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MB-3993 - USA (South Carolina) - Medicaid Billing and Nursing Documentation Services - Deadline April 9,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3993

Government authority located in South Carolina; USA based organization looking for expert vendor for medicaid billing and nursing documentation services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide medicaid billing and nursing documentation services.
A. Clinical Nursing: -
- Ensure indefinite access to all records for students past and present
- Allow scheduling of procedures and medications - creating a daily plan which can be followed by substitute nurses
- Track immunization compliance (with DHEC state released annual updates), screening information to grade level, pass/failure, referral, medical needs due to chronic illness, increase in communicability related to influenza, GI viruses, etc.
- Define the clinical documentation response based on body systems
- Show time frame of visit for billing units, (start time & end time)
- Allow for notes/comments by visit
- Provide for disposition documentation
- Provide health room usage data, student/school/district acuity reports, and to comply with mandatory reporting under the Nurse Grant of the Student Health and Fitness Act   Incorporate Individual Health Care Plans
- Encompass elaborate algorithms defining the manner of handling Medicaid ID numbers, consent, and revoked dates from data source outside of vendor's application
- Process data on all students in import including inactive students with old enrollment   Monthly import of student picture files, up to 6.2 gig
- On a daily basis, remove students from school census who leave school district/ transfer
- Utilize enrollment dates in import file to prioritize insurance records in table
- Import pre-enrolled students as active prior to enrollment start date
- Granular Import Error reports, showing both parsing and soft errors
B. Medicaid Billing: -
- Automatic export and import of 270 and 271 files
- Automatic export and import of 837 and 835 files
- Ability to void/ replace encounters
- Ability to enter encounters for all students, regardless of Medicaid eligibility status
- Monthly identify students eligible for Medicaid, from full district roster of students
- Ability to populate required billing information using other data sources (IEP system, clinical nursing notes/data, treatment notes, etc.)
- Robust reporting tools, customizable to the user.
- Reports from the 835 with check information, claims billed, paid, etc.    Identify those students who have current consent to bill Medicaid on file
- Ability to view data for time span longer than one year
- Ability to integrate with district and school calendars
- Ability to mark student attendance or absence
- Reminder/notification system at all levels (therapist/clinician, supervisor, district)
- Generate and house all forms and compliance related documents (i.e. consent)
(2) All question must be submitted no later than March 18, 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 : Thursday, 9 April, 2020

Question Answer Deadline : Wednesday, 18 March, 2020

Category : Medical Billing and Coding

Country : USA

State : South Carolina

Cost to Download This RFP Document : $ 5

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