MB-3850 - USA (Colorado) - Workers’ Compensation Third Party Administrator Service - Deadline February 27,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3850

Government Authority located in Colorado; USA based organization looking for expert vendor for workers’ compensation third party administrator service.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide workers’ compensation third party administrator service will perform a full range of workers’ compensation, general liability and auto liability program services related to claims management, analysis and reporting.
- Review and process auto liability claims
- Review and process general liability claims
- Provide twenty-four-hour (24hr) telephone contact to City employees when first report of injury notice is given to TPA
- Obtain medical reports and pay medical bills required by statute; monitor treatment to ensure it is reasonable, necessary and appropriate
- Admit or deny claims, with prior approval from the City, in accordance with statutory guidelines based on investigation and analyses of medical information
- Aid in communication/coordination with the City’s safety manager as necessary, including providing claims data needed to target safety, prevention and loss reduction initiatives
- Pay disability benefits on admitted cases in a timely manner; obtain medical verification on continuing disability before payment
- Outline claim strategy regarding defense and further claim handling in accordance with City settlement authorization
- Refer claims to authorized counsel when necessary and approved by the City; assist the City with defense of litigated cases when requested
- When requested, provide copies of all written correspondence to medical care providers, claimants, attorneys, rehabilitation counselors, investigator, State agencies and the City as their interest may require
- Provide Medicare set asides (MSA)
- Monthly performance/experience reporting to include trend analysis
- Provide quarterly staffing on all open claims, or as needed
- Assist with development of long-range goals, objectives and strategies including recommending innovative ideas and new products, proven programs and services to ensure a cost-effective workers’ compensation program
- Provide comprehensive range of services, including fee scheduling, pharmacy management, special network, diagnostic referrals, durable medical equipment, investigation, set asides and bill payment
- Provide full transparency of all fees with specific details for services provided including: Monthly and annual fees, Per-claim fees, Special project fees, File conversion fee, in any, All other fees, Specifically itemize fees in the proposal and then provide one total price in the proposal form
(2) All the questions must be submitted no later than February 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 premises.

Expiry Date : Thursday, 27 February, 2020

Question Answer Deadline : Friday, 14 February, 2020

Category : Medical Billing and Coding

Country : USA

State : Colorado

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