA based organization looking for expert vendor for medical cost containment services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide medical cost containment services
- Victim claims by utilizing a web-based claim and billing management system –Case Management system that is referred to as the Crime Victims Management System,
- Medical and other providers of services to victims/claimants submit billing documents to CVC which are imaged and stored,
- Victims of crime may submit their application and medical bills online via the CVC Web Portal,
- The automated system provides data interchange by SSH file transfer protocol (or secure file transfer protocol) (SFTP) between the current medical cost containment vendor and the OAG system,
- There are multiple separate electronic data interchanges (EDIs) utilizing secure SFTP between OAG/CVC and the current cost containment vendor,
- Billing Data:  Receives from cost containment vendor, on a daily basis, completed billing data on cost-contained bills;
- Explanation of Benefits - Receives from the cost containment vendor, on a daily basis, an electronic copy of all the Explanation of Benefits for each day’s transmissions,
- Contractor shall have the capability to produce and shall provide daily, monthly, quarterly, annual and summary of production reports, in both hard and soft formats (as requested by the OAG), with total activity by bill type, including but not limited to the information listed below:
- Number of bills received from CVC,
- Number of bills processed and returned,
- Oldest processing date of bills,
- Total number of pre-estimates by type,
- Total number of peer reviews and IMEs conducted,
- Total number of zero pays processed,
- Amount billed by providers,
- Sum of 3rd party or insurance reductions and payments;
- Amount remaining after 3rd party or insurance reductions and payments;
- Amount recommended for payment;
- Total net savings;
- Total net percentage saved; and
- Total audit fees.
(2) All the questions must be submitted no later than January 14, 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 : Friday, 31 January, 2020

Question Answer Deadline : Tuesday, 14 January, 2020

Category : Medical Billing and Coding

Country : USA

State : Texas

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