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MB-4017 - USA (California) - Workers Compensation Utilization and Peer Review Services - Deadline April 13,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4017

Government Authority located in California; USA based organization looking for expert vendor for workers compensation utilization and peer review services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide workers compensation utilization and peer review services to ensure any and all request for medical treatment, medications, medical diagnostic testing or surgery from providers are appropriate and follow medical based guidelines as well as all legal and statutory requirements.
- Metro maintains an in-house occupational nurse who will be reviewing requests for treatment. contractor must provide metro’s nurse case manager access to a physician for inquiries, provide metro access to an online document repository containing all PR/UR documentation such as file notes or any other claim related data, encrypt all electronic communications containing personally identifiable information, mail all required documents and letters when a medical determination is being made to all parties, maintain open communications with metro’s nurse case manager and/- or staff at all times, submit the appropriate utilization review plan to the state for approval, provide/manage and respond to all regulatory or compliance audits of UR/peer review of behalf of metro, have representatives available to appear or respond to any workers’ compensation proceedings including, but not limited to audit issues relating to utilization review reports or timeliness.
(2) All question must be submitted no later than April 3, 2020.

[C] Eligibility:

- Onshore (USA Organization Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location

[E] Proposal Submission:

Response should be submitted physically (courier or post).

Expiry Date : Monday, 13 April, 2020

Question Answer Deadline : Friday, 3 April, 2020

Category : Medical Billing and Coding

Country : USA

State : California

Cost to Download This RFP Document : $ 5

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