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MB-3874 - USA (North Carolina) - Group Inpatient and Outpatient Medical Scheme Services - Deadline February 21,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3874

Government Authority located in North Carolina; USA based organization looking for expert vendor for group inpatient and outpatient medical scheme services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide group inpatient and outpatient medical scheme services.
- A) Inpatient Limit - Ksh5million per family
- Age limit - Day 1 (term babies at 38 weeks) subject to notification within seven (7) days to 70 years old. Employee s aged over 60 years are required to submit comprehensive medical
reports
- Dependent children - Covered to 18 years of age and up to 25 years old subject to proof of full time learning
- Bed Entitlement net of NHIF - Standard EnSite room up to Ksh25,000 net of NHIF
- Pre‐existing and Chronic related conditions within IP- Ksh1,800,000 per family within IP limit
- Congenital & Prematurity/ Neonatal related complications - Ksh800,000 per family within IP limit
- Psychiatry and Psychotherapy related conditions - Ksh2,000,000 per family within IP limit
- Newly diagnosed chronic condition including cancer - Ksh5million per family within IP limit
- Acts of Terrorism and political violence - Ksh5million per family within IP limit
- 1st Emergency Caesarean section - Ksh350,000 per family within the IP limit
- Normal Maternity Deliveries: within Inpatient cover applies to female employees and spouses to male employees only - Ksh300,000 per family within the IP limit
- Maternity benefit will cater for: Normal Delivery, Maternity Complications, 2nd and subsequent Caesarean section Covered up to the overall Maternity benefit Maternity related complications covered up to - Ksh750,000
- Post Hospitalization Ksh50,000 per family within IP limit, up to 30 days from date of discharge
- Non-Accidental Inpatient Dental - Ksh300,000 per family within the IP limit
- Non-Accidental Inpatient Ophthalmology - Ksh300,000 per family within the IP limit
- Inpatient Dental and Optical expenses as a result of an accident Covered up to the overall limit
- Day Care Surgery under General Anaesthesia Covered up to the overall limit
(2) The 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 premises.

Expiry Date : Friday, 21 February, 2020

Category : Medical Billing and Coding

Country : USA

State : North Carolina

RFP Expired

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